FDG-PET/MRI in the presurgical evaluation of pediatric epilepsy.

IF 2.1 3区医学 Q2 PEDIATRICS

Pediatric Radiology Pub Date : 2024-09-01 Epub Date: 2024-08-10 DOI:10.1007/s00247-024-06011-6

Maria R Ponisio, John M Zempel, Jon T Willie, Stuart R Tomko, Sean D McEvoy, Jarod L Roland, Jonathan P Williams

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Abstract

In patients with drug-resistant epilepsy, difficulties in identifying the epileptogenic zone are well known to correlate with poorer clinical outcomes post-surgery. The integration of PET and MRI in the presurgical assessment of pediatric patients likely improves diagnostic precision by confirming or widening treatment targets. PET and MRI together offer superior insights compared to either modality alone. For instance, PET highlights abnormal glucose metabolism, while MRI precisely localizes structural anomalies, providing a comprehensive understanding of the epileptogenic zone. Furthermore, both methodologies, whether utilized through simultaneous PET/MRI scanning or the co-registration of separately acquired PET and MRI data, present unique advantages, having complementary roles in lesional and non-lesional cases. Simultaneous FDG-PET/MRI provides precise co-registration of functional (PET) and structural (MR) imaging in a convenient one-stop-shop approach, which minimizes sedation time and reduces radiation exposure in children. Commercially available fusion software that allows retrospective co-registration of separately acquired PET and MRI images is a commonly used alternative. This review provides an overview and illustrative cases that highlight the role of combining 18F-FDG-PET and MRI imaging and shares the authors' decade-long experience utilizing simultaneous PET/MRI in the presurgical evaluation of pediatric epilepsy.

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FDG-PET/MRI 在小儿癫痫手术前评估中的应用。

众所周知，在耐药性癫痫患者中，难以确定致痫区与手术后较差的临床疗效有关。将正电子发射计算机断层显像和磁共振成像整合到儿科患者的术前评估中，可以通过确认或扩大治疗目标来提高诊断的精确性。正电子发射计算机断层显像和核磁共振成像一起使用，比单独使用其中一种模式更能提供卓越的洞察力。例如，正电子发射计算机断层显像可突出显示异常的葡萄糖代谢，而核磁共振成像可精确定位结构异常，从而全面了解致痫区。此外，无论是通过同步 PET/MRI 扫描，还是将分别获取的 PET 和 MRI 数据进行联合注册，这两种方法都具有独特的优势，在病变和非病变病例中具有互补作用。同步FDG-PET/MRI以便捷的一站式方法提供了功能（PET）和结构（MR）成像的精确联合注册，最大限度地减少了儿童的镇静时间和辐射暴露。市售的融合软件可对分别获取的 PET 和 MRI 图像进行回顾性联合注册，是一种常用的替代方法。这篇综述概述了结合 18F-FDG-PET 和 MRI 成像的作用，并提供了例证，分享了作者十年来在小儿癫痫手术前评估中使用同步 PET/MRI 的经验。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Radiology 医学-核医学

CiteScore

4.40

自引率

17.40%

发文量

300

审稿时长

3-6 weeks

期刊介绍： Official Journal of the European Society of Pediatric Radiology, the Society for Pediatric Radiology and the Asian and Oceanic Society for Pediatric Radiology Pediatric Radiology informs its readers of new findings and progress in all areas of pediatric imaging and in related fields. This is achieved by a blend of original papers, complemented by reviews that set out the present state of knowledge in a particular area of the specialty or summarize specific topics in which discussion has led to clear conclusions. Advances in technology, methodology, apparatus and auxiliary equipment are presented, and modifications of standard techniques are described. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.