TY - JOUR T1 - Evaluation of Focal Cortical Dysplasia and Mixed Neuronal and Glial Tumors in Pediatric Epilepsy Patients Using <sup>18</sup>F-FDG and <sup>11</sup>C-Methionine PET JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 728 LP - 734 DO - 10.2967/jnumed.109.070920 VL - 51 IS - 5 AU - Ji Hoon Phi AU - Jin Chul Paeng AU - Hyo Sang Lee AU - Kyu-Chang Wang AU - Byung-Kyu Cho AU - Ji-Yeoun Lee AU - Sung-Hye Park AU - Joongyub Lee AU - Dong Soo Lee AU - Seung-Ki Kim Y1 - 2010/05/01 UR - http://jnm.snmjournals.org/content/51/5/728.abstract N2 - Focal cortical dysplasia (FCD) and mixed neuronal and glial tumors share many clinical characteristics; therefore, the presurgical differential diagnosis of these diseases using MRI is difficult in some cases. The aim of this study was to determine whether 11C-methionine PET, compared with 18F-FDG PET, was useful for the evaluation of these diseases. Methods: The clinical and imaging data of 30 pediatric lesional epilepsy patients pathologically diagnosed with FCD, dysembryoplastic neuroepithelial tumor (DNT), or ganglioglioma were reviewed. Eleven patients had FCD, 8 patients had a DNT, and 11 patients had a ganglioglioma. 18F-FDG and 11C-methinine PET scans were obtained from 25 patients and 15 patients, respectively. Visual grading analysis and quantitative assessment of 18F-FDG and 11C-methionine PET, represented as a lesion–to–gray matter ratio (LGR), were performed. Results: In the visual grading analysis, both 18F-FDG PET and 11C-methionine PET detected a significant difference among the 3 disease groups (P = 0.033 and P = 0.016, respectively), but discrimination of FCD from mixed neuronal and glial tumors was possible only with 11C-methionine PET. The mean LGR of 18F-FDG PET was 0.502 ± 0.119 for FCD, 0.631 ± 0.107 for DNTs, and 0.620 ± 0.196 for gangliogliomas; there was no significant difference in LGR among the groups (P = 0.111). However, the mean LGR of 11C-methionine PET was 1.078 ± 0.182 for FCD, 1.564 ± 0.368 for DNT, and 2.114 ± 0.723 for gangliogliomas; there was a significant difference in LGR among the groups (P = 0.014). Post hoc analysis revealed that the LGR of FCD was significantly different from that of DNTs and gangliogliomas. The mean LGR value of DNTs fell between those of FCD and gangliogliomas. Conclusion: Although 18F-FDG plays a major role in the preoperative work-up of epilepsy surgery patients, it appears from this study that 18F-FDG does not contribute to the differential diagnosis and that another tracer such as 11C-methinine is required. 11C-methinine PET results correlated well with the pathologic spectrum in pediatric lesional epilepsy patients. ER -