Abstract：
18F-FDG PET plays a major role in the pre-surgical evaluation of medically refractory epilepsy patients. The current standard of care is performing interictal evaluations of glucose metabolism. This is mostly related to the tracer kinetics of 18F-FDG owing to a long uptake phase which would translate into ictal injections having low sensitivities and low specificity and demonstrating not only ictal but post-ictal changes. It has been reported that this limitation can be overcome in some status epilepticus scenarios where prolonged seizures can then correlate better with 18F-FDG uptake kinetics. In these cases, focal visual qualitative hot spots are suggestive of the seizure onset zone (SOZ). However, we note that by using advanced subtraction techniques, the prolonged 18F-FDG uptake phase can be overcome in a variety of other cases as well. This opens the door to a slightly larger set of patients that may benefit from this higher resolution PET method. We present 4 cases where a novel subtraction 18F-FDG PET technique was used and elucidate its impact in these specific cases.
摘要：
18F-FDGPET在药物难治性癫痫患者的术前评价中起主要作用。目前的护理标准是进行葡萄糖代谢的发作间评估。这主要与18F-FDG的示踪剂动力学有关，这是由于长的摄取阶段会转化为具有低敏感性和低特异性的发作注射，并且不仅显示发作，而且显示发作后的变化。据报道，在某些癫痫持续状态的情况下，可以克服这种限制，其中长时间的癫痫发作可以与18F-FDG摄取动力学更好地相关。在这些情况下,局灶性视觉定性热点提示癫痫发作区（SOZ）。然而,我们注意到，通过使用先进的减法技术，延长的18F-FDG摄取阶段也可以在各种其他情况下克服。这为可能受益于这种更高分辨率PET方法的稍大的一组患者打开了大门。我们介绍了4例使用新型减法18F-FDGPET技术的情况，并阐明了其在这些特定情况下的影响。
