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Title: Bottom-of-sulcus dysplasia: the role of 18F-FDG PET in identifying a focal surgically remedial epileptic lesion.
Austin Authors: Berlangieri, Salvatore U ;Mito, R;Semmelroch, M;Pedersen, M;Jackson, G
Affiliation: Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, Australia
Molecular Imaging and Therapy
Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia
Issue Date: 15-Dec-2020
Date: 2020-12-15
Publication information: European Journal of Hybrid Imaging 2020; 4(1): 23
Abstract: Bottom-of-sulcus dysplasia (BOSD) is a type of focal cortical dysplasia and an important cause of intractable epilepsy. While the MRI features of BOSD have been well documented, the contribution of PET to the identification of these small lesions has not been widely explored. The aim of this study was to investigate the role of F-18 fluorodeoxyglucose (18F-FDG) PET in the identification of BOSD. Twenty patients with BOSD underwent both 18F-FDG PET and structural MRI scans as part of preoperative planning for surgery. Visual PET analysis was performed, and patients were classified as positive if they exhibited a focal or regional hypometabolic abnormality, or negative in the absence of a hypometabolic abnormality. MRI data were reviewed to determine if any structural abnormality characteristic of BOSD were observed before and after co-registration with PET findings. PET detected hypometabolic abnormalities consistent with the seizure focus location in 95% (19/20) of cases. Focal abnormalities were detected on 18F-FDG PET in 12/20 (60%) patients, while regional hypometabolism was evident in 7/20 (35%). BOSD lesions were missed in 20% (4/20) of cases upon initial review of MRI scans. Co-registration of 18F-FDG PET with MRI enabled detection of the BOSD in all four cases where the lesion was initially missed. Our findings show that 18F-FDG PET provides additional clinical value in the localisation and detection of BOSD lesions, when used in conjunction with MRI.
DOI: 10.1186/s41824-020-00092-w
ORCID: 0000-0003-3945-2293
Journal: European Journal of Hybrid Imaging
PubMed URL: 34191213
Type: Journal Article
Subjects: 18F-FDG PET
Bottom-of-sulcus dysplasia
Focal cortical dysplasia
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