Dataset Information

Hypometabolic patterns of focal cortical dysplasia in PET-MRI co-registration imaging: a retrospective evaluation in a series of 83 patients.

ABSTRACT:

Objective

To characterize the PET-MRI co-registration of hypometabolic patterns in focal cortical dysplasia (FCD) types I and II and provide some suggestions in presurgical evaluation of epilepsy surgery.

Methods

We retrospectively analyzed PET-MRI co-registration imaging data from a cohort of 83 epilepsy patients with histologically confirmed FCD types I and II. Hypometabolic patterns were classified into 4 types: bottom of sulcus hypometabolism (BOSH), single island of sulcus hypometabolism (SIOS), single gyrus or sulcus hypometabolism (SGOS), and multiple gyri and sulci hypometabolism (MGOS).

Results

Most of cases that were overlooked by conventional MRI and PET evaluation but positive in PET-MRI co-registration were focalized lesions in dorsolateral frontal lobe (9/15) and FCD type IIa was the most prevalent pathological type (11/15). The FCD histological types (p = 0.027) and locations (p < 0.001) were independent predictors of PET-MRI co-registration hypometabolic patterns. Focalized hypometabolic patterns (BOSH, SIOS, SGOS) were primarily observed in the frontal lobe (33/39) and FCD type II (43/62) and extensive pattern (MGOS) in temporal lobe (18/20) and FCD type I (16/21; p < 0.005).

Conclusion

PET-MRI co-registration enhanced the detection of FCD type IIa compared with conventional MRI and PET reading. The hypometabolic patterns of FCD type I and temporal lobe FCD were more extensive than those of FCD type II and frontal lobe FCD, respectively. The predilection of focalized hypometabolic patterns in frontal lobe FCD suggested that subtle lesions should be checked carefully in patients with suspected frontal lobe epilepsy.

SUBMITTER: Wang X

PROVIDER: S-EPMC10561385 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Hypometabolic patterns of focal cortical dysplasia in PET-MRI co-registration imaging: a retrospective evaluation in a series of 83 patients.

Wang Xiu X Hu Wenhan W Shao Xiaoqiu X Zheng Zhong Z Ai Lin L Sang Lin L Zhang Chao C Zhang Jian-Guo JG Zhang Kai K

Frontiers in neuroscience 20230925

<h4>Objective</h4>To characterize the PET-MRI co-registration of hypometabolic patterns in focal cortical dysplasia (FCD) types I and II and provide some suggestions in presurgical evaluation of epilepsy surgery.<h4>Methods</h4>We retrospectively analyzed PET-MRI co-registration imaging data from a cohort of 83 epilepsy patients with histologically confirmed FCD types I and II. Hypometabolic patterns were classified into 4 types: bottom of sulcus hypometabolism (BOSH), single island of sulcus hy ...[more]

PMID: 37817803

Similar Datasets

Project description:Purpose: The superior frontal sulcus (SFS), located in the prefrontal and premotor cortex, is considered as one of the common locations of focal cortical dysplasia (FCD). However, the characteristics of seizures arising from this area are incompletely known. The primary purpose of this study was to investigate the clinical features and the epileptic networks of seizures originating from the SFS. Methods: We included seventeen patients with type II FCD within the SFS. SFS was identified both visually and automatically. Semiological features were evaluated and grouped. Interictal 18FDG-PET imaging in all patients was compared to controls using statistical parametric mapping (SPM-PET). In those subjects with stereoelectroencephalography (SEEG), two different quantitative intracranial electroencephalography analyses were applied. Finally, the locations of the SFS-related hypometabolic regions and epileptogenic zones (EZs) were transformed into standard space for group analysis. Results: We identified two semiological groups. Group 1 (9/17) showed elementary motor signs (head version and tonic posturing), while group 2 (8/17) exhibited complex motor behavior (fear, hypermotor, and ictal pouting). Based on SPM-PET, an SFS-supplementary motor area (SMA) epileptic propagation network was found in group 1, and an SFS-middle cingulate cortex (MCC)-pregenual anterior cingulate cortex (pACC) propagation network was discovered in group 2. Intracranial EEG analysis suggested similar affected structures with high epileptogenicity. The SFS-related hypometabolic regions and EZs in these groups showed a posterior-anterior spatial relationship. Conclusions: Even though originating from the spatially restricted cortex, SFS seizures can be divided into two groups based on semiological features. The SFS-SMA and SFS-MCC-pACC epileptic propagation networks may play pivotal roles in the generation of different semiologies. The posterior-anterior spatial relationship of both hypometabolic regions and EZs provides potentially useful information for distinguishing different types of SFS seizures and surgical evaluation.

Project description:ObjectiveFluorine-18-fluorodeoxyglucose-positron emission tomography (FDG-PET) is routinely used for presurgical evaluation in many epilepsy centers. Hypometabolic characteristics have been extensively examined in prior studies, but the metabolic patterns associated with specific pathological types of drug-resistant epilepsy remain to be fully defined. This study was developed to explore the relationship between metabolic patterns or characteristics and surgical outcomes in type I and II focal cortical dysplasia (FCD) patients based on results from a large cohort.MethodsData from individuals who underwent epilepsy surgery from 2014 to 2019 with a follow-up duration of over 3 years and a pathological classification of type I or II FCD in our hospital were retrospectively analyzed. Hypometabolic patterns were quantitatively identified via statistical parametric mapping (SPM) and qualitatively analyzed via visual examination of PET-MRI co-registration images. Univariate analyses were used to explore the relationship between metabolic patterns and surgical outcomes.ResultsIn total, this study included data from 210 patients. Following SPM calculations, four hypometabolic patterns were defined including unilobar, multi-lobar, and remote patterns as well as cases where no pattern was evident. In type II FCD patients, the unilobar pattern was associated with the best surgical outcomes (p = 0.014). In visual analysis, single gyrus (p = 0.032) and Clear-cut hypometabolism edge (p = 0.040) patterns exhibited better surgery outcomes in the type II FCD group.ConclusionsPET metabolic patterns are well-correlated with the prognosis of type II FCD patients. However, similar correlations were not observed in type I FCD, potentially owing to the complex distribution of the epileptogenic region.Plain language summaryIn this study, we demonstrated that FDG-PET was a crucial examination for patients with FCD, which was a common cause of epilepsy. We compared the surgical prognosis for patients with different hypometabolism distribution patterns and found that clear and focal abnormal region in PET was correlated with good surgical outcome in type II FCD patients.

Project description:OBJECTIVE:Focal cortical dysplasia (FCD) lesion detection and subtyping remain challenging on conventional MRI. New diffusion models such as the spherical mean technique (SMT) and neurite orientation dispersion and density imaging (NODDI) provide measurements that potentially produce more specific maps of abnormal tissue microstructure. This study aims to assess the SMT and NODDI maps for computational and radiological lesion characterization compared to standard fractional anisotropy (FA) and mean diffusivity (MD). METHODS:SMT, NODDI, FA, and MD maps were calculated for 33 pediatric patients with suspected FCD (18 histologically confirmed). Two neuroradiologists scored lesion visibility on clinical images and diffusion maps. Signal profile changes within lesions and homologous regions were quantified using a surface-based approach. Diffusion parameter changes at multiple cortical depths were statistically compared between FCD type IIa and type IIb. RESULTS:Compared to fluid-attenuated inversion recovery (FLAIR) or T1-weighted imaging, lesions conspicuity on NODDI intracellular volume fraction (ICVF) maps was better/equal/worse in 5/14/14 patients, respectively, while on SMT intra-neurite volume fraction (INVF) in 3/3/27. Compared to FA or MD, lesion conspicuity on the ICVF was better/equal/worse in 27/4/2, while on the INVF in 20/7/6. Quantitative signal profiling demonstrated significant ICVF and INVF reductions in the lesions, whereas SMT microscopic mean, radial, and axial diffusivities were significantly increased. FCD type IIb exhibited greater changes than FCD type IIa. No changes were detected on FA or MD profiles. SIGNIFICANCE:FCD lesion-specific signal changes were found in ICVF and INVF but not in FA and MD maps. ICVF and INVF showed greater contrast than FLAIR in some cases and had consistent signal changes specific to FCD, suggesting that they could improve current presurgical pediatric epilepsy imaging protocols and can provide features useful for automated lesion detection.

Dataset Information

Hypometabolic patterns of focal cortical dysplasia in PET-MRI co-registration imaging: a retrospective evaluation in a series of 83 patients.

Objective

Methods

Results

Conclusion

Publications

Hypometabolic patterns of focal cortical dysplasia in PET-MRI co-registration imaging: a retrospective evaluation in a series of 83 patients.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets