Value of ~(18)F-FDG PET /CT in localizing epileptic foci in attack period or interphase

Objective To assess the value of 18F-fluorodeoxyglucose( FDG) PET/CT in localizing the epileptic foci in attack period or interphase. Methods All 60 patients underwent18F-FDG PET / CT. The images were analyzed by visual inspection and semiquantitative methods. The scalp electroencephalogram( EEG) was examined in all patients,among whom electrocorticogram( ECoG) or depth electroencephalogram( DEEG) was examined in 25 cases. Results( 1) Of 56 patients who in epileptic interictal time,PET / CT images show hypometabolic foci in 53case. Of 4 patients who in epileptic ictal time,PET / CT show hypermetabolic foci.( 2) PET /CT detected 80% solitary lesion and 15% multiple lesion. Among 48 solitary lesion,32 were located in temporal lobe.( 3)Compared with ECoG or DEEG,the accuracy of PET / CT to localize epileptic foci was 96%.( 4) 32 cases of mesial temporal lobe epilepsy underwent the anterior temporal lobectomy,and 30 reached Engel Ⅰ-Ⅱ. 16 cases of extratemporal epilepsy underwent the resection of epileptogenic foci,and 12 cases reached Engel IⅠ-Ⅱ postoperatively. Conclusions The results of18F-FDG PET / CT are highly accordant with that of EEG and MRI in mesial temporal lobe epilepsy. For extratemporal epilepsy,PET / CT is a noninvasive,sensitive and effective method to locate possible sites and extent of epileptogenic sources.