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Article Dans Une Revue European Journal of Nuclear Medicine and Molecular Imaging Année : 2020

Relationship between PET metabolism and SEEG epileptogenicity in focal lesional epilepsy

Résumé

Purpose: This study aims to evaluate the performance of 18 F-FDG PET for distinguishing the epileptogenic zone (EZ) from propagation and non-involved zones at brain area level, as defined using stereo-EEG, in patients with pharmacoresistant epilepsy due to malformations of cortical development (MCD). Additionally, we seek to determine the relationship between 18 F-FDG-PET data and post-surgical seizure outcome. Methods: Thirty-eight patients with MCD were explored with 18 F-FDG PET and stereo-EEG. We compared PET metabolism of each patient to a control-population of healthy subjects. Based on MRI and SEEG, we separated 4 distinct zones at individual level: lesional, epileptogenic non-lesional, propagation, and non-involved. Then, we analysed: 1) difference of PET metabolism within these four distinct zones; 2) performance of PET in defining the EZ within the SEEG-sampled areas; 3) relation between extension of PET hypometabolism and post-surgical seizure outcome. Results: We found: 1) a gradient of PET hypometabolism from non-involved to propagation, then to epileptogenic and lesional zones (p<0.001); 2) good performance of PET in defining the EZ (AUC of ROC curve = 0.82); 3) poorer post-surgical prognosis associated with PET hypometabolism extension beyond SEEG sampling (p=0.024). Conclusion: 18 F-FDG-PET has good accuracy in determining EZ in patients with MCD even if the hypometabolism is not limited to the EZ. Furthermore, hypometabolic extension is unfavourably associated with post-surgical prognosis.
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Dates et versions

hal-02863852 , version 1 (09-02-2022)

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Stanislas Lagarde, Mohamed Boucekine, Aileen Mcgonigal, Romain Carron, Didier Scavarda, et al.. Relationship between PET metabolism and SEEG epileptogenicity in focal lesional epilepsy. European Journal of Nuclear Medicine and Molecular Imaging, 2020, ⟨10.1007/s00259-020-04791-1⟩. ⟨hal-02863852⟩
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