正电子发射断层扫描（PET）在前颞叶切除术术前规划中的应用：疗效和局限性系统综述

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2024-09-18 DOI:10.1016/j.clineuro.2024.108562

Eric M. Teichner , Robert C. Subtirelu , Shiv Patil , Chitra Parikh , Arjun B. Ashok , Sahithi Talasila , Victoria A. Anderson , Talha Khan , Yvonne Su , Thomas Werner , Abass Alavi , Mona-Elisabeth Revheim

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引用次数: 0

摘要

导言颞叶癫痫（TLE）是一种使人衰弱的神经系统疾病，需要完善的诊断和治疗策略。本综述评估了正电子发射断层扫描（PET）在加强颞叶癫痫前叶切除术（ATL）术前规划方面的潜力。方法按照PRISMA（系统综述和Meta分析的首选报告项目）指南，使用PubMed、SCOPUS和ScienceDirect数据库对PET和ATL研究进行了全面的文献检索，检索时间为1985年至2022年。本综述研究了一系列放射性同位素，包括 FDG、H2O、FMZ、MPPF 和 FCWAY，分析了它们在检测致痫灶、确定切除范围和预测术后结果方面的功效。研究特别关注了核磁共振成像结果不确定的病例。结果共有 52 项研究被纳入最终分析。我们的分析表明，FDG-PET 成像有助于确定癫痫发作灶和预测术后结果。在核磁共振扫描未发现结构异常的情况下，FDG-PET 成像具有重要价值。此外，5-HT1A 拮抗剂、FCWAY 和 MPPF 等新型放射性同位素在定位癫痫发作灶（尤其是 MRI 阴性的 TLE）方面具有广阔的前景，尽管它们目前的应用相对有限。与脑电图和核磁共振成像等其他成像模式相结合，有助于改善致痫灶的定位，从而提高手术效果。进一步的研究必须侧重于确定这些放射性同位素在协调 ATL 手术规划和预测 TLE 患者术后预后方面的相对疗效和最佳组合。令人鼓舞的是，这些进展有可能彻底改变TLE的治疗方法，为患者带来更好的生活质量。

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Positron Emission Tomography (PET) in presurgical planning of anterior temporal lobectomy: A systematic review of efficacy and limitations

Introduction

Temporal lobe epilepsy (TLE), a debilitating neurological disorder, necessitates refined diagnostic and treatment strategies. This comprehensive review appraises the potential of positron emission tomography (PET) in enhancing the presurgical planning of Anterior Temporal Lobectomy (ATL) for patients afflicted with TLE.

Methods

A comprehensive literature search was conducted using the PubMed, SCOPUS, and ScienceDirect databases from 1985 to 2022, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for studies investigating PET and ATL. This review studied a range of radiotracers, including FDG, H₂O, FMZ, MPPF, and FCWAY, analyzing their efficacy in detecting epileptogenic foci, establishing resection boundaries, and predicting postoperative outcomes. The study paid special attention to cases where MRI findings were inconclusive.

Results

A total of 52 studies were included in the final analysis. Our analysis revealed that FDG-PET imaging was instrumental in identifying seizure foci and predicting postoperative results. It exhibited significant value in situations where structural abnormalities were absent on MRI scans. Furthermore, newer radiotracers such as 5-HT_1A antagonists, FCWAY and MPPF, presented promising potential for localizing seizure foci, particularly in MRI-negative TLE, despite their comparatively limited current usage.

Conclusion

PET imaging, although challenged by issues such as radiation exposure, limited accessibility, and high costs, offers considerable promise. Integration with other imaging modalities, such as EEG and MRI, has contributed to improved localization of epileptogenic foci and subsequently, enhanced surgical outcomes. Further research must focus on establishing the relative efficacy and optimal combinations of these radiotracers in the orchestration of ATL surgical planning and prognostication of postoperative outcomes for TLE patients. Encouragingly, these advancements hold the potential to revolutionize the management of TLE, delivering a better quality of life for patients.

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来源期刊

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.