The predictive value of FDG-PET with 3D-SSP for surgical outcomes in patients with temporal lobe epilepsy

被引：11
作者：
Higo, Takuma [1 ]
Sugano, Hidenori [1 ]
Nakajima, Madoka [1 ]
Karagiozov, Kostadin [1 ]
Iimura, Yasushi [1 ]
Suzuki, Masaru [2 ]
Sato, Kiyoshi [2 ]
Arai, Hajime [1 ]
机构：
[1] Juntendo Univ, Dept Neurosurg, Bunkyo Ku, 2-1-1 Hongo, Tokyo 1138421, Japan
[2] Juntendo Univ, Juntendo Tokyo Koto Geriatr Med Ctr, PET CT Res Ctr, Koto Ku, 3-3-20 Shinsuna, Tokyo, Japan
来源：
SEIZURE-EUROPEAN JOURNAL OF EPILEPSY | 2016年 / 41卷
关键词：
Temporal lobe epilepsy; FDG-PET; 3D-SSP; POSITRON-EMISSION-TOMOGRAPHY; F-18-FDG PET; GLUCOSE-METABOLISM; HYPOMETABOLISM; TOPOGRAPHY; SEIZURES;
D O I：
10.1016/j.seizure.2016.07.019
中图分类号：
R74 [神经病学与精神病学];
学科分类号：
摘要：
Purpose: We retrospectively evaluated the diagnostic value of F-18-2-fluorodeoxy-o-glucose positron emission tomography (FDG-PET) with statistical analysis for the foci detection and predictive utility for postsurgical seizure outcome of patients with mesial temporal lobe epilepsy (mTLE). Method: We evaluated 40 patients who were diagnosed mTLE and underwent selective amygdalo-hippocampectomy (SAH) or anterior temporal lobectomy (ATL) in our institute. Preoperative interictal FDG-PET with statistical analysis using three-dimensional stereotactic surface projection (3D-SSP) was detected with several clinical data including seizure semiology, MRI, scalp electroencephalography, surgical procedure with SAH or ATL and postsurgical outcome. The region of interest (ROI) was defined on `Hippocampus & Amygdala', Parahippocampal gyrus & Uncus', 'T1 & T2', and 73 & Fusiform gyrus'. We obtained the ratio of hypometabolism difference (RHD) by 3D-SSP, and evaluated the relation among hypometabolic extent, surgical outcome and surgical procedure. Result: The RHD in each ROIs ipsilateral to operative side was significantly higher than that of contralateral side in good outcome group. Hypometabolism of 'Hippocampus & Amygdala' was most reliable prognostic factor. Patients of discordant with presurgical examinations hardly showed obvious lateralized hypometabolism. Nevertheless, when they have significantly high RHD in mesial temporal lobe, good surgical outcome was expected. There was not significant difference of RHD distribution between SAH and ATL in good outcome group. Conclusion: Significant hypometabolism in mesial temporal lobe on FDG-PET with 3D-SSP is useful to predict good surgical outcome for patients with mTLE, particularly in discordant patients with hypometabolism in mesial temporal structure. However, FDG-PET is not indicative of surgical procedure. (C) 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
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页码：127 / 133
页数：7
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