Is central benzodiazepine receptor imaging useful for the identification of epileptogenic foci in localization-related epilepsies?
In the presurgical evaluation of patients with partial epilepsies, the most extensively studied functional neuro-imaging modality to define the origin of seizure onset is fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET). Generally, this technique reveals a widespread zone of interictal glucose hypometabolism in the region of the epileptogenic focus. However, the technique may miss the epileptogenic region and FDG PET abnormalities may extend beyond the seizure onset zone. Consequently, for the precise identification of epileptogenic regions more specific imaging probes than FDG are warranted. This review considers the clinical utility of iomazenil (IMZ) SPET and flumazenil (FMZ) PET for the precise localization of epileptogenic foci in partial epilepsy syndromes.
Goethals
Ingeborg
I
Division of Nuclear Medicine, Polikliniek 7, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. ingeborg.goethals@rug.ac.be
Van de Wiele
Christophe
C
Boon
Paul
P
Dierckx
Rudi
R
D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism; D004828:Epilepsies, Partial / Q000000981:diagnostic imaging* / Q000378:metabolism*; D005442:Flumazenil / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D005462:Fluorine Radioisotopes / Q000493:pharmacokinetics; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D007457:Iodine Radioisotopes / Q000493:pharmacokinetics; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D011963:Receptors, GABA-A / Q000378:metabolism*; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000378:metabolism; D014055:Tomography, Emission-Computed / Q000379:methods
D005462:Fluorine Radioisotopes; D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D011963:Receptors, GABA-A; D019788:Fluorodeoxyglucose F18; D005442:Flumazenil; C063038:iomazenil