Nuclear Medicine Imaging in Epilepsy

被引:1
作者
Sriwastwa, Aakanksha [1 ]
Trout, Andrew Timothy [1 ,2 ]
Mahoney, Bruce Wayne [1 ]
Wang, Lily L. [1 ]
Scheler, Jennifer L. [1 ]
机构
[1] Univ Cincinnati, Med Ctr, Dept Radiol, 3188 Bellevue Ave, Cincinnati, OH 45219 USA
[2] Cincinnati Childrens Hosp & Med Ctr, Dept Radiol, Cincinnati, OH USA
关键词
TEMPORAL-LOBE EPILEPSY; GLUCOSE-METABOLISM; FDG-PET; HYPOMETABOLISM; CHILDREN; LOBECTOMY; SURGERY; SEIZURES; SPECT; MRI;
D O I
10.1148/rg.240062
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Approximately one-third of patients with focal epilepsy have medically refractory focal epilepsy (MRFE), which significantly impacts their quality of life. Once a seizure focus is identified and determined to be in the noneloquent cortex, it can be surgically resected with the goal of freedom from seizures and minimal neurocognitive deficit. During noninvasive (phase I) presurgical planning, functional (nuclear) imaging and structural imaging are complementary in the accurate localization of the epileptogenic zone (EZ). PET and SPECT are complementary functional imaging modalities. Fluorine 18-fluorodeoxyglucose PET shows hypometabolism in the EZ, while SPECT radiotracers are used to assess regional cerebral perfusion. Functional imaging plays a more important role in patients with nonlesional epilepsy (approximately one-third of patients with MRFE), in patients with multiple lesions, or in the setting of electrophysiologic-structural discordance. Nuclear medicine imaging also helps in evaluating the functional integrity of the rest of the brain and unmasking abnormalities that are not apparent at structural imaging before surgery. During invasive (phase II) evaluation, the EZ seen at functional imaging helps in guiding intracranial electrode placement. This review of nuclear medicine imaging of epilepsy is focused on the radiotracers used, imaging acquisition and postprocessing, commonly encountered causes of MRFE in adults and children, radiologic appearances of MRFE, imaging artifacts, and interpretation pitfalls. The goal is to guide radiologists in optimally performing and interpreting these studies for effective multidisciplinary discussions of these complex patient cases. (c) RSNA, 2025 center dot radiographics.rsna.org
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页数:18
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共 58 条
[1]   SISCOM in Children with Tuberous Sclerosis Complex-Related Epilepsy [J].
Aboian, Mariam S. ;
Wong-Kisiel, Lily C. ;
Rank, Michelle ;
Wetjen, Nicholas M. ;
Wirrell, Elaine C. ;
Witte, Robert J. .
PEDIATRIC NEUROLOGY, 2011, 45 (02) :83-88
[2]   Transient focal cortical increase of interictal glucose metabolism in Sturge-Weber syndrome: Implications for epileptogenesis [J].
Alkonyi, Balint ;
Chugani, Harry T. ;
Juhasz, Csaba .
EPILEPSIA, 2011, 52 (07) :1265-1272
[3]   The Epidemiology of Epilepsy [J].
Beghi, Ettore .
NEUROEPIDEMIOLOGY, 2020, 54 (02) :185-191
[4]   Brain damage and IQ in unilateral Sturge-Weber syndrome: Support for a "fresh start" hypothesis [J].
Behen, Michael E. ;
Juhasz, Csaba ;
Wolfe-Christensen, Cortney ;
Guy, William ;
Halverson, Stacey ;
Rothermel, Robert ;
Janisse, James ;
Chugani, Harry T. .
EPILEPSY & BEHAVIOR, 2011, 22 (02) :352-357
[5]   Longitudinal changes in cortical glucose hypometabolism in children with intractable epilepsy [J].
Benedek, Krisztina ;
Juhasz, Csaba ;
Chugani, Diane C. ;
Muzik, Otto ;
Chugani, Harry T. .
JOURNAL OF CHILD NEUROLOGY, 2006, 21 (01) :26-31
[6]   Brain Normal Variations and Benign Findings in Fluorodeoxyglucose-PET/Computed Tomography Imaging [J].
Berti, Valentina ;
Mosconi, Lisa ;
Pupi, Alberto .
PET CLINICS, 2014, 9 (02) :129-+
[7]   Meningoceles in Idiopathic Intracranial Hypertension [J].
Bialer, Omer Y. ;
Rueda, Mario Perez ;
Bruce, Beau B. ;
Newman, Nancy J. ;
Biousse, Valerie ;
Saindane, Amit M. .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2014, 202 (03) :608-613
[8]   High-quality brain perfusion SPECT images may be achieved with a high-speed recording using 360° CZT camera [J].
Bordonne, Manon ;
Chawki, Mohammad B. ;
Marie, Pierre-Yves ;
Zaragori, Timothee ;
Roch, Veronique ;
Grignon, Rachel ;
Imbert, Laetitia ;
Verger, Antoine .
EJNMMI PHYSICS, 2020, 7 (01)
[9]   Insular cortex involvement in mesiotemporal lobe epilepsy: A positron emission tomography study [J].
Bouilleret, V ;
Dupont, S ;
Spelle, L ;
Baulac, M ;
Samson, Y ;
Semah, F .
ANNALS OF NEUROLOGY, 2002, 51 (02) :202-208
[10]   Adult-onset epilepsy associated with dysembryoplastic neuroepithelial tumors [J].
Burneo, J. G. ;
Tellez-Zenteno, J. ;
Steven, D. A. ;
Niaz, N. ;
Hader, W. ;
Pillay, N. ;
Wiebe, S. .
SEIZURE-EUROPEAN JOURNAL OF EPILEPSY, 2008, 17 (06) :498-504