PET/MRI in the Presurgical Evaluation of Patients with Epilepsy: A Concordance Analysis

Biomedicines

Júlia Singer¹  Zsófia Jordán²  Anna Kelemen²  Dániel Fabó²  Dávid Nagy²  Márton Tóth³  József Janszky³  Ferenc Nagy⁴  Max Wintermark⁵  Tamás Dóczi⁶  Endre Pál⁷  Gábor Bajzik⁸  Zsolt Vajda⁸  Vera Juhos⁹  Imre Repa^1,10  Zoltán Tóth^1,10  Mariann Moizs^1,10  Miklós Emri^1,10  János Lückl^1,10  Dániel Fajtai^1,10  István Kenessey^1,11  Péter Barsi^1,12  Katalin Borbély^1,13  Thomas Beyer^1,14 

[1] Accelsiors Ltd., H1222 Budapest, Hungary;Department of Neurology and Neurosurgery, National Institute of Mental Health, Neurology and Neurosurgery, H1145 Budapest, Hungary;Department of Neurology, Medical School, University of Pécs, H7623 Pécs, Hungary;Department of Neurology, Somogy County Moritz Kaposi Teaching Hospital, H7400 Kaposvár, Hungary;Department of Neuroradiology, MD Anderson, Houston, TX 77030, USA;Department of Neurosurgery, Medical School, University of Pécs, H7623 Pécs, Hungary;Department of Pathology, Medical School, University of Pécs, H7623 Pécs, Hungary;Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, Somogy County Moritz Kaposi Teaching Hospital, H7400 Kaposvár, Hungary;Epihope Non-Profit Kft, H1026 Budapest, Hungary;Medicopus Healthcare Provider and Public Nonprofit Ltd., Somogy County Moritz Kaposi Teaching Hospital, H7400 Kaposvár, Hungary;National Cancer Registry, National Institute of Oncology, H1122 Budapest, Hungary;Neuroradiology Department, Semmelweis University, H1083 Budapest, Hungary;PET/CT Outpatient Department, National Institute of Oncology, H1122 Budapest, Hungary;QIMP Team, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, 1090 Vienna, Austria;

关键词: epilepsy surgery;    medically refractory focal epilepsy;    presurgical evaluation;    MRI-negative patients;    discordant electroclinical and MRI data;    metabolic PET;   

DOI  :  10.3390/biomedicines10050949

来源: DOAJ

【 摘 要 】

The aim of our prospective study was to evaluate the clinical impact of hybrid [¹⁸F]-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging ([¹⁸F]-FDG PET/MRI) on the decision workflow of epileptic patients with discordant electroclinical and MRI data. A novel mathematical model was introduced for a clinical concordance calculation supporting the classification of our patients by subgroups of clinical decisions. Fifty-nine epileptic patients with discordant clinical and diagnostic results or MRI negativity were included in this study. The diagnostic value of the PET/MRI was compared to other modalities of presurgical evaluation (e.g., electroclinical data, PET, and MRI). The results of the population-level statistical analysis of the introduced data fusion technique and concordance analysis demonstrated that this model could be the basis for the development of a more accurate clinical decision support parameter in the future. Therefore, making the establishment of “invasive” (operable and implantable) and “not eligible for any further invasive procedures” groups could be much more exact. Our results confirmed the relevance of PET/MRI with the diagnostic algorithm of presurgical evaluation. The introduction of a concordance analysis could be of high importance in clinical and surgical decision-making in the management of epileptic patients. Our study corroborated previous findings regarding the advantages of hybrid PET/MRI technology over MRI and electroclinical data.

【 授权许可】

Unknown