Application value of multimodal MRI combined with PET metabolic parameters in temporal lobe epilepsy with dual pathology

Yu Kong; Nan Cheng; Feng-Juan Qiu; Lei Yao; Ming Gao; An-Qiang Chen; Qing-Xia Kong; Gu-Qing Zhang

doi:10.1016/j.ejrad.2023.111171

Application value of multimodal MRI combined with PET metabolic parameters in temporal lobe epilepsy with dual pathology

Eur J Radiol. 2023 Dec:169:111171. doi: 10.1016/j.ejrad.2023.111171. Epub 2023 Oct 27.

Authors

Yu Kong¹, Nan Cheng², Feng-Juan Qiu³, Lei Yao⁴, Ming Gao², An-Qiang Chen², Qing-Xia Kong⁵, Gu-Qing Zhang⁶

Affiliations

¹ Medical Imaging Department, Affiliated Hospital of Jining Medical University, Jining 272029, Shandong, China; College of Materials Science and Engineering, Qingdao University, Qingdao 266071, Shandong, China.
² Medical Imaging Department, Affiliated Hospital of Jining Medical University, Jining 272029, Shandong, China.
³ Department of Pediatric Rehabilitation, Affiliated Hospital of Jining Medical University, Jining 272029, Shandong, China.
⁴ Clinical Medical College, Jining Medical University, Jining 272067, Shandong, China.
⁵ Department of Neurology, Affiliated Hospital of Jining Medical University, Jining 272029, Shandong, China. Electronic address: kxdqy8@sohu.com.
⁶ Medical Imaging Department, Affiliated Hospital of Jining Medical University, Jining 272029, Shandong, China. Electronic address: zhangguqing777@163.com.

PMID: 38250750
DOI: 10.1016/j.ejrad.2023.111171

Abstract

Objectives: To investigate the application value of multimodal MRI combined with PET metabolic parameters in detecting temporal lobe epilepsy (TLE) with dual pathology (DP) and the prediction effect of post-surgical outcomes in these patients.

Methods: We retrospectively reviewed 50 patients with TLE-DP who underwent surgery at our hospital between January 2016 and December 2021 and collected the demographics, clinical characteristics, video-electroencephalography (v-EEG), neuroimaging, and surgical data. Seizure outcome data were collected during a regular follow-up of at least 12 months and were graded using Engel scores. Fisher's exact test was used to compare the differences in DP detection rates of various diagnostic modalities. Univariate and multivariate analyses were performed to explore the prognostic factors for predicting seizure outcomes post-surgery.

Results: Of the 50 patients, 20 were males. The median age was 30, the median age at first seizure was 14, and the median duration was ten years. Voxel-based morphometry-PET statistical parametric mapping-PET/MRI (VBM-PSPM-PET/MRI) had the highest detection rate, followed by PET/MRI, VBM analysis, and PET-SPM. Regardless of follow-up duration, v-EEG, PET, image post-processing methods, and VBM-PSPM-PET/MRI statistically correlated with seizure outcomes using the log-rank test in the Kaplan-Meier analysis. Multivariate analysis showed that VBM-PSPM-PET/MRI was an independent predictor of TLE-DP (hazard ratio (HR) = 15.674, 95 % CI = 0.002-0.122, P < 0.00 1).

Conclusions: Our study illustrates that VBM-PSPM-PET/MRI has the highest detection value in patients with TLE-DP and can provide independent prognostic information for patients who undergo surgery. This approach has the most substantial potential for the selection of candidates for patients who undergo surgical treatment and for prognostic stratification.

Keywords: Dual pathology; MRI; PET; Statistical parametric mapping; Temporal lobe epilepsy; Voxel-based morphometry.

MeSH terms

Adult
Epilepsy, Temporal Lobe* / diagnostic imaging
Epilepsy, Temporal Lobe* / surgery
Female
Humans
Magnetic Resonance Imaging
Male
Positron-Emission Tomography
Retrospective Studies
Seizures