Authors :
Presenting Author: Wei Wang, MD – Xuanwu Hospital, Capital Medical University, Beijing, China
Yajie Wang, MD – Xuanwu Hospital, Capital Medical University, Beijing, China
Xingyu Wang, BS – Xuanwu Hospital, Capital Medical University, Beijing, China
Yueshan Piao, MD – Xuanwu Hospital, Capital Medical University, Beijing, China
Yicong Lin, MD – Xuanwu Hospital, Capital Medical University, Beijing, China
Yuping Wang, MD, PhD – Xuanwu Hospital, Capital Medical University, Beijing, China
Rationale:
Fluorine 18 ([18F])–labeled DPA-714 binds to the translocator protein (TSPO), which is used in monitoring activated glial cells during inflammatory process, was found to be useful in localizing the epileptogenic zone. In this study, we aimed to analyze the application of [18F]DPA-714 PET in preoperative evaluation of epilepsy, and to validate the results through surgical outcome and pathological results.
Methods:
Patients who underwent epilepsy surgery with both preoperative [18F]DPA-714 PET and 18F-fluorodeoxyglucose ([18F]FDG) PET were retrospectively reviewed. We visually compared [18F]DPA-714 PET, [18F]FDG PET findings and clinical data. The asymmetry index (AI) from patient-specific regions of interest (ROIs) were also analyzed for both PET modalities. Pathological correlations with TSPO-positive findings were assessed using CD68 antibodies to identify microglial cells.
Results:
Eight patients were included in this study. All patients were seizure-free after one-year follow-up. Three patients had [18F]DPA-714 PET positive regions resected. These three patients had temporal lobe resection or temporal and opercular epileptogenic lesion resection, and the [18F]DPA-714 PET results of them were hypermatebolism in unilateral mesial temporal lobe. We compared the microglial cells density in the gray matter and white matter separately, and found that microglial cells density were higher in the mesial temporal regions ([18F]DPA-714 PET positive regions) than in the anterior lateral temporal regions ([18F]DPA-714 PET negative regions) in both gray matter (p = 0.003) and white matter (p < 0.001).