Siqi Zhang, Jie Hu, Zhigang Qi, Chenyang Yao, Bixiao Cui, Jingjuan Wang, Zhenming Wang, Jie Lu
{"title":"18f -氟脱氧葡萄糖和18kda转运蛋白在难治性癫痫术前定位中的PET/MRI混合成像","authors":"Siqi Zhang, Jie Hu, Zhigang Qi, Chenyang Yao, Bixiao Cui, Jingjuan Wang, Zhenming Wang, Jie Lu","doi":"10.1111/cns.70251","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>Surgery remains the only curative option for a third of refractory epilepsy patients, though success depends on precise localization of the epileptogenic zone (EZ). This study aims to assess the clinical value of hybrid <sup>18</sup>F-FDG and <sup>18</sup>F-DPA-714 PET/MRI for accurate localization and precise boundary delineation.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>The refractory epilepsy patients who underwent surgery at Xuanwu Hospital from November 2022 to November 2023 were retrospectively recruited. Preoperative simultaneous <sup>18</sup>F-FDG and <sup>18</sup>F-DPA-714 PET/MRI imaging were analyzed using the asymmetry index (AI) and a 4-point visual score, with the surgical site and pathological findings serving as the gold standard.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 43 patients (mean age: 26.30 ± 8.37 years, male: 28) were included in this study. Lesion localization accuracy within the EZ was 76.7% for <sup>18</sup>F-FDG PET/MRI, 69.8% for <sup>18</sup>F-DPA-714 PET/MRI, and 60.5% for conventional MRI (<i>p</i> = 0.26). In 26 MRI-positive cases, conventional MRI accurately localized all lesions within the EZ, with three cases showing negative findings on <sup>18</sup>F-FDG images and six on <sup>18</sup>F-DPA-714. Among 17 MRI-negative patients, thirteen demonstrated positive results on hybrid PET/MRI. Additionally, <sup>18</sup>F-DPA-714 PET/MRI proved more effective in delineating lesion boundaries. Compared to <sup>18</sup>F-FDG, the AI score was significantly lower (0.25 ± 0.18 vs. 0.46 ± 0.19, <i>p</i> < 0.001), while the visual score was higher (4.00 ± 2.00 vs. 3.00 ± 0.00, <i>p</i> = 0.01).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p><sup>18</sup>F-DPA-714 PET/MRI can effectively complement conventional MRI in the preoperative assessment of refractory epilepsy, with localization accuracy on par with <sup>18</sup>F-FDG and enhanced capability in delineating lesion boundaries.</p>\n </section>\n </div>","PeriodicalId":154,"journal":{"name":"CNS Neuroscience & Therapeutics","volume":"31 2","pages":""},"PeriodicalIF":5.0000,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cns.70251","citationCount":"0","resultStr":"{\"title\":\"Hybrid PET/MRI Imaging of 18F-Fluorodeoxyglucose and 18-kDa Translocator Protein for Presurgical Localization in Refractory Epilepsy\",\"authors\":\"Siqi Zhang, Jie Hu, Zhigang Qi, Chenyang Yao, Bixiao Cui, Jingjuan Wang, Zhenming Wang, Jie Lu\",\"doi\":\"10.1111/cns.70251\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Purpose</h3>\\n \\n <p>Surgery remains the only curative option for a third of refractory epilepsy patients, though success depends on precise localization of the epileptogenic zone (EZ). This study aims to assess the clinical value of hybrid <sup>18</sup>F-FDG and <sup>18</sup>F-DPA-714 PET/MRI for accurate localization and precise boundary delineation.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>The refractory epilepsy patients who underwent surgery at Xuanwu Hospital from November 2022 to November 2023 were retrospectively recruited. Preoperative simultaneous <sup>18</sup>F-FDG and <sup>18</sup>F-DPA-714 PET/MRI imaging were analyzed using the asymmetry index (AI) and a 4-point visual score, with the surgical site and pathological findings serving as the gold standard.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 43 patients (mean age: 26.30 ± 8.37 years, male: 28) were included in this study. Lesion localization accuracy within the EZ was 76.7% for <sup>18</sup>F-FDG PET/MRI, 69.8% for <sup>18</sup>F-DPA-714 PET/MRI, and 60.5% for conventional MRI (<i>p</i> = 0.26). In 26 MRI-positive cases, conventional MRI accurately localized all lesions within the EZ, with three cases showing negative findings on <sup>18</sup>F-FDG images and six on <sup>18</sup>F-DPA-714. Among 17 MRI-negative patients, thirteen demonstrated positive results on hybrid PET/MRI. Additionally, <sup>18</sup>F-DPA-714 PET/MRI proved more effective in delineating lesion boundaries. Compared to <sup>18</sup>F-FDG, the AI score was significantly lower (0.25 ± 0.18 vs. 0.46 ± 0.19, <i>p</i> < 0.001), while the visual score was higher (4.00 ± 2.00 vs. 3.00 ± 0.00, <i>p</i> = 0.01).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p><sup>18</sup>F-DPA-714 PET/MRI can effectively complement conventional MRI in the preoperative assessment of refractory epilepsy, with localization accuracy on par with <sup>18</sup>F-FDG and enhanced capability in delineating lesion boundaries.</p>\\n </section>\\n </div>\",\"PeriodicalId\":154,\"journal\":{\"name\":\"CNS Neuroscience & Therapeutics\",\"volume\":\"31 2\",\"pages\":\"\"},\"PeriodicalIF\":5.0000,\"publicationDate\":\"2025-02-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cns.70251\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"CNS Neuroscience & Therapeutics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/cns.70251\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"CNS Neuroscience & Therapeutics","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/cns.70251","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
Hybrid PET/MRI Imaging of 18F-Fluorodeoxyglucose and 18-kDa Translocator Protein for Presurgical Localization in Refractory Epilepsy
Purpose
Surgery remains the only curative option for a third of refractory epilepsy patients, though success depends on precise localization of the epileptogenic zone (EZ). This study aims to assess the clinical value of hybrid 18F-FDG and 18F-DPA-714 PET/MRI for accurate localization and precise boundary delineation.
Methods
The refractory epilepsy patients who underwent surgery at Xuanwu Hospital from November 2022 to November 2023 were retrospectively recruited. Preoperative simultaneous 18F-FDG and 18F-DPA-714 PET/MRI imaging were analyzed using the asymmetry index (AI) and a 4-point visual score, with the surgical site and pathological findings serving as the gold standard.
Results
A total of 43 patients (mean age: 26.30 ± 8.37 years, male: 28) were included in this study. Lesion localization accuracy within the EZ was 76.7% for 18F-FDG PET/MRI, 69.8% for 18F-DPA-714 PET/MRI, and 60.5% for conventional MRI (p = 0.26). In 26 MRI-positive cases, conventional MRI accurately localized all lesions within the EZ, with three cases showing negative findings on 18F-FDG images and six on 18F-DPA-714. Among 17 MRI-negative patients, thirteen demonstrated positive results on hybrid PET/MRI. Additionally, 18F-DPA-714 PET/MRI proved more effective in delineating lesion boundaries. Compared to 18F-FDG, the AI score was significantly lower (0.25 ± 0.18 vs. 0.46 ± 0.19, p < 0.001), while the visual score was higher (4.00 ± 2.00 vs. 3.00 ± 0.00, p = 0.01).
Conclusion
18F-DPA-714 PET/MRI can effectively complement conventional MRI in the preoperative assessment of refractory epilepsy, with localization accuracy on par with 18F-FDG and enhanced capability in delineating lesion boundaries.
期刊介绍：
CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.
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