Dynamic FDG-PET in Localization of Focal Epilepsy: A Pilot Study
Abstract number :
2.159
Submission category :
5. Neuro Imaging / 5B. Functional Imaging
Year :
2021
Submission ID :
1826101
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:52 AM
Authors :
Mark Quigg, MD, MSc - University of Virginia; Nathan Fountain - University of Virginia; Thomas Eluvathingal Muttikal1 - University of Virginia; James Massey - University of Virginia; Robert Schetlick - University of Virginia; Vikram Seshadri - University of Virginia; Katherine Zarroli - Univeristy of Florida Jacksonville; Bijoy Kundu - University of Virginia
Rationale: Epilepsy surgery remains underutilized, in part because non-invasive methods of potential seizure foci localization are inadequate.
Methods: 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 (Figure 1). 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 corrections to generate tracer parametric maps compared between mean radiation values between hemispheres with z-scores.
Results: We identified ROI with the lowest negative z scores (< -1.65 SD) as hypometabolic. dFDG-PET found focal regions of altered metabolism in all cases in which standard clinical FDG-PET found no abnormalities (Figure 2).
Neuro Imaging