PET/MRI and PET/MRI/SISCOM coregistration in the presurgical evaluation of refractory focal epilepsy

Epilepsy Research
S FernándezMar Carreño

Abstract

We aimed to investigate the usefulness of coregistration of positron emission tomography (PET) and magnetic resonance imaging (MRI) findings (PET/MRI) and of coregistration of PET/MRI with subtraction ictal single-photon emission computed tomography (SPECT) coregistered to MRI (SISCOM) (PET/MRI/SISCOM) in localizing the potential epileptogenic zone in patients with drug-resistant epilepsy. We prospectively included 35 consecutive patients with refractory focal epilepsy whose presurgical evaluation included a PET study. Separately acquired PET and structural MRI images were coregistered for each patient. When possible, ictal SPECT and SISCOM were obtained and coregistered with PET/MRI. The potential location of the epileptogenic zone determined by neuroimaging was compared with the seizure onset zone determined by long-term video-EEG monitoring and with invasive EEG studies in patients who were implanted. Structural MRI showed no lesions in 15 patients. In these patients, PET/MRI coregistration showed a hypometabolic area in 12 (80%) patients that was concordant with seizure onset zone on EEG in 9. In 7 patients without MRI lesions, PET/MRI detected a hypometabolism that was undetected on PET alone. SISCOM, obtained in 25 patien...Continue Reading

References

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Citations

Aug 27, 2013·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Antonio ValentínMichalis Koutroumanidis
May 12, 2018·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·P SharmaS Beniczky
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