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Voxel-based morphometric MRI post-processing and PET/MRI co-registration reveal subtle abnormalities in cingulate

Ke Sun1, Zhiwei Ren1, Dongju Yang2

  • 1Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.

Epilepsy Research
|February 20, 2021
PubMed
Summary
This summary is machine-generated.

Advanced MRI post-processing and PET/MRI co-registration effectively identify subtle abnormalities in cingulate epilepsy (CE) patients with negative conventional MRI scans. Combining these techniques significantly improves presurgical evaluation for better surgical targeting.

Keywords:
Cingulate epilepsyFocal cortical dysplasiaInvasive electroencephalographyMagnetic resonance imagingMagnetoencephalographyMorphometric analysis programPET/MRI co-registration

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Area of Science:

  • Neurology
  • Medical Imaging
  • Epilepsy Surgery

Background:

  • Cingulate epilepsy (CE) presents diagnostic challenges in presurgical evaluation due to heterogeneous semiology and non-localizing scalp EEG.
  • Conventional MRI is often negative in CE, complicating the identification of seizure onset zones.

Purpose of the Study:

  • To evaluate advanced neuroimaging techniques, specifically MRI post-processing using morphometric analysis program (MAP) and 18F-fluorodeoxyglucose-positron emission tomography-MRI (PET/MRI) co-registration, for patients with MRI-negative CE.

Main Methods:

  • Retrospective analysis of 10 patients with MRI-negative CE who underwent surgical resection and were seizure-free for over 12 months.
  • Application and comparison of MAP and PET/MRI co-registration with invasive EEG (iEEG) findings.
  • Analysis of scalp EEG, magnetoencephalography (MEG), and pathological findings.

Main Results:

  • MAP detected subtle abnormalities in 70% of patients, while PET/MRI co-registration identified focal hypometabolism in 50%.
  • Combining MAP and PET/MRI co-registration improved detection rates to 90% for seizure onset zones.
  • Pathology revealed various types of focal cortical dysplasia (FCD) in all patients.

Conclusions:

  • MAP and PET/MRI co-registration are valuable tools for identifying subtle FCD in MRI-negative CE.
  • The combination of these advanced imaging methods significantly enhances the detection of epileptic abnormalities for surgical planning.
  • Routine incorporation of MAP and PET/MRI co-registration is recommended for presurgical evaluation in CE.