title: Neuroimaging techniques in epilepsy.
abstract: OBJECTIVE
  To review state-of-the-art neuroimaging modalities in epilepsy and their clinical applications.
  
  
  METHODS
  PubMed literature searches to March 2010, using the following key words: 'epilepsy', 'positron emission tomography (PET)', 'single photon emission computed tomography (SPECT)', 'MR volumetry', 'diffusion tensor imaging', and 'functional MR imaging'.
  
  
  METHODS
  All articles including neuroimaging techniques in epilepsy were included in the review.
  
  
  RESULTS
  High-field magnetic resonance imaging is fundamental for high-resolution structural imaging. Functional radionuclide imaging (positron emission tomography/single-photon emission computed tomography) can provide additional information to improve overall accuracy, and show good results with high concordance rates in temporal lobe epilepsy. Magnetic resonance spectroscopy is a useful adjunct consistently demonstrating changing metabolites in the epileptogenic region. Magnetic resonance volumetric imaging shows excellent sensitivity and specificity for temporal lobe epilepsy but thus far it has been inconsistent for extratemporal epilepsy. Diffusion tensor imaging with tractography allows visualisation of specific tracts such as connections with the language and visual cortex to enhance preoperative evaluation. Functional magnetic resonance imaging using blood oxygen level-dependent activation techniques is mainly used in presurgical planning for the high-sensitivity mapping of the eloquent cortex. Both contrast-bolus and arterial spin labelling magnetic resonance perfusion imaging show good correlation with clinical lateralisation of seizure disorder.
  
  
  CONCLUSIONS
  Structural imaging is essential in localisation and lateralisation of the seizure focus. Functional radionuclide imaging or advanced magnetic resonance imaging techniques can provide complementary information when an epileptogenic substrate is not identified or in the presence of non-concordant clinical and structural findings.
authors.affiliation: Department of Radiology, Tuen Mun Hospital, Hong Kong.
authors.forename: Vincent
authors.initials: V
authors.lastname: Lai
authors.forename: Henry K
authors.initials: HK
authors.lastname: Mak
authors.forename: Ada W Y
authors.initials: AW
authors.lastname: Yung
authors.forename: W Y
authors.initials: WY
authors.lastname: Ho
authors.forename: K N
authors.initials: KN
authors.lastname: Hung
mesh_terms: D056324:Diffusion Tensor Imaging / Q000379:methods; D004827:Epilepsy / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods*; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods