Full-Length Original Research
Evaluation of focus laterality in temporal lobe epilepsy: A quantitative study comparing double inversion-recovery MR imaging at 3T with FDG-PET
Article first published online: 7 OCT 2013
Wiley Periodicals, Inc. © 2013 International League Against Epilepsy
Volume 54, Issue 12, pages 2174–2183, December 2013
How to Cite
Epilepsia, 54(12):2174–2183, 2013
- Issue published online: 4 DEC 2013
- Article first published online: 7 OCT 2013
- Manuscript Accepted: 27 AUG 2013
- Health and Labor Sciences Research
- Comprehensive Research on Disability Health and Welfare
- Ministry of Health, Labor and Welfare, Japan
- Double inversion-recovery;
- Voxel-based analysis;
- Temporal lobe epilepsy;
- Epileptogenic focus laterality
To quantitatively compare the diagnostic capability of double inversion-recovery (DIR) with F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) for detection of seizure focus laterality in temporal lobe epilepsy (TLE).
This study was approved by the institutional review board, and written informed consent was obtained. Fifteen patients with TLE and 38 healthy volunteers were enrolled. All magnetic resonance (MR) images were acquired using a 3T-MRI system. Voxel-based analysis (VBA) was conducted for FDG-PET images and white matter segments of DIR images (DIR-WM) focused on the whole temporal lobe (TL) and the anterior part of the temporal lobe (ATL). Distribution of hypometabolic areas on FDG-PET and increased signal intensity areas on DIR-WM were evaluated, and their laterality was compared with clinically determined seizure focus laterality. Correct diagnostic rates of laterality were evaluated, and agreement between DIR-WM and FDG-PET was assessed using κ statistics.
Increased signal intensity areas on DIR-WM were located at the vicinity of the hypometabolic areas on FDG-PET, especially in the ATL. Correct diagnostic rates of seizure focus laterality for DIR-WM (0.80 and 0.67 for the TL and the ATL, respectively) were slightly higher than those for FDG-PET (0.67 and 0.60 for the TL and the ATL, respectively). Agreement of laterality between DIR-WM and FDG-PET was substantial for the TL and almost perfect for the ATL (κ = 0.67 and 0.86, respectively).
High agreement in localization between DIR-WM and FDG-PET and nearly equivalent detectability of them show us an additional role of MRI in TLE.