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Updated: Aug 13, 2026
Radiotracer Administration for High Temporal Resolution Positron Emission Tomography of the Human Brain: Application to FDG-fPET
Published on: October 22, 2019
Relationship between bilateral temporal hypometabolism and EEG findings for mesial temporal lobe epilepsy: analysis
Mi Ae Kim1, Kyoung Heo, Min Kyung Choo
1Department of Neurology, Yonsei University College of Medicine, Severance Hospital, Shinchon-dong 134, Seoul 120-752, Republic of Korea.
Purpose:
To investigate the clinical significance of bilateral temporal hypometabolism (BTH) for patients with mesial temporal lobe epilepsy (MTLE) by using statistical parametric mapping (SPM).
Methods:
Interictal 18F-FDG PET scans were performed for 29 patients with surgically treated MTLE. Clinical data, interictal epileptiform discharges (IEDs), ictal scalp EEG and intracarotid amobarbital test (IAT) were analyzed. To assess an 18F-FDG PET image, an SPM analysis as well as visual interpretation were applied.
Results:
In 9 of 29 patients, the 18F-FDG PET scan revealed BTH by the SPM analysis, while only 3 patients showed BTH by the visual assessment. When the patients were classified into the unilateral temporal hypometabolism (UTH) and BTH groups based on the SPM results, bitemporal IEDs occurred significantly more frequently in the BTH group than in the UTH group (66.7% versus 22.2%). Bilateral independent seizure onset seen on the scalp EEG and bitemporal epilepsy were present only in the BTH group. Lateralized ictal onset was present less frequently in the BTH group than in the UTH group (44.4% versus 83.3%). There was no statistically significant difference in age at onset, duration of epilepsy, generalized seizure, history of febrile convulsion and CNS infection, lateralization throughout the whole tracing, lateralization on the IAT test, and surgical outcome between the UTH and BTH groups.
Conclusion:
Bilaterality of the EEG findings correlated with BTH on 18F-FDG PET by the SPM method. Our results suggest that analysis of 18F-FDG PET by using SPM may have a role in predicting those patients with bitemporal excitability or bitemporal independent epileptogenicity, and these patients should be monitored carefully.
Insights
Statistical parametric mapping (SPM) analysis of 18F-FDG PET scans identified bilateral temporal hypometabolism (BTH) in mesial temporal lobe epilepsy (MTLE) patients. BTH correlated with bilateral EEG findings, suggesting bitemporal excitability.
Area of Science:
- Neuroscience
- Medical Imaging
- Epilepsy Research
Background:
- Mesial temporal lobe epilepsy (MTLE) is a common form of epilepsy.
- Accurate identification of epileptogenic zones is crucial for surgical treatment.
- Bilateral temporal hypometabolism (BTH) on 18F-FDG PET may indicate complex epilepsy patterns.
Purpose of the Study:
- To evaluate the clinical significance of BTH in MTLE patients using SPM.
- To correlate BTH findings with electroencephalography (EEG) and other clinical data.
Main Methods:
- Retrospective analysis of 29 surgically treated MTLE patients.
- Interictal 18F-FDG PET scans assessed using SPM and visual interpretation.
- Correlation with clinical data, interictal epileptiform discharges (IEDs), scalp EEG, and intracarotid amobarbital test (IAT).
Main Results:
- SPM analysis detected BTH in 9/29 patients, compared to 3/29 by visual assessment.
- BTH group showed significantly higher rates of bitemporal IEDs (66.7%) and bilateral independent seizure onset.
- Unilateral temporal hypometabolism (UTH) group had more frequent lateralized ictal onset (83.3%).
Conclusions:
- SPM analysis of 18F-FDG PET is more sensitive in detecting BTH than visual assessment.
- BTH correlates with bilateral EEG findings, indicating potential bitemporal epileptogenicity.
- SPM-based PET analysis may aid in identifying MTLE patients requiring closer monitoring for bitemporal involvement.
