title: Evaluation of focus laterality in temporal lobe epilepsy: a quantitative study comparing double inversion-recovery MR imaging at 3T with FDG-PET.
abstract: OBJECTIVE
  To quantitatively compare the diagnostic capability of double inversion-recovery (DIR) with F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) for detection of seizure focus laterality in temporal lobe epilepsy (TLE).
  
  
  METHODS
  This study was approved by the institutional review board, and written informed consent was obtained. Fifteen patients with TLE and 38 healthy volunteers were enrolled. All magnetic resonance (MR) images were acquired using a 3T-MRI system. Voxel-based analysis (VBA) was conducted for FDG-PET images and white matter segments of DIR images (DIR-WM) focused on the whole temporal lobe (TL) and the anterior part of the temporal lobe (ATL). Distribution of hypometabolic areas on FDG-PET and increased signal intensity areas on DIR-WM were evaluated, and their laterality was compared with clinically determined seizure focus laterality. Correct diagnostic rates of laterality were evaluated, and agreement between DIR-WM and FDG-PET was assessed using κ statistics.
  
  
  RESULTS
  Increased signal intensity areas on DIR-WM were located at the vicinity of the hypometabolic areas on FDG-PET, especially in the ATL. Correct diagnostic rates of seizure focus laterality for DIR-WM (0.80 and 0.67 for the TL and the ATL, respectively) were slightly higher than those for FDG-PET (0.67 and 0.60 for the TL and the ATL, respectively). Agreement of laterality between DIR-WM and FDG-PET was substantial for the TL and almost perfect for the ATL (κ = 0.67 and 0.86, respectively).
  
  
  CONCLUSIONS
  High agreement in localization between DIR-WM and FDG-PET and nearly equivalent detectability of them show us an additional role of MRI in TLE.
authors.affiliation: Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Emiko
authors.initials: E
authors.lastname: Morimoto
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Okada
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Kanagaki
authors.forename: Akira
authors.initials: A
authors.lastname: Yamamoto
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Fushimi
authors.forename: Riki
authors.initials: R
authors.lastname: Matsumoto
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Takaya
authors.forename: Akio
authors.initials: A
authors.lastname: Ikeda
authors.forename: Takeharu
authors.initials: T
authors.lastname: Kunieda
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kikuchi
authors.forename: Dominik
authors.initials: D
authors.lastname: Paul
authors.forename: Susumu
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Takahashi
authors.forename: Kaori
authors.initials: K
authors.lastname: Togashi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D013702:Temporal Lobe / Q000473:pathology / Q000503:physiopathology; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: Double inversion-recovery; Epileptogenic focus laterality; FDG-PET; Temporal lobe epilepsy; Voxel-based analysis