Emiko Morimoto MD, Presenter: Nothing to Disclose

Tomohisa Okada MD, PhD, Abstract Co-Author: Nothing to Disclose

Mitsunori Kanagaki MD, PhD, Abstract Co-Author: Nothing to Disclose

Akira Yamamoto MD, PhD, Abstract Co-Author: Nothing to Disclose

Yasutaka Fushimi MD, PhD, Abstract Co-Author: Nothing to Disclose

Riki Matsumoto MD, PhD, Abstract Co-Author: Nothing to Disclose

Shigetoshi Takaya MD, PhD, Abstract Co-Author: Nothing to Disclose

Akio Ikeda MD, PhD, Abstract Co-Author: Nothing to Disclose

Takeharu Kunieda MD, PhD, Abstract Co-Author: Nothing to Disclose

Takayuki Kikuchi MD, PhD, Abstract Co-Author: Nothing to Disclose

Dominik Paul, Abstract Co-Author: Employee, Siemens AG

Susumu Miyamoto MD, PhD, Abstract Co-Author: Nothing to Disclose

Ryosuke Takahashi MD, PhD, Abstract Co-Author: Nothing to Disclose

Kaori Togashi MD, PhD, Abstract Co-Author: Research Grant, Bayer AG Research Grant, DAIICHI SANKYO Group Research Grant, Eisai Co, Ltd Research Grant, FUJIFILM Holdings Corporation Research Grant, Nihon Medi-Physics Co, Ltd Research Grant, Shimadzu Corporation Research Grant, Toshiba Corporation Research Grant, Covidien AG

To quantitatively compare diagnostic capability of double inversion recovery (DIR) with fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) for detection of seizure focus laterality in temporal lobe epilepsy (TLE).

This study was approved by the institutional review board, and written informed consent was obtained. Fifteen TLE patients and 38 healthy volunteers were enrolled. All MR images were acquired using a 3T-MRI system. Voxel-based analysis was conducted for FDG-PET images and white matter segments of DIR images (DIR-WM) focused on the whole temporal lobe (TL) and the anterior part of the temporal lobe (ATL). Distribution of hypometabolic areas on FDG-PET and increased signal intensity areas on DIR-WM was evaluated, and their laterality was compared with clinically-determined seizure focus laterality. Correct diagnostic rates of laterality were evaluated, and agreement between DIR-WM and FDG-PET was assessed using κ statistics.

Increased signal intensity areas on DIR-WM were located at the vicinity of the hypometabolic areas on FDG-PET, especially in the ATL. Correct diagnostic rates of seizure focus laterality for DIR-WM (0.80 and 0.67 for the TL and the ATL, respectively) were slightly higher than those for FDG-PET (0.67 and 0.60 for the TL and the ATL, respectively). Agreement of laterality between DIR-WM and FDG-PET was substantial for the TL and almost perfect for the ATL (κ = 0.67 and 0.86, respectively).

High agreement in localization between DIR-WM and FDG-PET and nearly equivalent detectability of them show us an additional role of MRI in temporal lobe epilepsy.

For evaluation of seizure focus in TLE, DIR would play an indispensable role to avoid radiation exposure, especially in children, and when FDG-PET examination is not available.

Morimoto, E, Okada, T, Kanagaki, M, Yamamoto, A, Fushimi, Y, Matsumoto, R, Takaya, S, Ikeda, A, Kunieda, T, Kikuchi, T, Paul, D, Miyamoto, S, Takahashi, R, Togashi, K, Evaluation of Focus Laterality in Temporal Lobe Epilepsy: A Quantitative Study Comparing Double Inversion-recovery MR Imaging at 3T with FDG-PET.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13012380.html