Use of statistical parametric mapping of ¹⁸F-FDG-PET in frontal lobe epilepsy

 

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Summary:

Aim: Evaluation of the use of statistical parametrical mapping (SPM) of FDG-PET for seizure lateralization in frontal lobe epilepsy. Patients: 38 patients with suspected frontal lobe epilepsy supported by clinical findings and video-EEG monitoring. Method: Statistical parametrical maps were generated by subtraction of individual scans from a control group, formed by 16 patients with negative neurological/psychiatric history and no abnormalities in the MR scan. The scans were also analyzed visually as well as semiquantitatively by manually drawn ROIs. Results: SPM showed a better accordance to the results of surface EEG monitoring compared with visual scan analysis and ROI quantification. In comparison with intracranial EEG recordings, the best performance was achieved by combining the ROI based quantification with SPM analysis. Conclusion: These findings suggest that SPM analysis of FDG-PET data could be a useful as complementary tool in the evaluation of seizure focus lateralization in patients with supposed frontal lobe epilepsy.

Zusammenfassung:

Ziel dieser Studie war die Evaluierung von statistischem parametrischem Mapping (SPM) der FDG-PET für die Lateralisierung epileptogenen Foki bei Patienten mit Frontallappenepilepsie. Patienten: Eingeschlossen wurden 38 Patienten, bei denen anhand klinischer Kriterien und Ergebnisse des Video-EEG-Monitorings die Diagnose einer Frontallappenepilepsie gestellt worden war. Methode: Mittels SPM-Analyse wurden PET-Aufnahmen jedes Patienten mit denen der Kontrollgruppe verglichen und hypometabole Hirnareale ermittelt. Als Kontrollgruppe dienten 16 Patienten mit negativer neurologischer und psychiatrischer Anamnese sowie unauffälligem Befund der cMRT. Ergebnisse: SPM zeigte im Vergleich mit den Ergebnissen der visuellen Beurteilung und ROI-Quantifizierung bessere Übereinstimmung mit dem Oberflächen-EEG. Die Korrelation der Ergebnisse aller Analysemethoden mit intrakraniellem EEG zeigte die höchste Sensitivität der FDG-PET bei der Kombination ROI-Quantifizierung und SPM. Schlussfolgerung: Unsere Ergebnisse bestätigen die Wertigkeit der SPM zu Analyse von FDG-PET-Daten. Die Methode kann als ein zusätzliches Analyseverfahren für die Lateralisierung des epileptogenen Fokus bei Patienten mit Frontallappenepilepsie eingesetzt werden.

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