Miao Zhang1, Wei Liu2, Peng Huang2, Xiaozhu Lin1, Xinyun Huang1, Hongping Meng1, Jin Wang1, Kejia Hu2, Jian Li3, Mu Lin4, Bomin Sun2, Shikun Zhan5, Biao Li6. 1. Department of Nuclear Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China. 2. Department of Neurosurgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China. 3. Clinical Research Center, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China. 4. MR Collaborations, Siemens Healthcare Ltd., Shanghai, China. 5. Department of Neurosurgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China. Electronic address: zsk10715@rjh.com.cn. 6. Department of Nuclear Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China. Electronic address: lb10363@rjh.com.cn.
Abstract
PURPOSE: Stereo-electroencephalography (SEEG) implantation before epilepsy surgery is critical for precise localization and complete resection of the seizure onset zone (SOZ). Combined metabolic and morphological imaging using hybrid PET/MRI may provide supportive information for the optimization of the SEEG coverage of brain structures. In this study, we originally imported PET/MRI images into the SEEG positioning system to evaluate the application of PET/MRI in guiding SEEG implantation in refractory epilepsy patients. MATERIALS: Forty-two patients undergoing simultaneous PET/MRI examinations were recruited. All the patients underwent SEEG implantation guided by hybrid PET/MRI and surgical resection or ablation of epileptic lesion. Surgery outcome was assessed using a modified Engel classification one year (13.60 ± 2.49 months) after surgery. Areas of SOZ were identified using hybrid PET/MRI and concordance with SEEG was evaluated. Logistic regression analysis was used to predict the presence of a favorable outcome with the coherence of concordance of PET/MRI and SEEG. RESULTS: Hybrid PET/MRI (including visual PET, MRI, plus MI Neuro) identified SOZ lesions in 38 epilepsy patients (90.47 %). PET/MRI showed the same SOZ localization with SEEG in 29 patients (69.05 %), which was considered to be concordant. The concordance between the PET/MRI and SEEG findings was significantly predictive of a successful surgery outcome (odds ratio = 20.41; 95 % CI = 2.75-151.4, P = 0.003**). CONCLUSION: Hybrid PET/MRI combined visual PET, multiple sequences MRI and SPM PET helps identify epilepsy lesions particularly in subtle hypometabolic areas. Patients with concordant epileptic lesion localization on PET/MRI and SEEG demonstrated a more favorable outcome than those with inconsistent localization between modalities.
PURPOSE: Stereo-electroencephalography (SEEG) implantation before epilepsy surgery is critical for precise localization and complete resection of the seizure onset zone (SOZ). Combined metabolic and morphological imaging using hybrid PET/MRI may provide supportive information for the optimization of the SEEG coverage of brain structures. In this study, we originally imported PET/MRI images into the SEEG positioning system to evaluate the application of PET/MRI in guiding SEEG implantation in refractory epilepsypatients. MATERIALS: Forty-two patients undergoing simultaneous PET/MRI examinations were recruited. All the patients underwent SEEG implantation guided by hybrid PET/MRI and surgical resection or ablation of epileptic lesion. Surgery outcome was assessed using a modified Engel classification one year (13.60 ± 2.49 months) after surgery. Areas of SOZ were identified using hybrid PET/MRI and concordance with SEEG was evaluated. Logistic regression analysis was used to predict the presence of a favorable outcome with the coherence of concordance of PET/MRI and SEEG. RESULTS: Hybrid PET/MRI (including visual PET, MRI, plus MI Neuro) identified SOZ lesions in 38 epilepsypatients (90.47 %). PET/MRI showed the same SOZ localization with SEEG in 29 patients (69.05 %), which was considered to be concordant. The concordance between the PET/MRI and SEEG findings was significantly predictive of a successful surgery outcome (odds ratio = 20.41; 95 % CI = 2.75-151.4, P = 0.003**). CONCLUSION: Hybrid PET/MRI combined visual PET, multiple sequences MRI and SPM PET helps identify epilepsy lesions particularly in subtle hypometabolic areas. Patients with concordant epileptic lesion localization on PET/MRI and SEEG demonstrated a more favorable outcome than those with inconsistent localization between modalities.
Authors: Jeremy N Ford; Elizabeth M Sweeney; Myrto Skafida; Shannon Glynn; Michael Amoashiy; Dale J Lange; Eaton Lin; Gloria C Chiang; Joseph R Osborne; Silky Pahlajani; Mony J de Leon; Jana Ivanidze Journal: Am J Nucl Med Mol Imaging Date: 2021-08-15
Authors: Katalin Borbély; Miklós Emri; István Kenessey; Márton Tóth; Júlia Singer; Péter Barsi; Zsolt Vajda; Endre Pál; Zoltán Tóth; Thomas Beyer; Tamás Dóczi; Gábor Bajzik; Dániel Fabó; József Janszky; Zsófia Jordán; Dániel Fajtai; Anna Kelemen; Vera Juhos; Max Wintermark; Ferenc Nagy; Mariann Moizs; Dávid Nagy; János Lückl; Imre Repa Journal: Biomedicines Date: 2022-04-20