RT Journal Article
SR Electronic
T1 Correlation of Quantitative Analysis and Focal Hypometabolism on FDG PET Scan to Cortical Resection of Seizure Focus in Refractory Epilepsy
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1674
OP 1674
VO 59
IS supplement 1
A1 Joseph, Usha
A1 Dawood, Lydia
A1 Wan, David
A1 Gayed, Isis
YR 2018
UL http://jnm.snmjournals.org/content/59/supplement_1/1674.abstract
AB 1674Purpose: Fluorine-18 flurodeoxy glucose positron emission tomography/computed tomography (FDG PET/CT) is one of the imaging modalities used to localize epileptic foci in the brain non-invasively by showing areas of glucose hypometabolism in the interictal phase. Objectives: Our study aims to determine correlation of quantitative regional and voxel brain analysis of focal glucose hypometabolism on FDG PET brain images using MIM Neurologic software with the cortical resection site and patient outcomes. Methods: The medical charts were retrospectively reviewed for 98 patients who underwent PET/CT imaging for refractory seizures at our hospital from January 2014 to Nov 2016. Data collected included patients’ demographics, medical history, relevant physical findings and relevant imaging studies (including brain FDG PET/CT, brain MRI and CT scans, routine EEG , 24 hour continuous video electroencephalography monitoring (VEM), stereo electro corticography (SEEG), cortical resection site, pathologic findings and relevant surgical and medical treatment history. Abnormalities seen on PET images were compared to brain MRI image, EEG and other relevant brain imaging studies Quantitative analysis of areas of glucose hypometabolism seen on FDG PET scan was correlated with the site of cortical resection of the epileptogenic focus and with intracranial cortical electroencephalography recording for accuracy of seizure site localization. Results: 98 patients (50 females, 48 males) underwent PET/CT for seizures refractory to medical treatment and were retrospectively included in this study with average age 29.3 years. Out of 98 patients, 66 PET/CT scans (67.35%) were found to correlate with the SEEG and the site of seizure focus resection. The hypometabolic area quantitative analysis correctly identified the seizure focus region in these patients. In 9 cases PET/CT was found to be more accurate than the routine and 24h EEG, as evidenced by its correlation with intracranial EEG recordings and surgical pathologic findings of the epileptic focus which are considered the most accurate modalities. Conclusions: Quantitative analysis enhances the reliability of visual interpretation of FDG PET scan with better correlation with cortical electrography and surgical resection outcomes.