@article {Theodore1375, author = {William H. Theodore and Ashley R. Martinez and Omar I. Khan and Clarissa J. Liew and Sungyoung Auh and Irene M. Dustin and John Heiss and Susumu Sato}, title = {PET of Serotonin 1A Receptors and Cerebral Glucose Metabolism for Temporal Lobectomy}, volume = {53}, number = {9}, pages = {1375--1382}, year = {2012}, doi = {10.2967/jnumed.112.103093}, publisher = {Society of Nuclear Medicine}, abstract = {The objective of this study was to compare 5-hydroxytryptamine receptor 1A (5-HT1A) PET with cerebral metabolic rate of glucose (CMRglc) PET for temporal lobectomy planning. Methods: We estimated 5-HT1A receptor binding preoperatively with 18F-trans-4-fluoro-N-2-[4-(2-methoxyphenyl) piperazin-1-yl]ethyl-N-(2-pyridyl) cyclohexane carboxamide (18F-FCWAY) PET and CMRglc measurement with 18F-FDG in regions drawn on coregistered MRI after partial-volume correction in 41 patients who had anterior temporal lobectomy with at least a 1-y follow-up. Surgery was tailored to individual preresection evaluations and intraoperative electrocorticography. Mean regional asymmetry values and the number of regions with asymmetry exceeding 2 SDs in 16 healthy volunteers were compared between seizure-free and non{\textendash}seizure-free patients. 18F-FCWAY but not 18F-FDG and MRI data were masked for surgical decisions and outcome assessment. Results: Twenty-six of 41 (63\%) patients seizure-free since surgery had significantly different mesial temporal asymmetries, compared with 15 non{\textendash}seizure-free patients for both 18F-FCWAY (F1,39 = 5.87; P = 0.02) and 18F-FDG PET (F1,38 = 5.79; P = 0.021). The probability of being seizure-free was explained by both 18F-FDG and 18F-FCWAY PET, but not MRI, with a significant additional 18F-FCWAY effect (χ22 = 9.8796; P = 0.0072) after the probability of being seizure-free was explained by 18F-FDG. Although MRI alone was not predictive, any combination of 2 lateralizing imaging studies was highly predictive of seizure freedom. Conclusion: Our study provides class III evidence that both 5-HT1A receptor PET and CMRglc PET can contribute to temporal lobectomy planning. Additional studies should explore the potential for temporal lobectomy based on interictal electroencephalography and minimally invasive imaging studies.}, issn = {0161-5505}, URL = {https://jnm.snmjournals.org/content/53/9/1375}, eprint = {https://jnm.snmjournals.org/content/53/9/1375.full.pdf}, journal = {Journal of Nuclear Medicine} }