title: Initial experience in hybrid PET-MRI for evaluation of refractory focal onset epilepsy.
abstract: OBJECTIVE
  We aim to evaluate the utility/improved accuracy of hybrid PET/MR compared to current practice separate 3T MRI and PET-CT imaging for localization of seizure foci.
  
  
  METHODS
  In a pilot study, twenty-nine patients undergoing epilepsy surgery evaluation were imaged using PET/MR. This subject group had 29 previous clinical 3T MRI as well as 12 PET-CT studies. Prior clinical PET and MR images were read sequentially while the hybrid PET/MR was concurrently read.
  
  
  RESULTS
  The median interval between hybrid PET/MR and prior imaging studies was 5 months (range 1-77 months). In 24 patients, there was no change in the read between the clinical exams and hybrid PET/MR while new anatomical or functional lesions were identified by hybrid PET/MR in 5 patients without significant clinical change. Four new anatomical MR lesions were seen with concordant PET findings. The remaining patient revealed a new abnormal PET lesion without an MR abnormality. All new PET/MR lesions were clinically significant with concordant EEG and/or SPECT results as potential epileptic foci.
  
  
  CONCLUSIONS
  Our initial hybrid PET-MRI experience increased diagnostic yields for detection of potential epileptic lesions. This may be due to the unique advantage of improved co-registration and simultaneous review of both structural and functional data.
authors.affiliation: Department of Neurology, University of North Carolina, Chapel Hill, NC, United States; Department of Neurosurgery, University of North Carolina, Chapel Hill, NC, United States. Electronic address: shinhw@neurology.unc.edu.
authors.forename: Hae W
authors.initials: HW
authors.lastname: Shin
authors.affiliation: Department of Radiology, University of North Carolina, Chapel Hill, NC, United States.
authors.forename: Valerie
authors.initials: V
authors.lastname: Jewells
authors.affiliation: Department of Radiology, University of North Carolina, Chapel Hill, NC, United States.
authors.forename: Arif
authors.initials: A
authors.lastname: Sheikh
authors.affiliation: Department of Biostatistics, University of North Carolina, Chapel Hill, NC, United States.
authors.forename: Jingwen
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Biostatistics, University of North Carolina, Chapel Hill, NC, United States.
authors.forename: Hongtu
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Department of Radiology, University of North Carolina, Chapel Hill, NC, United States.
authors.forename: Hongyu
authors.initials: H
authors.lastname: An
authors.affiliation: Department of Radiology, University of North Carolina, Chapel Hill, NC, United States.
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.affiliation: Department of Radiology, University of North Carolina, Chapel Hill, NC, United States.
authors.forename: Dinggang
authors.initials: D
authors.lastname: Shen
authors.affiliation: Department of Neurosurgery, University of North Carolina, Chapel Hill, NC, United States.
authors.forename: Eldad
authors.initials: E
authors.lastname: Hadar
authors.affiliation: Department of Neurology, University of North Carolina, Chapel Hill, NC, United States; Department of Radiology, University of North Carolina, Chapel Hill, NC, United States.
authors.forename: Weili
authors.initials: W
authors.lastname: Lin
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D003933:Diagnosis; D000069279:Drug Resistant Epilepsy / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D004569:Electroencephalography; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D064847:Multimodal Imaging / Q000379:methods*; D010865:Pilot Projects; D049268:Positron-Emission Tomography / Q000379:methods*; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D012640:Seizures / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D015899:Tomography, Emission-Computed, Single-Photon
keywords: 3T MRI and PET-CT; Epilepsy; Epilepsy surgery evaluation; Hybrid PET-MRI