'Double cortex' sign on FDG-PET/CT in diffuse band heterotopia

Area of Science:

• Neuroimaging
• Neurology
• Medical Diagnostics

Background:

• F-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) is vital for pre-surgical evaluation of drug-resistant epilepsy.
• It complements Magnetic Resonance Imaging (MRI) in assessing grey matter heterotopias.

Purpose of the Study:

• To illustrate the characteristic metabolic abnormality pattern in diffuse band heterotopia (DBH), also known as double cortex syndrome.
• To highlight the utility of FDG-PET/CT in identifying the 'double cortex' sign.

Main Methods:

• Utilized FDG-PET/CT imaging.
• Correlated metabolic activity with anatomical structures using concurrent CT for anato-metabolic coregistration.

Main Results:

• Demonstrated characteristic metabolic activity in both the heterotopic inner cortical band and the overlying true cortex.
• The 'double cortex' sign on FDG-PET was observed due to this dual metabolic activity.
• Concurrent CT provided precise anatomical localization of the metabolic findings.

Conclusions:

• FDG-PET/CT imaging effectively visualizes the metabolic signature of diffuse band heterotopia.
• The 'double cortex' sign on FDG-PET/CT is a key indicator for diagnosing DBH.
• This imaging modality enhances pre-surgical planning for patients with epilepsy and grey matter abnormalities.