Comparative study of PET imaging with EEG and MRI in patients with intractable epilepsy

Objective:To compare the results of PET,EEG and MRI in patients with intractable epilepsy,and to explore the application value and feasiblity of 18 F FDG PET in the localization of epileptogenic focus.Methods:Brain imaging of 18 F FDG PET was determined in 102 patients (M64,F38,average age 22.1) with intractable epilepsy,five patients were imaged by PET during ictal and 97 were imaged during interictal phase. All the patients received the examination of EEG and some of MRI. The efficacy of 18 F FDG PET for the localization of epileptogenic foci was compared with that of EEG and MRI.Results:102 patients showed interictal one or more hypometabolism and ictal focal hypermetabolism. The positive rate of detection epileptic focus was 92.4% and accurate lateralization and localization rate was 52.9%,significantly higher than those by EEG and MRI (p0 01) The finding of epileptogenic foci by EEG in concordance with PET was 41.2%,MRI in concordance with PET was 41.7%.Conclusions:PET imaging might be a sensitive and safe method for effective localization of epileptogenic focus. It might have significant advantages over EEG and MRI in detecting and localizing epileptogenic focus. However,it might be still doubtful that abnormal metabolism areas by PET do all belong to epileptogenic foci. A combination of PET,EEG and MRI might increase the positive rate and accuracy for localization.