title: Surgical decision making in temporal lobe epilepsy: a comparison of [(18)F]FDG-PET, MRI, and EEG.
abstract: OBJECTIVE
  The goals of this work were (1) to determine the effect of [(18)F]fluorodeoxyglucose positron emission tomography (FDG-PET), MRI, and EEG on the decision to perform temporal lobe epilepsy (TLE) surgery, and (2) to determine if FDG-PET, MRI, or EEG predicts surgical outcome.
  
  
  METHODS
  All PET scans ordered (2000-2010) for epilepsy or seizures were tabulated. Medical records were investigated to determine eligibility and collect data. Statistical analysis included odds ratios, κ statistics, univariate analysis, and logistic regression.
  
  
  RESULTS
  Of the 186 patients who underwent FDG-PET, 124 had TLE, 50 were surgical candidates, and 34 had surgery with post-operative follow-up. Median length of follow-up was 24 months. MRI, FDG-PET, and EEG were significant predictors of surgical candidacy (P<0.001) with odds ratios of 42.8, 20.4, and 6.3, respectively. FDG-PET was the only significant predictor of postoperative outcome (P<0.01).
  
  
  CONCLUSIONS
  MRI showed a trend toward having the most influence on surgical candidacy, but only FDG-PET predicted surgical outcome.
authors.affiliation: Nuclear Medicine Section, Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. astruck@uwhealth.org
authors.forename: Aaron F
authors.initials: AF
authors.lastname: Struck
authors.forename: Lance T
authors.initials: LT
authors.lastname: Hall
authors.forename: John M
authors.initials: JM
authors.lastname: Floberg
authors.forename: Scott B
authors.initials: SB
authors.lastname: Perlman
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Dulli
mesh_terms: D000328:Adult; D003657:Decision Making; D004569:Electroencephalography / Q000379:methods*; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D011237:Predictive Value of Tests; D014055:Tomography, Emission-Computed / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D019788:Fluorodeoxyglucose F18