Interictal and postictal 18 F-FDG PET/CT in epileptogenic zone localization.

Autor: Carvalho MS; Medicina Nuclear Diagnóstico (MND), Campinas, SP, Brazil., Alvim MKM; Departamento de Neurologia, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-Unicamp), Campinas, SP, Brazil., Etchebehere E; Serviço de Medicina Nuclear, Departamento de Anestesiologia, Oncologia e Radiologia (DAOR), Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-Unicamp), Campinas, SP, Brazil., Santos AO; Serviço de Medicina Nuclear, Departamento de Anestesiologia, Oncologia e Radiologia (DAOR), Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-Unicamp), Campinas, SP, Brazil., Ramos CD; Serviço de Medicina Nuclear, Departamento de Anestesiologia, Oncologia e Radiologia (DAOR), Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-Unicamp), Campinas, SP, Brazil., Argenton JLP; Departamento de Bioestatística, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil., Cendes F; Departamento de Neurologia, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-Unicamp), Campinas, SP, Brazil., Amorim BJ; Serviço de Medicina Nuclear, Departamento de Anestesiologia, Oncologia e Radiologia (DAOR), Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-Unicamp), Campinas, SP, Brazil.
Jazyk: angličtina
Zdroj: Radiologia brasileira [Radiol Bras] 2022 Sep-Oct; Vol. 55 (5), pp. 273-279.
DOI: 10.1590/0100-3984.2021.0141
Abstrakt: Objective: To evaluate the performance of 18 F-fluorodeoxyglucose positron-emission tomography/computed tomography ( 18 F-FDG PET/CT) in localizing epileptogenic zones, comparing 18 F-FDG injection performed in the traditional interictal period with that performed near the time of a seizure.
Materials and Methods: We evaluated patients with refractory epilepsy who underwent 18 F-FDG PET/CT. The reference standards for localization of the epileptogenic zone were histopathology and follow-up examinations (in patients who underwent surgery) or serial electroencephalography (EEG) recordings, long-term video EEG, and magnetic resonance imaging (in patients who did not). The 18 F-FDG injection was performed whether the patient had an epileptic seizure during the EEG monitoring period or not. The 18 F-FDG PET/CT results were categorized as concordant or discordant with the reference standards.
Results: Of the 110 patients evaluated, 10 were in a postictal group (FDG injection after a seizure) and 100 were in the interictal group. The 18 F-FDG PET/CT was concordant with the reference standards in nine (90%) of the postictal group patients and in 60 (60%) of the interictal group patients. Among the nine postictal group patients in whom the results were concordant, the 18 F-FDG PET/CT showed hypermetabolism and hypometabolism in the epileptogenic zone in four (44.4%) and five (55.6%), respectively.
Conclusion: Our data indicate that 18 F-FDG PET/CT is a helpful tool for localization of the epileptogenic zone and that EEG monitoring is an important means of correlating the findings. In addition, postictal 18 F-FDG PET/CT is able to identify the epileptogenic zone by showing either hypometabolism or hypermetabolism.
Databáze: MEDLINE
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