title: Glucose Metabolic Profile by Visual Assessment Combined with Statistical Parametric Mapping Analysis in Pediatric Patients with Epilepsy.
abstract: PET with18F-FDG has been used for presurgical localization of epileptogenic foci; however, in nonsurgical patients, the correlation between cerebral glucose metabolism and clinical severity has not been fully understood. The aim of this study was to evaluate the glucose metabolic profile using18F-FDG PET/CT imaging in patients with epilepsy.Methods:One hundred pediatric epilepsy patients who underwent18F-FDG PET/CT, MRI, and electroencephalography examinations were included. Fifteen age-matched controls were also included.18F-FDG PET images were analyzed by visual assessment combined with statistical parametric mapping (SPM) analysis. The absolute asymmetry index (|AI|) was calculated in patients with regional abnormal glucose metabolism.Results:Visual assessment combined with SPM analysis of18F-FDG PET images detected more patients with abnormal glucose metabolism than visual assessment only. The |AI| significantly positively correlated with seizure frequency (P< 0.01) but negatively correlated with the time since last seizure (P< 0.01) in patients with abnormal glucose metabolism. The only significant contributing variable to the |AI| was the time since last seizure, in patients both with hypometabolism (P= 0.001) and with hypermetabolism (P= 0.005). For patients with either hypometabolism (P< 0.01) or hypermetabolism (P= 0.209), higher |AI| values were found in those with drug resistance than with seizure remission. In the post-1-y follow-up PET studies, a significant change of |AI| (%) was found in patients with clinical improvement compared with those with persistence or progression (P< 0.01).Conclusion:18F-FDG PET imaging with visual assessment combined with SPM analysis could provide cerebral glucose metabolic profiles in nonsurgical epilepsy patients. |AI| might be used for evaluation of clinical severity and progress in these patients. Patients with a prolonged period of seizure freedom may have more subtle (or no) metabolic abnormalities on PET. The clinical value of PET might be enhanced by timing the scan closer to clinical seizures.
authors.affiliation: Department of Nuclear Medicine, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China.|Zhejiang University Medical PET Center, Hangzhou, China.|Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China.|Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China.
authors.forename: Yuankai
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Pediatrics, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China; and.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Feng
authors.affiliation: Department of Nuclear Medicine, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China.|Zhejiang University Medical PET Center, Hangzhou, China.|Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China.|Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Wu
authors.affiliation: Department of Nuclear Medicine, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China.|Zhejiang University Medical PET Center, Hangzhou, China.|Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China.|Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China.
authors.forename: Haifeng
authors.initials: H
authors.lastname: Hou
authors.affiliation: Department of Nuclear Medicine, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China.|Zhejiang University Medical PET Center, Hangzhou, China.|Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China.|Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China.
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Ji
authors.affiliation: Department of Nuclear Medicine, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China.|Zhejiang University Medical PET Center, Hangzhou, China.|Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China.|Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of Nuclear Medicine, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China.|Zhejiang University Medical PET Center, Hangzhou, China.|Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China.|Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Department of Nuclear Medicine, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China.|Zhejiang University Medical PET Center, Hangzhou, China.|Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China.|Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Pediatrics, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China; and.
authors.forename: Haiying
authors.initials: H
authors.lastname: Cheng
authors.affiliation: Department of Pediatrics, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China; and.
authors.forename: Liuyan
authors.initials: L
authors.lastname: Gao
authors.affiliation: Department of Clinical Epidemiology & Biostatistics, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Zexin
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Nuclear Medicine, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China.|Zhejiang University Medical PET Center, Hangzhou, China.|Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China.|Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Nuclear Medicine, The Second Hospital of Zhejiang University School of Medicine, Hangzhou, China meitian@zju.edu.cn.|Zhejiang University Medical PET Center, Hangzhou, China.|Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China.|Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Tian
mesh_terms: D002648:Child; D004827:Epilepsy / Q000000981:diagnostic imaging / Q000378:metabolism*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D055432:Metabolomics; D000072078:Positron Emission Tomography Computed Tomography; D012189:Retrospective Studies
chemical_list: D019788:Fluorodeoxyglucose F18; D005947:Glucose
keywords: epilepsy; glucose metabolism; positron emission tomography (PET); statistical parametric mapping (SPM)