Compatibility of MRI and FDG-PET findings with histopathological results in patients with focal cortical dysplasia. (February 2017)

• Record Type: Journal Article
• Authors: Halac, Gulistan; Delil, Sakir; Zafer, Dila; Isler, Cihan; Uzan, Mustafa; Comunoglu, Nil; Oz, Buge; Yeni, S. Naz; Vatankulu, Betul; Halac, Metin; Ozkara, Cıgdem
• Is Part Of: Seizure. Volume 45(2017)
• Page Start: 80
• Page End: 86
• Publication Date: 2017-02
• Subjects: Drug-resistant epilepsy -- Focal cortical dysplasia -- PET -- MRI; Epilepsy -- Periodicals; Epilepsy -- Periodicals; Seizures -- Periodicals; Épilepsie -- Périodiques; Electronic journals; Electronic journals; 616.853
• DOI: 10.1016/j.seizure.2016.11.024
• Languages: English
• ISSNs: 1059-1311

Abstract

Highlights: Patients with PET hypometabolism had earlier onset of seizures. Majority of patients with MR lesion had FCD type 2. No correlation between histopathology and other variables (age at onset, gender, duration). PET positivity did not correlate with histopathology. Abstract: Purpose: The present study aimed to determine if the specific characteristics of fluorodeoxyglucose-positron emission tomography (FDG-PET) analyses of the FCD subgroups were compatible with the magnetic resonance imaging (MRI) and clinical findings of the patients in these subgroups. Methods: This study included 71 patients who had a presurgical evaluation workup performed due to drug-resistant seizures, who underwent epilepsy surgery, and who were histopathologically diagnosed with FCD. Relationships involving MRI and FDG-PET findings and clinical data from pathological subgroups and patients were assessed. Results: According to the International League Against Epilepsy (ILAE) classifications of FCD, 28 of the patients were type I and 43 were type II. FCD was visible on the MRI scans of 53 patients, and a majority of this group was classified as type II FCD (n = 34). Of these 53 patients, FCD was located in the temporal area of 21 patients, the extratemporal area of 29 patients. Of the patients who exhibited FDG-PET hypometabolism (PET-positive), 23 were classified as temporal, 17 as frontal, 11 showed involvement of the posterior cortex. The age of seizure onset was younger in PET-positive patients (p = 0.032), and histopathological analyses revealed that 23 patients had type I FCD and 30 patients had type II FCD. Conclusion: PET scans reveal a lesion by showing hypometabolism in patients who have refractory epilepsy and an early age of onset with FCD. The lesions of MRI-negative/PET-positive FCD patients tend to be localized in the temporal lobe and that FCD may be localized in the frontal lobe of MRI-negative/PET-negative patients. However, the histopathological examinations of MRI-positive/PET-positive, MRI-negative/PET-positive, and MRI-negative/PET-negative patients did not exhibit a particular histopathological subtype.