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FDG-PET/MRI coregistration improves detection of cortical dysplasia in patients with epilepsy.


ABSTRACT:

Objective

Patients with cortical dysplasia (CD) are difficult to treat because the MRI abnormality may be undetectable. This study determined whether fluorodeoxyglucose (FDG)-PET/MRI coregistration enhanced the recognition of CD in epilepsy surgery patients.

Methods

Patients from 2004-2007 in whom FDG-PET/MRI coregistration was a component of the presurgical evaluation were compared with patients from 2000-2003 without this technique. For the 2004-2007 cohort, neuroimaging and clinical variables were compared between patients with mild Palmini type I and severe Palmini type II CD.

Results

Compared with the 2000-2003 cohort, from 2004-2007 more CD patients were detected, most had type I CD, and fewer cases required intracranial electrodes. From 2004-2007, 85% of type I CD cases had normal non-University of California, Los Angeles (UCLA) MRI scans. UCLA MRI identified CD in 78% of patients, and 37% of type I CD cases had normal UCLA scans. EEG and neuroimaging findings were concordant in 52% of type I CD patients, compared with 89% of type II CD patients. FDG-PET scans were positive in 71% of CD cases, and type I CD patients had less hypometabolism compared with type II CD patients. Postoperative seizure freedom occurred in 82% of patients, without differences between type I and type II CD cases.

Conclusions

Incorporating fluorodeoxyglucose-PET/MRI coregistration into the multimodality presurgical evaluation enhanced the noninvasive identification and successful surgical treatment of patients with cortical dysplasia (CD), especially for the 33% of patients with nonconcordant findings and those with normal MRI scans from mild type I CD.

SUBMITTER: Salamon N 

PROVIDER: S-EPMC2676967 | biostudies-literature | 2008 Nov

REPOSITORIES: biostudies-literature

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Publications

FDG-PET/MRI coregistration improves detection of cortical dysplasia in patients with epilepsy.

Salamon N N   Kung J J   Shaw S J SJ   Koo J J   Koh S S   Wu J Y JY   Lerner J T JT   Sankar R R   Shields W D WD   Engel J J   Fried I I   Miyata H H   Yong W H WH   Vinters H V HV   Mathern G W GW  

Neurology 20081101 20


<h4>Objective</h4>Patients with cortical dysplasia (CD) are difficult to treat because the MRI abnormality may be undetectable. This study determined whether fluorodeoxyglucose (FDG)-PET/MRI coregistration enhanced the recognition of CD in epilepsy surgery patients.<h4>Methods</h4>Patients from 2004-2007 in whom FDG-PET/MRI coregistration was a component of the presurgical evaluation were compared with patients from 2000-2003 without this technique. For the 2004-2007 cohort, neuroimaging and cli  ...[more]

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2018-03-10 | GSE96067 | GEO