title: FDG-PET and volumetric MRI in the evaluation of patients with partial epilepsy.
abstract: We performed interictal FDG-PET- and MRI-based hippocampal volumetric measurements on 18 adult patients with complex partial epilepsy of temporal lobe origin in whom we had identified their ictal focus by video-telemetry EEG. Sixteen patients (89%) had regional hypometabolism, 11 (61%) had focal 1.5-tesla T2-weighted MRI (two structural abnormalities, nine hippocampal formation [HF] increased T2 signal), and nine (50%) had absolute HF atrophy ipsilateral to the temporal ictal focus. Ten (55%) had abnormal L/R HF ratios, nine ipsilateral to the EEG focus. All patients with abnormal MRI volumetric studies had focal PET abnormalities. Only seven had both abnormal HF volume ratios and T2 MRI (all increased HF T2 signal). There was a significant correlation between hippocampal volume and inferior mesial and lateral temporal lobe cerebral metabolic rate of glucose asymmetry index (p < 0.01), suggesting that hypometabolism may reflect hippocampal atrophy. PET is more sensitive than MRI volumetry in identifying the ictal focus but does not provide additional information when HF atrophy is present.
authors: Epilepsy Research Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD.
authors: W D
authors: WD
authors: Gaillard
authors: S
authors: S
authors: Bhatia
authors: S Y
authors: SY
authors: Bookheimer
authors: S
authors: S
authors: Fazilat
authors: S
authors: S
authors: Sato
authors: W H
authors: WH
authors: Theodore
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D003847:Deoxyglucose / Q000031:analogs & derivatives*; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D014055:Tomography, Emission-Computed
chemical_list: D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose