Roland Sebastian Talanow MD, PhD, Presenter: Nothing to Disclose

Guiyun Wu MD, Abstract Co-Author: Nothing to Disclose

To investigate the metabolic behavior of different disease processes and pathology in epilepsy.

FDG-PET images of 280 patients with refractory epilepsy who have been surgically treated were retrospectively analyzed. The image findings were compared with the surgical pathology reports.

For all the pathology type reported, the major manifestations are regional hypometabolism. 92.1% (153/166) of patients with sclerosis demonstrated FDG hypometabolism. 5.4% (9/166) were normometabolic and 2.4% (4/166) had increased FDG uptake (hypermetabolism). 84.5% (60/71) of patients with MCD demonstrated hypometabolism, 8.4% (6/71) hypermetabolism and 7% (5/71) showed normal metabolism. All of the neoplasms (24/24) and inflammatory process (25/25) showed regional hypometabolism.

The study suggests that although the major findings on FDG-PET in patients with refractory epilepsy are hypometabolic, attention should also be paid in patients with regional hypermetabolism, which might sufficiently localize the seizure origin. It might be worthwhile to repeat the study if no regions of hypometabolism are found and EEG is suggesting frequent spiking activity.

The majority of patients with refractory epilepsy demonstrate hypometabolism on FDG PET. Repeating the study might be worthwile in patients with normometabolism and frequent spiking activity on EEG.

Talanow, R, Wu, G, PET Manifestation in Different Pathology in Epilepsy.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8011950.html