PET/MRI helpful in difficult cases of epilepsy: Study

France: Hybrid PET/MR can help in identifying brain lesions causing seizures in patients with drug-resistant epilepsy in cases of failure of standard approaches, reveals a recent study. The findings of the study, published in the journal Epilepsy Research, offer hope for patients for whom surgery is often the only treatment option as it allows to optimize the presurgical workup and increases the proportion of successful surgery even in the more complex cases.

Previous studies have shown hybrid PET/MR to be a promising tool in focal drug-resistant epilepsy, however, the additional value for the detection of epileptogenic lesions and surgical decision-making remains to be established.

For the study, Francine Chassoux, GHU Paris-Sainte-Anne, Paris, France, and colleagues retrospectively compared 18F-FDG PET/MR images with those obtained by a previous 18F-FDG PET co-registered with MRI (PET+MR) in 25 consecutive patients (16 females, 13-60 years) investigated for focal drug-resistant epilepsy.

Visual analysis was performed by two readers blinded from imaging modalities, asked to assess the technical characteristics (co-registration, quality of images), the confidence in results, the location of PET abnormalities and the presence of a structural lesion on MRI. Clinical impact on surgical strategy and outcome was assessed independently. 

"Hybrid PET/MR may improve the detection of epileptogenic lesions, allowing to optimize the presurgical work-up and to increase the proportion of successful surgery even in the more complex cases," wrote the study authors.

Reference:

Anthime Flaus, Charles Mellerio, Sebastian Rodrigo, Vincent Brulon, Vincent Lebon, Francine Chassoux. 18F-FDG PET/MR IN FOCAL EPILEPSY: A NEW STEP FOR IMPROVING THE DETECTION OF EPILEPTOGENIC LESIONS. Epilepsy Research, 2021, 106819, ISSN 0920-1211, https://doi.org/10.1016/j.eplepsyres.2021.106819.