Double match of 18F-fluorodeoxyglucose-PET and iomazenil-SPECT improves outcomes of focus resection surgery

Double match of 18F-fluorodeoxyglucose-PET and iomazenil-SPECT improves outcomes of focus... Background When the results of electroencephalography (EEG), magnetic resonance imaging (MRI), and seizure semiology are discordant or no structural lesion is evident on MRI, single-photon emission computed tomography (SPECT) and positron emission tomography (PET) are important examinations for lateralization or localization of epileptic regions. We hypothesized 18 18 that the concordance between interictal 2-[ F]fluoro-2-deoxy-D-glucose ( FDG)-PET and iomazenil (IMZ)-SPECT could suggest the epileptogenic lobe in patients with non-lesional findings on MRI. Method Fifty-nine patients (31 females, 28 males; mean age, 29 years; median age, 27 years; range, 7–56 years) underwent subdural electrode implantation followed by focus resection. All patients underwent FDG-PET, IMZ-SPECT, and focus resection surgery. Follow-up was continued for ≥ 2 years. We evaluated surgical outcomes as seizure-free or not and analyzed correlations between outcomes and concordances of low-uptake lobes on PET, SPECT, or both PET and SPECT to the resection lobes. We used uni- and multivariate logistic regression analyses. Results In univariate analyses, all three concordances correlated significantly with seizure-free outcomes (PET, p = 0.017; SPECT, p = 0.030; both PET and SPECT, p = 0.006). In multivariate analysis, concordance between resection and low-uptake lobes in both PET and SPECT correlated significantly with seizure-free outcomes (p http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Acta Neurochirurgica Springer Journals

Double match of 18F-fluorodeoxyglucose-PET and iomazenil-SPECT improves outcomes of focus resection surgery

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Publisher
Springer Vienna
Copyright
Copyright © 2018 by Springer-Verlag GmbH Austria, part of Springer Nature
Subject
Medicine & Public Health; Neurosurgery; Interventional Radiology; Neuroradiology; Neurology; Surgical Orthopedics; Minimally Invasive Surgery
ISSN
0001-6268
eISSN
0942-0940
D.O.I.
10.1007/s00701-018-3573-1
Publisher site
See Article on Publisher Site

Abstract

Background When the results of electroencephalography (EEG), magnetic resonance imaging (MRI), and seizure semiology are discordant or no structural lesion is evident on MRI, single-photon emission computed tomography (SPECT) and positron emission tomography (PET) are important examinations for lateralization or localization of epileptic regions. We hypothesized 18 18 that the concordance between interictal 2-[ F]fluoro-2-deoxy-D-glucose ( FDG)-PET and iomazenil (IMZ)-SPECT could suggest the epileptogenic lobe in patients with non-lesional findings on MRI. Method Fifty-nine patients (31 females, 28 males; mean age, 29 years; median age, 27 years; range, 7–56 years) underwent subdural electrode implantation followed by focus resection. All patients underwent FDG-PET, IMZ-SPECT, and focus resection surgery. Follow-up was continued for ≥ 2 years. We evaluated surgical outcomes as seizure-free or not and analyzed correlations between outcomes and concordances of low-uptake lobes on PET, SPECT, or both PET and SPECT to the resection lobes. We used uni- and multivariate logistic regression analyses. Results In univariate analyses, all three concordances correlated significantly with seizure-free outcomes (PET, p = 0.017; SPECT, p = 0.030; both PET and SPECT, p = 0.006). In multivariate analysis, concordance between resection and low-uptake lobes in both PET and SPECT correlated significantly with seizure-free outcomes (p

Journal

Acta NeurochirurgicaSpringer Journals

Published: Jun 1, 2018

References

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