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. 2022 May;49(6):1930-1938.
doi: 10.1007/s00259-021-05657-w. Epub 2021 Dec 23.

Morphometric analysis program and quantitative positron emission tomography in presurgical localization in MRI-negative epilepsies: a simultaneous PET/MRI study

Kun Guo #  1 , Jingjuan Wang #  1 , Zhenming Wang  1 , Yihe Wang  2 , Bixiao Cui  1 , Guoguang Zhao  2 , Jie Lu  3   4
Affiliations

Morphometric analysis program and quantitative positron emission tomography in presurgical localization in MRI-negative epilepsies: a simultaneous PET/MRI study

Kun Guo et al. Eur J Nucl Med Mol Imaging. 2022 May.

Abstract

Purpose: To evaluate morphometric analysis program (MAP) and quantitative positron emission tomography (QPET) in epileptogenic zone (EZ) identification using a simultaneous positron emission tomography/magnetic resonance imaging (PET/MRI) system in MRI-negative epilepsies.

Methods: Seventy-one localization-related MRI-negative epilepsies who underwent preoperative simultaneous PET/MRI examination and surgical resection were enrolled retrospectively. MAP was performed on a T1-weighted volumetric sequence, and QPET was analyzed using statistical parametric mapping (SPM) with comparison to age- and gender-matched normal controls. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MAP, QPET, MAP + QPET, and MAP/QPET in EZ localization were assessed. The correlations between surgical outcome and modalities concordant with cortical resection were analyzed.

Results: Forty-five (63.4%) patients had Engel I seizure outcomes. The sensitivity, specificity, PPV, and NPV of MAP were 64.4%, 69.2%, 78.3%, and 52.9%, respectively. The sensitivity, specificity, PPV, NPV of QPET were 73.3%, 65.4%, 78.6%, and 58.6%, respectively. MAP + QPET, defined as two tests concordant with cortical resection, had reduced sensitivity (53.3%) but increased specificity (88.5%) relative to individual tests. MAP/QPET, defined as one or both tests concordant with cortical resection, had increased sensitivity (86.7%) but reduced specificity (46.2%) relative to individual tests. The regions determined by MAP, QPET, MAP + QPET, or MAP/QPET concordant with cortical resection were significantly associated with the seizure-free outcome.

Conclusion: QPET has a superior sensitivity than MAP, while the combined MAP + QPET obtained from a simultaneous PET/MRI scanner may improve the specificity of the diagnostic tests in EZ localization coupled with the preferable surgical outcome in MRI-negative epilepsies.

Keywords: Epilepsy; Localization; MAP; PET/MRI; Quantitative PET.

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References

    1. Malmgren K, Krýsl D. Epilepsy: long-term outcomes in MRI-negative patients with epilepsy. Nat Rev Neurol. 2017;13:132–3. - DOI - PubMed
    1. Pellinen J, Kuzniecky R, Doyle W, Devinsky O, Dugan P. MRI-negative PET-negative epilepsy long-term surgical outcomes: a single-institution retrospective review. Epilepsy Res. 2020;67:106481. - DOI
    1. Wang ZI, Jones SE, Jaisani Z, Najm IM, Prayson RA, Burgess RC, et al. Voxel-based morphometric magnetic resonance imaging (MRI) postprocessing in MRI-negative epilepsies. Ann Neurol. 2015;77:1060–75. - DOI - PubMed - PMC
    1. Sun K, Ren Z, Yang D, Wang X, Yu T, Ni D, et al. Voxel-based morphometric MRI post-processing and PET/MRI co-registration reveal subtle abnormalities in cingulate epilepsy. Epilepsy Res. 2021;171:106568. - DOI - PubMed
    1. Wagner J, Weber B, Urbach H, Elger CE, Huppertz HJ. Morphometric MRI analysis improves detection of focal cortical dysplasia type II. Brain. 2011;134:2844–54. - DOI - PubMed

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