Abstract
BackgroundTo evaluate the use of unbiased computer-assisted lateralization of temporal lobe epilepsy (TLE) by z-score parametric PET imaging (ZPET).Methods38 patients with histologically proven unilateral TLE due to pure hippocampal sclerosis, referred for pre-surgical PET evaluation of intractable seizure over a 5-year period, were included. The F-18 FDG images were oriented along temporal long axis and then transformed into ZPET images on a voxel by voxel basis. Multiple regions of interests (21 in total) were placed on cortical, subcortical and cerebellar structures on twenty-eight out of 38 patients with totally seizure-free (class I) outcome. Paired t-tests with Bonferroni correction were used to determine the location of the most asymmetric regions as variables for subsequent discriminant analysis of the entire group of the patients.ResultsThe computer program identified the anterior half of the temporal lobe (p < 0.0005) and thalami (p = 0.021) as the most asymmetric regions in TLE patients with Class I outcome. Discriminant analysis using z-scores from a total of 8 ROIs (in 4 pairs) on these structures correctly lateralized thirty-seven out of 38 (97%) patients (sensitivity = 94%; specificity = 100%). The only false localization came from a patient with equivocal z-scores on the temporal lobes and this patient turned out to have poor outcome.ConclusionThe computer-assisted lateralization of TLE using ZPET provides an accurate, fast and objective way of seizure evaluation.
Highlights
To evaluate the use of unbiased computer-assisted lateralization of temporal lobe epilepsy (TLE) by z-score parametric positron emission tomography (PET) imaging (ZPET)
These regions might represent underlying pathology that was potentially epileptogenic [3]. Such results indicate that discerning the presence and the exact extent of hypometabolism is clinically significant in planning surgery and predicting outcome
Routine interpretation of PET images to evaluate hypometabolism involves visual assessment of images normalized to the region of maximal uptake
Summary
To evaluate the use of unbiased computer-assisted lateralization of temporal lobe epilepsy (TLE) by z-score parametric PET imaging (ZPET). Choi et al noticed that extratemporal cortical hypometabolism outside the seizure focus, in particular hypometabolism in the contralateral cerebral cortex, might be associated with a poorer postoperative seizure outcome in TLE. These regions might represent underlying pathology that was potentially epileptogenic [3]. Such results indicate that discerning the presence and the exact extent of hypometabolism is clinically significant in planning surgery and predicting outcome. Automatic unbiased techniques to better elucidate regional metabolic abnormalities are important to the treatment of patients with temporal lobe epilepsy
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
