Automated Online Quantification Method for 18F-FDG Positron Emission Tomography/CT Improves Detection of the Epileptogenic Zone in Patients with Pharmacoresistant Epilepsy
AimsTo assess the validity of an online method to quantitatively evaluate cerebral hypometabolism in patients with pharmacoresistant focal epilepsy as a complement to the visual analysis of the 18F-FDG positron emission tomography (PET)/CT exam.MethodsA total of 39 patients with pharmacoresistant ep...
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doaj-a8989b3487d7481e9b9042a14ff257172020-11-25T00:37:06ZengFrontiers Media S.A.Frontiers in Neurology1664-22952017-09-01810.3389/fneur.2017.00453259074Automated Online Quantification Method for 18F-FDG Positron Emission Tomography/CT Improves Detection of the Epileptogenic Zone in Patients with Pharmacoresistant EpilepsyVanessa Cristina Mendes Coelho0Marcia E. Morita1Barbara J. Amorim2Celso Darío Ramos3Clarissa L. Yasuda4Helder Tedeschi5Enrico Ghizoni6Fernando Cendes7Neurology/Epilepsy, Unicamp – University of Campinas, Campinas, BrazilNeurology/Epilepsy, Unicamp – University of Campinas, Campinas, BrazilNuclear Medicine Department, Unicamp – University of Campinas, Campinas, BrazilNuclear Medicine Department, Unicamp – University of Campinas, Campinas, BrazilNeurology/Epilepsy, Unicamp – University of Campinas, Campinas, BrazilNeurosurgery/Epilepsy, Unicamp – University of Campinas, Campinas, BrazilNeurosurgery/Epilepsy, Unicamp – University of Campinas, Campinas, BrazilNeurology/Epilepsy, Unicamp – University of Campinas, Campinas, BrazilAimsTo assess the validity of an online method to quantitatively evaluate cerebral hypometabolism in patients with pharmacoresistant focal epilepsy as a complement to the visual analysis of the 18F-FDG positron emission tomography (PET)/CT exam.MethodsA total of 39 patients with pharmacoresistant epilepsy and probable focal cortical dysplasia [22 patients with frontal lobe epilepsy (FLE) and 17 with temporal lobe epilepsy (TLE)] underwent a presurgical evaluation including EEG, video-EEG, MRI, and 18F-FDG PET/CT. We conducted the automated quantification of their 18F-FDG PET/CT data and compared the results with those of the visual-PET analysis conducted by experienced nuclear medicine physicians. For each patient group, we calculated Cohen’s Kappa coefficient for the visual and quantitative analyses, as well as each method’s sensitivity, specificity, and positive and negative predictive values.ResultsFor the TLE group, both the visual and quantitative analyses showed high agreement. Thus, although the quantitative analysis could be used as a complement, the visual analysis on its own was consistent and precise. For the FLE group, on the other hand, the visual analysis categorized almost half of the cases as normal, revealing very low agreement. For those patients, the quantitative analysis proved critical to identify the focal hypometabolism characteristic of the epileptogenic zone. Our results suggest that the quantitative analysis of 18F-FDG PET/CT data is critical for patients with extratemporal epilepsies, and especially those with subtle MRI findings. Furthermore, it can easily be used during the routine clinical evaluation of 18F-FDG PET/CT exams.SignificanceOur results show that quantification of 18F-FDG PET is an informative complementary method that can be added to the routine visual evaluation of patients with subtle lesions, particularly those in the frontal lobes.http://journal.frontiersin.org/article/10.3389/fneur.2017.00453/fullepilepsyfocal cortical dysplasiapositron emission tomography imagingquantificationautomated data analysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Vanessa Cristina Mendes Coelho Marcia E. Morita Barbara J. Amorim Celso Darío Ramos Clarissa L. Yasuda Helder Tedeschi Enrico Ghizoni Fernando Cendes |
spellingShingle |
Vanessa Cristina Mendes Coelho Marcia E. Morita Barbara J. Amorim Celso Darío Ramos Clarissa L. Yasuda Helder Tedeschi Enrico Ghizoni Fernando Cendes Automated Online Quantification Method for 18F-FDG Positron Emission Tomography/CT Improves Detection of the Epileptogenic Zone in Patients with Pharmacoresistant Epilepsy Frontiers in Neurology epilepsy focal cortical dysplasia positron emission tomography imaging quantification automated data analysis |
author_facet |
Vanessa Cristina Mendes Coelho Marcia E. Morita Barbara J. Amorim Celso Darío Ramos Clarissa L. Yasuda Helder Tedeschi Enrico Ghizoni Fernando Cendes |
author_sort |
Vanessa Cristina Mendes Coelho |
title |
Automated Online Quantification Method for 18F-FDG Positron Emission Tomography/CT Improves Detection of the Epileptogenic Zone in Patients with Pharmacoresistant Epilepsy |
title_short |
Automated Online Quantification Method for 18F-FDG Positron Emission Tomography/CT Improves Detection of the Epileptogenic Zone in Patients with Pharmacoresistant Epilepsy |
title_full |
Automated Online Quantification Method for 18F-FDG Positron Emission Tomography/CT Improves Detection of the Epileptogenic Zone in Patients with Pharmacoresistant Epilepsy |
title_fullStr |
Automated Online Quantification Method for 18F-FDG Positron Emission Tomography/CT Improves Detection of the Epileptogenic Zone in Patients with Pharmacoresistant Epilepsy |
title_full_unstemmed |
Automated Online Quantification Method for 18F-FDG Positron Emission Tomography/CT Improves Detection of the Epileptogenic Zone in Patients with Pharmacoresistant Epilepsy |
title_sort |
automated online quantification method for 18f-fdg positron emission tomography/ct improves detection of the epileptogenic zone in patients with pharmacoresistant epilepsy |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neurology |
issn |
1664-2295 |
publishDate |
2017-09-01 |
description |
AimsTo assess the validity of an online method to quantitatively evaluate cerebral hypometabolism in patients with pharmacoresistant focal epilepsy as a complement to the visual analysis of the 18F-FDG positron emission tomography (PET)/CT exam.MethodsA total of 39 patients with pharmacoresistant epilepsy and probable focal cortical dysplasia [22 patients with frontal lobe epilepsy (FLE) and 17 with temporal lobe epilepsy (TLE)] underwent a presurgical evaluation including EEG, video-EEG, MRI, and 18F-FDG PET/CT. We conducted the automated quantification of their 18F-FDG PET/CT data and compared the results with those of the visual-PET analysis conducted by experienced nuclear medicine physicians. For each patient group, we calculated Cohen’s Kappa coefficient for the visual and quantitative analyses, as well as each method’s sensitivity, specificity, and positive and negative predictive values.ResultsFor the TLE group, both the visual and quantitative analyses showed high agreement. Thus, although the quantitative analysis could be used as a complement, the visual analysis on its own was consistent and precise. For the FLE group, on the other hand, the visual analysis categorized almost half of the cases as normal, revealing very low agreement. For those patients, the quantitative analysis proved critical to identify the focal hypometabolism characteristic of the epileptogenic zone. Our results suggest that the quantitative analysis of 18F-FDG PET/CT data is critical for patients with extratemporal epilepsies, and especially those with subtle MRI findings. Furthermore, it can easily be used during the routine clinical evaluation of 18F-FDG PET/CT exams.SignificanceOur results show that quantification of 18F-FDG PET is an informative complementary method that can be added to the routine visual evaluation of patients with subtle lesions, particularly those in the frontal lobes. |
topic |
epilepsy focal cortical dysplasia positron emission tomography imaging quantification automated data analysis |
url |
http://journal.frontiersin.org/article/10.3389/fneur.2017.00453/full |
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