Clinical value of PET-CT 3D mode brain image in the localizition of epileptic foci

Objective To assess the value of 18F-FDG PET cerebral 3D mode in the localization of epileptic foci.Method 13 cases with epilepsy included 9 cases of primary epilepsy and 4 cases of secondary epilepsy.The brain scan with 3D mode was performed on all the patients and the images were analyzed by eyes and semi-quantitative method by two experienced nuclear medicine physicians.The scalp electroencephalogram(EEG)was performed on all the patients,and electrocorticogram(EcoG) or depth electroencephalogram(DEEG) were performed on 2 cases to verify the PET results,MRI and/or CT examination were obtained in 12 cases.Results 92.3% was abnormal displaying hypometabolic foci on PET imaging(12/13).PET was more sensitive than EEG and MRI/CT detecting the lesions(92.3℅,69.2℅ and 33.3℅,respectively,χ2=14.3 and 35.0,P0.01).Solitary lesion detection rate of PET was 61.5%,which was higher than EEG(61.5% vs.38.4℅,χ2 =23.1,P0.01).Compared with golden standard of EcoG or DEEG,the sensitivity and specificity of PET localizing the epileptic foci were 95℅ and 89℅.Conclusion 18 F-FDG PET is a sensitive and accurate image modality in the localization of epileptic foci and is useful to direct surgical treatment and orientate radiation therapy.