Planned ictal FDG PET imaging for localization of extratemporal epileptic foci.
OBJECTIVE
This work demonstrates the feasibility of planned ictal positron emission tomography (PET) with [18F]fluoro-2-deoxy-glucose (FDG) for localization of epileptic activity in patients with frequent partial seizures of extratemporal origin.


METHODS
Ictal PET imaging was performed in four patients (two men and two women, ages 28-61) with continuous or very frequent (every 3-15 min) partial seizures. All patients had abnormalities apparent on magnetic resonance (MR) or computed tomographic (CT) imaging, two with extensive brain lesions that precluded precise localization of the seizure focus with interictal PET or single-photon emission tomography (SPECT) imaging.


RESULTS
Ictal PET imaging demonstrated a restricted area of focal hypermetabolism concordant with surface electroencephalographic (EEG) recording in all cases. The PET images were registered to MR imaging data for further anatomic localization of hypermetabolic regions in three cases. The ictal PET data were used to guide neurosurgical intervention in one case.


CONCLUSIONS
We conclude that planned ictal PET imaging may be a useful and potentially superior approach to ictal SPECT for identifying the epileptic focus in a selected group of patients with continuous or frequent simple partial seizures.
Meltzer
C C
CC
Department of Radiology, University of Pittsburgh, Pennsylvania, USA. meltzer@radserv.arad.upmc.edu
Adelson
P D
PD
Brenner
R P
RP
Crumrine
P K
PK
Van Cott
A
A
Schiff
D P
DP
Townsend
D W
DW
Scheuer
M L
ML
D000293:Adolescent; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014055:Tomography, Emission-Computed; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18; D005947:Glucose