Initial experience in hybrid PET-MRI for evaluation of refractory focal onset epilepsy. (September 2015)

• Record Type: Journal Article
• Authors: Shin, Hae W.; Jewells, Valerie; Sheikh, Arif; Zhang, Jingwen; Zhu, Hongtu; An, Hongyu; Gao, Wei; Shen, Dinggang; Hadar, Eldad; Lin, Weili
• Is Part Of: Seizure. Volume 31(2015)
• Page Start: 1
• Page End: 4
• Publication Date: 2015-09
• Subjects: Hybrid PET-MRI -- Epilepsy -- Epilepsy surgery evaluation -- 3 T MRI and PET-CT; Epilepsy -- Periodicals; Epilepsy -- Periodicals; Seizures -- Periodicals; Épilepsie -- Périodiques; Electronic journals; Electronic journals; 616.853
• DOI: 10.1016/j.seizure.2015.06.010
• Languages: English
• ISSNs: 1059-1311

Abstract

Highlights: Hybrid PET-MRI was used in epilepsy surgery evaluation. Five new anatomical or functional lesions were identified by hybrid PET-MRI in 29 patients. All new PET-MRI lesions were clinically significant as potential epileptic foci. Our initial hybrid PET-MRI experience increased diagnostic yields. Abstract: Purpose: We aim to evaluate the utility/improved accuracy of hybrid PET/MR compared to current practice separate 3 T MRI and PET-CT imaging for localization of seizure foci. Method: In a pilot study, twenty-nine patients undergoing epilepsy surgery evaluation were imaged using PET/MR. This subject group had 29 previous clinical 3 T MRI as well as 12 PET-CT studies. Prior clinical PET and MR images were read sequentially while the hybrid PET/MR was concurrently read. Results: The median interval between hybrid PET/MR and prior imaging studies was 5 months (range 1–77 months). In 24 patients, there was no change in the read between the clinical exams and hybrid PET/MR while new anatomical or functional lesions were identified by hybrid PET/MR in 5 patients without significant clinical change. Four new anatomical MR lesions were seen with concordant PET findings. The remaining patient revealed a new abnormal PET lesion without an MR abnormality. All new PET/MR lesions were clinically significant with concordant EEG and/or SPECT results as potential epileptic foci. Conclusion: Our initial hybrid PET-MRI experience increased diagnostic yields for detection of potential epileptic lesions. This may be due to the unique advantage of improved co-registration and simultaneous review of both structural and functional data.