RT Journal Article SR Electronic T1 The Preliminary Clinical application of brain 18F-FDG PET/CT-MRI coregistration in schizencephaly with intractable epilepsy JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 1669 OP 1669 VO 59 IS supplement 1 A1 Yongjin Tang A1 Yong Cheng A1 Jingjie Shang A1 Bin Guo A1 Jian Gong A1 Xueying Ling A1 Lu WANG A1 Hao Xu YR 2018 UL http://jnm.snmjournals.org/content/59/supplement_1/1669.abstract AB 1669Background: Schizencephaly is a developmental anomaly of the brain that is sometimes associated with intractable seizures. Patients that suffer from medically refractory seizures may be considered for surgical treatment. The aim of this study was to analyze the image features of brain 18F-FDG PET/CT and PET/MRI, and assess the application value of PET/CT-MRI coregistration in schizencephaly with intractable epilepsy. Methods: From December 2013 to September 2017, 1325 cases of epilepsy were examined by brain 18F-FDG PET/CT and PET/MRI. Among them, 10 patients had schizencephaly with refractory epilepsy, of whom 5 were males and 5 females, and the age was 2-31 years old. They underwent video-EEG monitoring, brain18F-FDG PET/CT scans, and 3D Bravo T1-weighted, CUBE T2-FLAIR MRI scan using the PET/CT-MRI system (GE, USA), and analyzed the image features of PET/CT and PET/MR. Anterior temporal lobectomy was performed distant from the schizencephalic cleft in a patient. Results: Of the 10 patients, MRI showed a total of 14 schizencephalic clefts, which were unilateral, 8 in the right hemisphere and 6 in the left hemisphere. According to the width of cleft, it can be divided into opened lip cleft type and closed lip cleft type. In 10 cases of unilateral cleft malformation, there were 3 cases with 4 opened lip cleft and 7 cases with 10 closed lip clefts. The imaging findings of the schizencephalic cleft were divided into 3 degrees, 4 cases of I degree, 3 cases of second degree and 3 cases of degree III. In 10 patients with 14 clefts, involving the frontal lobe in 7 cases with 9 clefts, involving the temporal lobe in 4 cases with 5 clefts, while 4 cases involving the frontal and parietal lobe were 4, and fracture extent more than three lobes in 3 cases with 3 clefts. Of the 10 patients, 3 were accompanied by gray matter heterotopia tubers, 1 accompanied by cerebellar gyrus and 2 with hyaline septum. All 10 patients with focal seizure activity showed one or more lesions in the epileptic lobe on Video-EEG. Compared with the contralateral brain region, in this group, 5 clefts were normal levels of metabolism in 4 cases, and 9 clefts with total or partial hypometabolism in 6 cases. Of the 10 patients, only 2 of them were only reduced in cleft metabolism, and the other 8 patients had different levels of metabolic reduction in the other brain regions except the clefts. Of the 4 patients with normal metabolic clefts, 3 were accompanied by metabolic reduction in other brain regions (1 case was on the same side lobe, 2 cases in the contralateral brain regions). Video-EEG is also an abnormal discharge in the region. Conclusions: > PET/MRI can not only show epileptogenic foci in schizencephalic clefts, but also find epileptic foci in other brain regions, which provide important evidence for preoperative evaluation of epilepsy. keywords: PET/MRI , PET/CT, intractable epilepsy, schizencephaly