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| The value of interictal 18F-FDG combined with 13N-NH3·H2O PET imaging in localizing epileptogenic zone in presurgical mesial temporal lobe epilepsy |
LU Dong-yan, GAO Shuo, YANG Wei-dong, CAI Li, LI Yan-sheng, LI Wei-long
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| General Hospital of Tianjin Medical University, Tianjin 300052, China |
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Abstract Objective: The aim of this study was to evaluate the value of interictal 18F-FDG and 13N-NH3·H2O PET imaging in localizing the epileptic foci in patients with mesial temporal lobe epilepsy(MTLE). Methods: Preoperative MRI, 18F-FDG and 13N-NH3·H2O PET data in 17 MTLE patients confirmed by electrocorticogram(ECoG) and depth electroencephalogram(DEEG) were retrospectively analysed. The PET images were visually assessed with ROI-based analysis. The 18F-FDG and 13N-NH3·H2O PET images were compared. Results: According to the ROI-based analysis, the FDG uptake and the CBF(cerebral blood flow) correctly determined the side of the epileptic temporal lobe in twelve cases(70.6%) and nine cases(52.9%) respectively, correctly determined the side of the epileptic focus on the mesial temporal structure in five cases(29.4%) and four cases(23.5%), respectively. The diagnostic performance of the two agents were in moderate concordance by Kappa test(Kappa=0.638, P=0.005). And there was no statistically significant difference in the localization accuracy between the two agents. FDG uptake combined CBF correctly determined the side of the epileptic focus on the mesial temporal structure in eight cases(47.1％). Conclusion: Positron emission tomography measurement of FDG uptake was most sensitive in detecting the side of the epileptic temporal lobe, CBF PET also can lateralize the epileptic temporal lobe effectively. When combine FDG uptake with CBF imaging, the specificity may be improved.
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Received: 14 December 2009
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2010, Vol. 21 
