Assessment of the role of FDG PET in the diagnosis and management of children with refractory epilepsy.
OBJECTIVE
We performed a retrospective analysis of the results of FDG PET scans in children with refractory epilepsy referred to our centre over an 8-year period, with a view to ascertaining the impact of FDG PET on subsequent patient management.


METHODS
A questionnaire was used to assess the impact of FDG PET scan on diagnosis, management and clinical decision-making processes for epilepsy surgery from the managing clinician's perspective. FDG PET scan results were also compared with MRI, EEG and SPECT results and coded according to whether the FDG PET scan provided independent information and localisation of epileptogenic regions.


RESULTS
A total of 118 eligible patients under the age of 14 years were identified, with questionnaires being completed on 113 evaluable patients (96%). The pre-PET management plan consisted of consideration for surgery in 92 patients (81%) and medical therapy for the remaining 21 patients (19%). Managing physicians rated FDG PET as providing information additional to that obtained with other investigations regarding epileptogenic sites in 88 patients (77%). FDG PET had either a minor or a major impact on clinical management in 58 patients (51%), principally with regard to surgical candidacy.


CONCLUSIONS
FDG PET has a definite role in the assessment of paediatric patients with refractory epilepsy who are being considered for surgery. In the future, analysis of FDG PET data in specific subpopulations of children with refractory epilepsy may lead to novel insights regarding aetiology.
Ollenberger
Glenn P
GP
Department of Nuclear Medicine and Centre for PET, University of Melbourne, Melbourne, Australia.
Byrne
Amanda J
AJ
Berlangieri
Salvatore U
SU
Rowe
Christopher C
CC
Pathmaraj
Kunthi
K
Reutens
David C
DC
Berkovic
Samuel F
SF
Scheffer
Ingrid E
IE
Scott
Andrew M
AM
D000927:Anticonvulsants / Q000627:therapeutic use; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007223:Infant; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods* / Q000706:statistics & numerical data; D011300:Preoperative Care / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D017211:Treatment Failure; D016896:Treatment Outcome
D000927:Anticonvulsants; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18