18F-FDG-PET/CT for Localizing the Epileptogenic Focus in Patients with Different Types of Focal Cortical Dysplasia

Feng Wang; Shu-Ting Hong; Ying Zhang; Zhen Xing; Yuan-Xiang Lin

doi:10.2147/NDT.S442459

¹⁸F-FDG-PET/CT for Localizing the Epileptogenic Focus in Patients with Different Types of Focal Cortical Dysplasia

Neuropsychiatr Dis Treat. 2024 Feb 3:20:211-220. doi: 10.2147/NDT.S442459. eCollection 2024.

Authors

Feng Wang^#¹, Shu-Ting Hong^#¹, Ying Zhang², Zhen Xing³, Yuan-Xiang Lin¹

Affiliations

¹ Neurosurgery Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
² Nuclear Medicine Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
³ Radiology Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: To determine the diagnostic and localization value of ¹⁸F-fluorodeoxyglucose-positron emission tomography (PET)/computed tomography (CT) in patients with focal cortical dysplasia (FCD) who underwent epilepsy surgery.

Methods: One hundred and eight patients with pathologically proven FCD who underwent surgery for refractory epilepsy were retrospectively analyzed. All patients underwent magnetic resonance imaging (MRI), ¹⁸F-FDG-PET/CT, and video electroencephalography. An MRI diagnosis of FCD was defined as MRI+. A PET/CT diagnosis of FCD was defined as PET/CT+.

Results: MRI and PET/CT detected FCD in 20.37% and 93.52% of patients, respectively. The difference was significant. Twenty-one patients were MRI+/PET+, 80 were MRI-/PET+, six were MRI-/PET-, and one was MRI+/PET-. The MRI positivity rate was lowest in patients with FCD type IIIa (5.6%, P < 0.05). Prevalence of MRI-/PET+ was highest in patients with FCD type IIIa (88.89%, P < 0.05).

Conclusion: PET/CT is superior to MRI in detecting FCD. FCD type IIIa was more likely than other types to show MRI-/PET+. This suggests that PET/CT has particular diagnostic value for FCD type IIIa patients with negative MRI findings.

Keywords: 18F-FDG-PET/CT; epilepsy; focal cortical dysplasia; pathological types.

Grants and funding

This study was supported by the Joint Funds for the Innovation of Science and Technology, Fujian Province, China (No. 2019Y9121 and 2019Y9123).