INTRODUCTION INTO CLINICAL PRACTICE IN UKRAINE OF A COMBINED PET-CT STUDY FOR THE DIAGNOSIS OF DRUG-RESISTANT EPILEPSY IN CHILDREN
DOI:
https://doi.org/10.32689/2663-0672-2023-5-5Keywords:
combined positron emission tomography with computed tomography, radiopharmaceutical, 18F-fluorodisoxyglucose, pharmacoresistant epilepsy, foci of hypometabolism.Abstract
Abstract. Background. To date, 70% of patients with epilepsy are treated with drug therapy due to its high rate of development and variability, but about 30% of patients remain pharmacoresistant. Epilepsy surgery has become a specialized area in neurosurgery, where surgical removal or disconnection of a part of the brain suspected to be an epileptogenic zone allows for complete cure or significant reduction in seizure frequency. Aim. The study aimed to analyze of modern scientific sources from available scientometric databases and the results of practical implementation of combined PET-CT examination in clinical practice in Ukraine. Materials and methods: the analysis of modern scientific sources from available scientometric databases and the results of practical implementation of combined PET-CT examination in clinical practice in Ukraine. Results. The data on the use of combined PET-CT examination for the diagnosis of drug-resistant epilepsy in children are analyzed and presented. It was shown that postoperative success directly depends on how well the epilepsy focus was localized, due to the specific preoperative examination of the patient. Currently, diagnostics is based primarily on the study of the clinical phenomenology of the pathological process, the detection of structural changes in brain substance by magnetic resonance imaging (MRI) or computed tomography (CT), as well as the determination of the nature and localization of abnormalities in the bioelectrical activity of the brain using electroencephalography. MRI findings do not always coincide with clinical electroencephalographic findings, causing some difficulties in differential diagnosis. Therefore, when epileptic activity cannot be localized by standard diagnostic methods, the use of positron emission tomography with computed tomography (PET/CT) has been widely studied recently to investigate molecular and cellular disorders of the brain and to expand the possibilities for studying epileptogenesis and individualizing the diagnosis of epilepsy in children. The paper presents the first experience of introducing combined PET/CT as a neuroimaging method for epilepsy in children into clinical practice in Ukraine. Conclusions. The use of 18F-fluorodeoxyglucose to assess the state of the cortex and basal nuclei in PET/CT is the optimal method for preoperative diagnosis of children with pharmacoresistant epilepsy.
References
Sukprakun C., Tepmongkol S. Nuclear imaging for localization and surgical outcome prediction in epilepsy: A review of latest discoveries and future perspectives. Frontiers in neurology. 2022. Vol. 13. P. 1083775. https://doi.org/10.3389/fneur.2022.1083775.
Prevalence of epilepsy in Morocco: A population-based study / Souirti Z. et al. Epilepsia open, 2023. Vol. 8. № 4. P. 1340–1349. https://doi.org/10.1002/epi4.12802.
Drug-Resistant Epilepsy and Surgery / Sheng J. et al. Current neuropharmacology. 2018. Vol. 16. № 1. P. 17–28. https://doi.org/10.2174/1570159X15666170504123316.
GBD 2016 Epilepsy Collaborators. Global, regional, and national burden of epilepsy, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet. Neurology. 2019. Vol. 18. № 4. P. 357–375. https://doi.org/10.1016/S1474-4422(18)30454-X.
Shkumat N. A., Vali R., Shammas A. Clinical evaluation of reconstruction and acquisition time for pediatric 18F-FDG brain
PET using digital PET/CT. Pediatric radiology. 2020. Vol. 50. № 7. P. 966–972. https://doi.org/10.1007/s00247-020-04640-1.
Utility of Absolute Quantification in Non-lesional Extratemporal Lobe Epilepsy Using FDG PET/MR Imaging / Shkumat N. A. et al. Frontiers in neurology. 2020. Vol. 11. P. 54. https://doi.org/10.3389/fneur.2020.00054.
A deep learning framework for 18F-FDG PET imaging diagnosis in pediatric patients with temporal lobe epilepsy / Zhang Q. et al. European journal of nuclear medicine and molecular imaging. 2021. Vol. 48. № 8. P. 2476–2485. https://doi.org/10.1007/s00259-020-05108-y.
Nano-delivery systems as a promising therapeutic potential for epilepsy: Current status and future perspectives / Movahedpour A. et al. CNS neuroscience & therapeutics. 2023. Vol. 29. № 11. P. 3150–3159. https://doi.org/10.1111/cns.14355.
Validation of FDG-PET datasets of normal controls for the extraction of SPM-based brain metabolism maps / Caminiti S. P. et al. European journal of nuclear medicine and molecular imaging. 2021. Vol. 48. № 8. P. 2486–2499. https://doi.org/10.1007/s00259-020-05175-1.
Utility of hybrid PET/MRI multiparametric imaging in navigating SEEG placement in refractory epilepsy / Zhang M. et al. Seizure, 2020. Vol. 81. P. 295–303. https://doi.org/10.1016/j.seizure.2020.08.027.
18F-FDG-PET hypometabolic pattern reveals multifocal epileptic foci despite limited unique stereotyped seizures / Taussig D. et al. Epilepsy research. 2021. Vol. 172. P. 106589. https://doi.org/10.1016/j.eplepsyres.2021.106589.
Impact of ictal subtraction SPECT and PET in presurgical evaluation / Peedicail J. S. et al. Acta neurologica Scandinavica. 2021. Vol. 143. № 3. P. 271–280. https://doi.org/10.1111/ane.13362.
Comparison of non-invasive imaging modalities in presurgical evaluation of temporal lobe epilepsy patients: a multicenter study / Habibabadi J. M. et al. Acta neurologica Belgica. 2021. Vol. 121. № 6. P. 1815–1821. https://doi.org/10.1007/s13760-020-01550-9.
Focal cortical hypermetabolism in atypical benign rolandic epilepsy / Curnow S. R. et al. Epilepsy research. 2020.
Vol. 161. P. 106288. https://doi.org/10.1016/j.eplepsyres.2020.106288.
Interictal and postictal 18F-FDG PET/CT in epileptogenic zone localization / Carvalho M. S. et al. Radiologia brasileira. 2022. Vol. 55. № 5. P. 273–279. https://doi.org/10.1590/0100-3984.2021.0141.
EANM procedure guidelines for brain PET imaging using [18F]FDG, version 3 / Guedj E.et al. European journal of nuclear
medicine and molecular imaging. 2022. Vol. 49. № 2. P. 632–651. https://doi.org/10.1007/s00259-021-05603-w.
Suppiah S., Didier M. A., Vinjamuri S. The who, when, why, and how of PET amyloid imaging in management of alzheimer’s
disease-review of literature and interesting images. Diagnostics (Basel, Switzerland). 2019. Vol. 9. № 2. P. 65. https://doi.
org/10.3390/diagnostics9020065.
Khalaf A. M., Nadel H. R. Dahmoush H. M. Simultaneously Acquired MRI Arterial Spin-Labeling and Interictal FDGPET
Improves Diagnosis of Pediatric Temporal Lobe Epilepsy. AJNR. American journal of neuroradiology. 2022. Vol. 43. № 3.
P. 468–473. https://doi.org/10.3174/ajnr.A7421.
Objective PET study of glucose metabolism asymmetries in children with epilepsy: Implications for normal brain
development / Pilli V. K. et al. Human brain mapping. 2019. Vol. 40. № 1. P. 53–64. https://doi.org/10.1002/hbm.24354.
Performance of PET imaging for the localization of epileptogenic zone in patients with epilepsy: a meta-analysis / Niu N.
et al. European radiology. 2021. Vol. 31. № 8. P. 6353–6366. https://doi.org/10.1007/s00330-020-0а7645-4.
Chemistry for Positron Emission Tomography: Recent Advances in 11 C, 18 F-, 13 N-, and 15 O-Labeling Reactions /
Deng X. et al. Angewandte Chemie (International ed. in English). 2019. Vol. 58. № 9. P. 2580–2605. https://doi.org/10.1002/ anie.201805501.
Seizure Outcome After Surgery for Refractory Epilepsy Diagnosed by 18F-fluorodeoxyglucose positron emission
tomography (18F-FDG PET/MRI): A Systematic Review and Meta-Analysis / Guo et al. J. World neurosurgery. 2023. Vol. 173.
P. 34–43. https://doi.org/10.1016/j.wneu.2023.01.114.
