Dynamic FDG-PET in localization of focal epilepsy: A pilot study.

Dynamic FDG-PET in localization of focal epilepsy: A pilot study.
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局灶性癫痫定位中的动态FDG-PET:一项初步研究。

DOI:
10.1016/j.yebeh.2021.108204
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发表时间:
2021-09
期刊:
Epilepsy & behavior : E&B
影响因子:
--
通讯作者:
Quigg M
Quigg M
中科院分区:
其他
文献类型:
--
作者:
Seshadri V;Zarroli KA;Schetlick RS;Massey JC;Reyes JM;Eluvathingal Muttikal TJ;Patrie JT;Berr SS;Fountain NB;Kundu BK;Quigg M

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癫痫手术仍然未得到充分利用,部分原因是潜在癫痫灶定位的非侵入性方法不足。我们使用动态2-[18 F]氟-2-脱氧-d-葡萄糖正电子发射断层扫描(dFDG-PET)成像的高分辨率参数定量来定位标准临床静态PET图像正常的患者的低代谢病灶。我们获得了dFDG-PET脑图像与同步EEG在一个小时的采集7例无MRI证据的局灶性癫痫记录摄取和局灶性辐射衰减。对图像进行衰减和运动校正,并与高分辨率T1加权患者MRI配准,并将每个半球分割为18个感兴趣区域(ROI)。示踪剂摄取用具有部分体积(PV)校正的模型校正的血液输入函数校准,以生成示踪剂参数图,该示踪剂参数图在具有z分数的半球之间的平均辐射值之间进行比较。我们将具有最低负z分数(<-1.65 SD)的ROI确定为低代谢。动态2-[18 F]氟-2-脱氧-d-葡萄糖正电子发射断层扫描(在所有病例中发现代谢改变的局灶性区域,其中标准临床FDG-PET未发现异常。动态FDG-PET的这项初步研究表明,值得进一步研究,以评估葡萄糖动力学是否提供了改进的临床实用性定位癫痫灶超过标准的静态技术。
Epilepsy surgery remains underutilized, in part because non-invasive methods of potential seizure foci localization are inadequate. We used high-resolution, parametric quantification from dynamic 2-[18F] fluoro-2-deoxy-d-glucose positron emission tomography (dFDG-PET) imaging to locate hypometabolic foci in patients whose standard clinical static PET images were normal. We obtained dFDG-PET brain images with simultaneous EEG in a one-hour acquisition on seven patients with no MRI evidence of focal epilepsy to record uptake and focal radiation decay. Images were attenuation- and motion-corrected and co-registered with high-resolution T1-weighted patient MRI and segmented into 18 regions of interest (ROI) per hemisphere. Tracer uptake was calibrated with a model corrected blood input function with partial volume (PV) corrections to generate tracer parametric maps compared between mean radiation values between hemispheres with z-scores. We identified ROI with the lowest negative z scores (<−1.65 SD) as hypometabolic. Dynamic 2-[18F] fluoro-2-deoxy-d-glucose positron emission tomography ( found focal regions of altered metabolism in all cases in which standard clinical FDG-PET found no abnormalities. This pilot study of dynamic FDG-PET suggests that further research is merited to evaluate whether glucose dynamics offer improved clinical utility for localization of epileptic foci over standard static techniques.
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