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18F-fluorodeoxyglucose and 18F-flumazenil positron emission tomography in patients with refractory epilepsy

Marina Hodolic

Marina Hodolic

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Hodolic, Marina
, 
Raffi Topakian

Raffi Topakian

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Topakian, Raffi
 und 
Robert Pichler

Robert Pichler

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Pichler, Robert
  
19. Juli 2016
18F-fluorodeoxyglucose and 18F-flumazenil positron emission tomography in patients with refractory epilepsy's Cover Image
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Artikel-Kategorie: Review Article
Online veröffentlicht: 19. Juli 2016
Seitenbereich: 247 - 253
Eingereicht: 23. Feb. 2016
Akzeptiert: 29. Apr. 2016
DOI: https://doi.org/10.1515/raon-2016-0032
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© 2016 Radiol Oncol
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Figure 1

Focal epilepsy in 17 year old male patient. Interictal 18F-FDG PET (A): physiological distribution of 18F-FDG in the brain. Ictal 18F-FDG PET (B): hypermetabolism frontolateral in the right hemisphere (arrow).
Focal epilepsy in 17 year old male patient. Interictal 18F-FDG PET (A): physiological distribution of 18F-FDG in the brain. Ictal 18F-FDG PET (B): hypermetabolism frontolateral in the right hemisphere (arrow).

Figure 2

18F-FDG PET (B)scan vs. 18F-Flumazenil PET (C)in a 19 year old female patient with bilateral hippocampal sclerosis as shown by MRI (A). Both PET modalities present low temporomesial uptake being larger on the left side, but benzodiazepinereceptor imaging appears sharper and presents a focal defect.
18F-FDG PET (B)scan vs. 18F-Flumazenil PET (C)in a 19 year old female patient with bilateral hippocampal sclerosis as shown by MRI (A). Both PET modalities present low temporomesial uptake being larger on the left side, but benzodiazepinereceptor imaging appears sharper and presents a focal defect.

Figure 3

Focal epilepsy in 56 year old male patient. (A)MRI: astrogliosis of the right hippocampus (later proven by histology); (B)18F-FDG PET: minal temporomesial hypometabolism of both sides; (C)18F-Flumazenil PET: focal defect of tracer uptake at the right hippocampus.
Focal epilepsy in 56 year old male patient. (A)MRI: astrogliosis of the right hippocampus (later proven by histology); (B)18F-FDG PET: minal temporomesial hypometabolism of both sides; (C)18F-Flumazenil PET: focal defect of tracer uptake at the right hippocampus.

Some PET tracers used for imaging of epileptic focus and PET scan findings

PET scanFindings on PET scan
18F-FDG interictalDecreased metabolism
18F-FDG ictalIncreased and decreased metabolism (complex pattern)
18F-FDG postictalIncreased and decreased metabolism (complex pattern)
Serotonin receptor (e.g. 18F-Mefway)Reduced binding
Dopamine receptor (e.g. 18F-Fallypride)Reduced binding
18F-Flumazenil (GABA receptor)Decreased binding
15O-H2O interictalReduced perfusion
15O-H2O ictalIncreased perfusion
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