[18F]FDG PET/MRI and magnetoencephalography may improve presurgical localization of temporal lobe epilepsy

医学 脑磁图 一致性 神经组阅片室 放射科 磁共振成像 统计参数映射 颞叶 正电子发射断层摄影术 神经外科 核医学 癫痫 神经学 脑电图 内科学 精神科
作者
Kun Guo,Jingjuan Wang,Bixiao Cui,Yihe Wang,Yaqin Hou,Guoguang Zhao,Jie Lu
出处
期刊:European Radiology [Springer Nature]
卷期号:32 (5): 3024-3034 被引量:12
标识
DOI:10.1007/s00330-021-08336-4
摘要

To evaluate the clinical value of the combination of [18F]FDG PET/MRI and magnetoencephalography (MEG) ([18F]FDG PET/MRI/MEG) in localizing the epileptogenic zone (EZ) in temporal lobe epilepsy (TLE) patients. Seventy-three patients with localization-related TLE who underwent [18F]FDG PET/MRI and MEG were enrolled retrospectively. PET/MRI images were interpreted by two radiologists; the focal hypometabolism on PET was identified using statistical parametric mapping (SPM). MEG spike sources were co-registered onto T1-weighted sequence and analyzed by Neuromag software. The clinical value of [18F]FDG PET/MRI, MEG, and PET/MRI/MEG in locating the EZ was assessed using cortical resection and surgical outcomes as criteria. The correlations between surgical outcomes and modalities concordant or non-concordant with cortical resection were analyzed. For 46.6% (34/73) of patients, MRI showed definitely structural abnormality concordant with surgical resection. SPM results of [18F]FDG PET showed focal temporal lobe hypometabolism concordant with surgical resection in 67.1% (49/73) of patients, while the concordant cases increased to 82.2% (60/73) patients with simultaneous MRI co-registration. MEG was concordant with surgical resection in 71.2% (52/73) of patients. The lobar localization was defined in 94.5% (69/73) of patients by the [18F]FDG PET/MRI/MEG. The results of PET/MRI/MEG concordance with surgical resection were significantly higher than that of PET/MRI or MEG (χ2 = 13.948, p < 0.001; χ2 = 5.393, p = 0.020). The results of PET/MRI/MEG cortical resection concordance with surgical outcome were shown to be better than PET/MRI or MEG (χ2 = 6.695, p = 0.012; χ2 = 16.991, p < 0.0001). Presurgical evaluation by [18F]FDG PET/MRI/MEG could improve the identification of the EZ in TLE and may further guide surgical decision-making. • Lobar localization was defined in 94.5% of patients by the [18F]FDG PET/MRI/MEG. • The results of PET/MRI/MEG concordance with surgical resection were significantly higher than that of PET/MRI or MEG alone. • The results of PET/MRI/MEG cortical resection concordance with surgical outcome were shown to be better than that of PET/MRI or MEG alone.
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