title: The Utility of Positron Emission Tomography in Epilepsy.
abstract: The role of fludeoxyglucose F 18 positron emission tomography (PET) in the presurgical evaluation of patients with medically intractable epilepsy continues to be refined. The purpose of this study was to systematically review the literature to assess the diagnostic accuracy and utility of PET in this setting. Thirty-nine studies were identified through MEDLINE and EMBASE databases that met the inclusion criteria. In adult patients, PET hypometabolism showed a 56 to 90% agreement with seizure onset localized by intracranial electroencephalogram (pediatric: 21 to 86%). In temporal lobe epilepsy patients with good surgical outcome, PET displayed moderate to high sensitivity in localizing the seizure focus (range: 71 to 89%). The sensitivity increased by 8 to 23% when PET results were combined with magnetic resonance imaging or electroencephalogram. PET has been shown to affect patient management by improving the guidance of intracranial electrodes placement, altering the decision to perform surgery, or excluding patients from further evaluation.
authors.affiliation: 1Epilepsy Program,Department of Clinical Neurological Sciences,Western University,London Health Sciences Center,London,Ontario.
authors.forename: Jorge G
authors.initials: JG
authors.lastname: Burneo
authors.affiliation: 2Program in Evidence-Based Care,Cancer Care Ontario,McMaster University,Juravinski Hospital Site,Hamilton,Ontario.
authors.forename: Raymond
authors.initials: R
authors.lastname: Poon
authors.affiliation: 2Program in Evidence-Based Care,Cancer Care Ontario,McMaster University,Juravinski Hospital Site,Hamilton,Ontario.
authors.forename: Sarah
authors.initials: S
authors.lastname: Kellett
authors.affiliation: 3Division of Neurology,Department of Pediatrics,Hospital for Sick Children and University of Toronto,Toronto,Ontario.
authors.forename: O Carter
authors.initials: OC
authors.lastname: Snead
mesh_terms: D000818:Animals; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000175:diagnosis / Q000601:surgery*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D049268:Positron-Emission Tomography; D016896:Treatment Outcome
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: Electroencephalography; epilepsy; epilepsy - pediatric; epilepsy surgery; positron emission tomography