Hajime Yokota1, Hiroyuki Uetani2, Hiroyuki Tatekawa3, Akifumi Hagiwara4, Emiko Morimoto3, Michael Linetsky5, Bryan Yoo5, Benjamin M Ellingson6, Noriko Salamon5. 1. Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States; Department of Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan. 2. Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States; Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan. Electronic address: hiromaelen5@gmail.com. 3. Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States; Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan. 4. Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States; Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan. 5. Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States. 6. Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States; UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, United States.
Abstract
PURPOSE: Although magnetic resonance imaging (MRI) and 18F-2-fluorodeoxyglucose-positron emission tomography (FDG-PET) are used for pre-surgical assessment of focal cortical dysplasia (FCD), they often disagree. This study aimed to identify factors that contribute to discrepancies in FCD imaging between MRI and FDG-PET. METHODS: Sixty-two patients (mean age, 18.9 years) with a FCD type I or II were retrospectively selected. These patients were visually categorized into two groups: 1) extent of PET abnormality larger than MRI abnormality and 2) vice versa or equivalent. Predictive factors of these two groups were analyzed by multivariate logistic regression. The extent of hypometabolic transient zone surrounding FCDs and their mean standardized uptake values were measured and compared by the Mann-Whitney U-test. RESULTS: FCDs were detected on MRI and PET in 46 and 55 patients, respectively, whereas no abnormality was detected in 4 patients. The PET hypometabolic areas were larger than the MRI abnormal areas in 26 patients (88 % in the temporal lobe), whereas the PET hypometabolic areas were equivalent or smaller than the MRI abnormal areas in 32 patients (69 % in the frontal lobe). The temporal lobe location was an independent predictor for differentiating the two groups (OR = 35.2, 95 % CI = 6.81-168.0, P < .001). The temporal lobe lesions had significantly wider transient zones and lower standardized uptake values than those in the other lobes (P < .001, both). CONCLUSION: The discrepancies between MRI and FDG-PET findings of FCD were associated with temporal lobe location.
PURPOSE: Although magnetic resonance imaging (MRI) and 18F-2-fluorodeoxyglucose-positron emission tomography (FDG-PET) are used for pre-surgical assessment of focal cortical dysplasia (FCD), they often disagree. This study aimed to identify factors that contribute to discrepancies in FCD imaging between MRI and FDG-PET. METHODS: Sixty-two patients (mean age, 18.9 years) with a FCD type I or II were retrospectively selected. These patients were visually categorized into two groups: 1) extent of PET abnormality larger than MRI abnormality and 2) vice versa or equivalent. Predictive factors of these two groups were analyzed by multivariate logistic regression. The extent of hypometabolic transient zone surrounding FCDs and their mean standardized uptake values were measured and compared by the Mann-Whitney U-test. RESULTS: FCDs were detected on MRI and PET in 46 and 55 patients, respectively, whereas no abnormality was detected in 4 patients. The PET hypometabolic areas were larger than the MRI abnormal areas in 26 patients (88 % in the temporal lobe), whereas the PET hypometabolic areas were equivalent or smaller than the MRI abnormal areas in 32 patients (69 % in the frontal lobe). The temporal lobe location was an independent predictor for differentiating the two groups (OR = 35.2, 95 % CI = 6.81-168.0, P < .001). The temporal lobe lesions had significantly wider transient zones and lower standardized uptake values than those in the other lobes (P < .001, both). CONCLUSION: The discrepancies between MRI and FDG-PET findings of FCD were associated with temporal lobe location.
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