|
|
The relationship between interictal 18F-FDG PET/CT image pattern and prognosis of adult patients with temporal lobe epilepsy |
LU Ling-ling, CHEN Yu-feng, GUO Jia, WANG Zhi-guo, ZHAN Ying, WU Xiao-dan, ZHANG Guo-xu |
Department of Nuclear Medicine, General Hospital of Northern Theater Command, Shenyang 110016, China |
|
|
Abstract Objective: To investigate the relationship between interictal 18F-FDG PET/CT image pattern and prognosis of adult patients with adult temporal lobe epilepsy. Methods: A retrospective analysis from August 2013 to March 2018 was made for patients undertaking interictal brain 18F-FDG PET/CT. There were 62 cases in total, including 22 cases(35.48%) of women and 40 cases(64.52%) of men, age range 18~58(31.48±10.48) years. According to the number of lesions(single/multiple),side(ipsilateral/bilateral), PET/CT image could be divided into one single low metabolic lesion group, low unilateral multiple metabolic lesions on the same side and double side. According to Engel grading, the patients were divided into 45 cases(72.58%) in the satisfactory efficacy group(Engel Ⅰ) and 17 cases(27.42%) in the unsatisfactory efficacy group(Engel Ⅱ+Engel Ⅲ+Engel Ⅳ). Univariate analysis was performed on the number and side of lesions on PET/CT, and Logistic regression analysis was performed on the factors with statistical significance, to summarize the relationship between the metabolic change pattern of 18F-FDG PET/CT and the postoperative prognosis of adult patients with temporal lobe epilepsy. Result: The results of univariate analysis showed that the number and side of lesions were statistically significant(P values were 0.001 and 0.02, respectively). Logistic regression analysis showed that the number of lesions was strongly correlated with the prognosis(OR=7.219, 95%CI: 0.339~8.676, P=0.008), while the number of lesions was not correlated with the prognosis(OR=1.714, 95%CI: 1.691~30.809, P=0.515). Conclusion: 18F-FDG PET/CT brain metabolism imaging can be used to predict the postoperative efficacy of adult patients with temporal lobe epilepsy. Patients with single low-metabolism lesions have better surgical efficacy, and the number of low-metabolism lesions is an independent predictor of surgical prognosis.
|
Received: 21 May 2019
|
|
|
|
|
[1]Catarino CB, Kasperaviciūte D, Thom M, et al. Genomic microdeletions associated with epilepsy: not a contraindication to resective surgery[J]. Epilepsia, 2011, 52(8): 1388-1392.
[2]Blümcke I, Coras R, Miyata H, et al. Defining clinico-neuropatho-logical subtypes of mesial temporal lobe epilepsy with hippocampal sclerosis[J]. Brain Pathol, 2012, 22(3): 402-411.
[3]中国抗癫痫协会. 临床诊疗指南(癫痫病分册)[M]. 北京:人民卫生出版社,2015:29.
[4]Chang EF, Englot DJ, Vadera S. Minimally invasive surgical approaches for temporal lobe epilepsy[J]. Epilepsy Behav, 2015, 47: 24-33.
[5]万衡,雷叮,于文生,等. 药物难治性颖叶癫痈手术远期效果评估[J]. 中国临床神经外科杂志,2006,11(10):598-600.
[6]Takahashi ML, Soma T, Kawai K, et al. Voxel-based comparison of preoperative FDG-PET between mesial temporal lobe epilepsy patients with and without postoperative seizure-free outcomes[J]. Ann Nucl Med, 2012, 26(9): 698-706.
[7]赵春雷,陈自谦,钱根年,等. 18F-FDG PET与MRI在难治性颞叶癫痫定侧诊断中的价值研究[J]. 中国临床医学影像杂志,2016,27(5):305-308.
[8] Deleo F, Garbelli R, Milesi G, et al. Short- and long-term surgical outcomes of temporal lobe epilepsy associated with hippocampal sclerosis: Relationships with neuropathology[J]. Epilepsia, 2016, 57(2): 306-315.
[9]Jost J, Raharivelo A, Ratsimbazafy V, et al. Availability and cost of major and first-line antiepileptic drugs: a comprehensive evaluation in the capital of Madagascar[J]. Springerplus, 2016, 5(1): 1726.
[10]Guan J, Karsy M, Ducis K, et al. Surgical strategieses for pediatric epilepsy[J]. Transl Pediatr, 2016, 5(2): 55-66.
[11]Robert K, Ivana T, Jan C, et al. “MRI-negative PET-positive” temporal lobe epilepsy: Invasive EEG findings, histopathology, and postoperative outcomes[J]. Epilepsy Behav, 2011, 22(3): 537-541.
[12]Gokdemir S, Halac M, Albayram S, et al. Contribution of FDG-PET in epilepsy surgery: consistency and postoperative results compared with magnetic resonance imaging and electroen cephalography[J]. Turk Neurosurg, 2015, 25(1): 53-57.
[13]Benbadis SR, So NK, Antar MA, et al. The value of PET scan(and MRI and Wada test) in patients with bitemporal epileptiform abnormalities[J]. Arch Neurol, 1995, 52(11): 1062-1068.
[14]Rubinger L, Chan C, D’Arco F, et al. Change in presurgical diagnostic imaging evaluation affects subsequent pediatric epile psy surgery outcome[J]. Epilepsia, 2016, 57(1): 32-40.
[15]Menon RN, Radhakrishnan A, Parameswaran R, et al. Does F-18 FDG-PET substantially alter the surgical decision-making in drug-resistant partial epilepsy?[J]. Epilepsy Behav, 2015, 51: 133-139.
[16]Duchowny M. Clinical, functional, and neurophysiologic assessment of dysplastic cortical networks: Implications for cortical functioning and surgical management[J]. Epilepsia, 2009, 50(Suppl 9): 19-27.
[17]Nelissen N, Van Paesschen W, Baete K, et al. Correlations of interictal FDG-PET metabolism and ictal SPECT perfusion changes in human temporal lobe epilepsy with hippocampal sclerosis[J]. Neuroimage, 2006, 32(2): 684-695.
[18]Willmann O, Wennberg R, May T, et al. The contribution of 18F-FDG PET in preoperative epilepsy surgery evaluation for patients with temporal lobe epilepsy: A meta-analysis[J]. Seizure, 2007, 16(6): 509-520.
[19]Chassoux F, Artiges E, Semah F, et al. 18F-FDG-PET patterns of surgical success and failure in mesial temporal lobe epilepsy[J]. Neurology, 2017, 88(11): 1045-1053.
[20]Hughes JR. Gamma, fast, and ultrafast waves of the brain: their relationships with epilepsy and behavior[J]. Epilepsy Behav, 2008, 13(1): 25-31.
[21]潘中允. 实用核医学[M]. 北京:人民卫生出版社,2014:807-811.
[22]Guedj E, Bonini F, Gavaret M, et al. 18FDG-PET in different subtypes of temporal lobe epilepsy: SEEG validation and predictive value[J]. Epilepsia, 2015, 56(3): 414-421.
[23]青浩渺,崔瑞雪,窦万臣,等. 颞叶癫痫患者术前颞叶外低代谢与手术疗效的相关性分析[J]. 中华核医学与分子影像杂志,2015,35(1):18-21.
[24]Stanisic M, Coello C, Ivanovic J, et al. Seizure outcomes in relation to the extent of resection of the perifocal fluorodexyglu cose and flumazenil PET abnormalities in anteromedial temporal lobectomy[J]. Acta Neurochir(Wien), 2015, 157(11): 1905-1916. |
|
|
|