Utility of hybrid PET/MRI in stereoelectroencephalography guided radiofrequency thermocoagulation in MRI negative epilepsy patients

Frontiers in Neuroscience

Neuroscience

Bomin Sun¹  Wei Liu¹  Zhengyu Lin¹  Chunyan Cao¹  Shikun Zhan¹  Hongyang Li¹  Miao Zhang²  Zhengdao Deng³ 

[1] Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;Research Group of Experimental Neurosurgery and Neuroanatomy, KU Leuven, Leuven, Belgium;

关键词: drug-resistant epilepsy;    SEEG-guided RFTC;    hybrid PET/MRI;    multifocal epilepsy;    epilepsy surgery;   

DOI  :  10.3389/fnins.2023.1163946

 received in 2023-02-11, accepted in 2023-05-26,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionHybrid positron emission tomography/magnetic resonance imaging (PET/MRI) is a novel advanced non-invasive presurgical examination tool for patients with drug-resistant epilepsy (DRE). This study aims to evaluate the utility of PET/MRI in patients with DRE who undergo stereoelectroencephalography-guided radiofrequency thermocoagulation (SEEG-guided RFTC).MethodsThis retrospective study included 27 patients with DRE who underwent hybrid PET/MRI and SEEG-guided RFTC. Surgery outcome was assessed using a modified Engel classification, 2 years after RFTC. Potential areas of the seizure onset zone (SOZ) were identified on PET/MRI and confirmed by SEEG.ResultsFifteen patients (55%) became seizure-free after SEEG-guided RFTC. Engel class II, III, and IV were achieved in six, two, and four patients, respectively at the 2 years follow-up. MRI was negative in 23 patients and structural abnormalities were found in four patients. Hybrid PET/MRI contributed to the identification of new structural or metabolic lesions in 22 patients. Concordant results between PET/MRI and SEEG were found in 19 patients in the identification of SOZ. Among the patients with multifocal onset, seizure-free status was achieved in 50% (6/12).ConclusionSEEG-guided RFTC is an effective and safe treatment for drug-resistant epilepsy. Hybrid PET/MRI serves as a useful tool for detecting the potential SOZs in MRI-negative patients and guide the implantation of SEEG electrodes. Patients with multifocal epilepsy may also benefit from this palliative treatment.

【 授权许可】

Unknown   
Copyright © 2023 Li, Zhang, Lin, Deng, Cao, Zhan, Liu and Sun.