Frontiers in Neurology (Jun 2018)

Multimodality Image Post-processing in Detection of Extratemporal MRI-Negative Cortical Dysplasia

  • Wen-han Hu,
  • Wen-han Hu,
  • Xiu Wang,
  • Li-na Liu,
  • Xiao-qiu Shao,
  • Kai Zhang,
  • Kai Zhang,
  • Yan-shan Ma,
  • Lin Ai,
  • Jun-ju Li,
  • Jian-guo Zhang,
  • Jian-guo Zhang,
  • Jian-guo Zhang

DOI
https://doi.org/10.3389/fneur.2018.00450
Journal volume & issue
Vol. 9

Abstract

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Purpose: To determine the diagnostic value of individual image post-processing techniques in a series of patients who underwent extratemporal operations for histologically proven, MRI-negative focal cortical dysplasia (FCD).Methods: The morphometric analysis program (MAP), PET/MRI co-registration and statistical parametric mapping (SPM) analysis of PET (SPM-PET) techniques were analyzed in 33 consecutive patients. The epileptogenic zone (EZ) assumed by MAP, PET/MRI, and SPM-PET was compared with the location of the FCD lesions determined by stereoelectroencephalography (SEEG) and histopathological study. The detection rate of each modality was statistically compared.Results: Three lesions were simultaneously detected by the three post-processing methods, while two lesions were only MAP positive, and 8 were only PET/MRI positive. The detection rate of MAP, PET/MRI, SPM-PET and the combination of the three modalities was 24.2, 90.9, 57.6, and 97.0%, respectively. Taking the pathological subtype into account, no type I lesions were detected by MAP, and PET/MRI was the most sensitive method for detecting FCD types II and IIA. During a mean follow-up period of 22.94 months, seizure freedom was attained in 26/33 patients (78.8%) after focal corticectomy.Conclusions: MAP, PET/MRI, and SPM-PET provide complementary information for FCD detection, intracranial electrode design, and lesion resection. PET/MRI was particularly useful, with the highest detection rate of extratemporal MRI-negative FCD.

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