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Updated: Jan 26, 2026

A Pipeline for 3D Multimodality Image Integration and Computer-assisted Planning in Epilepsy Surgery
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A Pipeline for 3D Multimodality Image Integration and Computer-assisted Planning in Epilepsy Surgery

Published on: May 20, 2016

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Focal Cortical Dysplasia and Refractory Epilepsy: Role of Multimodality Imaging and Outcome of Surgery

S Jayalakshmi1, S K Nanda2, S Vooturi2

  • 1From the Departments of Neurology (S.J., S.K.N., S.V.) sita_js@hotmail.com sita.js@gmail.com.

AJNR. American Journal of Neuroradiology
|April 20, 2019
PubMed
Abstract

Insights

Multimodality imaging, including MR imaging and FDG-PET, improves seizure freedom in patients with drug-resistant epilepsy caused by focal cortical dysplasia (FCD). FDG-PET is particularly effective for type I FCD, enhancing surgical outcomes.

Area of Science:

  • Neurology
  • Medical Imaging
  • Epileptology

Background:

  • Focal cortical dysplasia (FCD) is a primary cause of drug-resistant epilepsy.
  • Accurate presurgical localization of FCD is crucial for successful epilepsy surgery.

Purpose of the Study:

  • To assess the effectiveness of presurgical noninvasive multimodality imaging in guiding epilepsy surgery for FCD.
  • To determine the impact of different imaging techniques on long-term seizure freedom.

Main Methods:

  • Retrospective analysis of 188 patients with FCD and refractory epilepsy.
  • Evaluation of MR imaging, FDG-PET, and ictal SPECT for FCD detection.
  • Correlation of imaging findings with surgical outcomes and histopathology.

Main Results:

  • Multimodality imaging achieved 97.5% sensitivity for localizing FCD and predicting seizure freedom.
  • FDG-PET demonstrated the highest sensitivity (78.2%) among individual modalities.
  • MR imaging sensitivity was lower for type I FCD (60.8%) compared to type II FCD (84.8%).

Conclusions:

  • Presurgical localization using at least two imaging modalities significantly improves seizure freedom rates in FCD-related epilepsy.
  • FDG-PET is the most sensitive modality for predicting seizure freedom, especially in cases of type I FCD.

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