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001-es BibID:	BIBFORM096996
Első szerző:	Tóth Márton (neurológus)
Cím:	The role of hybrid FDG-PET/MRI on decision-making in presurgical evaluation of drug-resistant epilepsy / Tóth Márton, Barsi Péter, Tóth Zoltán, Borbély Katalin, Lückl János, Emri Miklós, Repa Imre, Janszky József, Dóczi Tamás, Horváth Zsolt, Halász Péter, Juhos Vera, Gyimesi Csilla, Bóné Beáta, Kuperczkó Diána, Horváth Réka, Nagy Ferenc, Kelemen Anna, Jordán Zsófia, Újvári Ákos, Hagiwara Koichi, Isnard Jean, Pál Endre, Fekésházy Attila, Fabó Dániel, Vajda Zsolt
Dátum:	2021
ISSN:	1471-2377
Megjegyzések:	Background: When MRI fails to detect a potentially epileptogenic lesion, the chance of a favorable outcome after epilepsy surgery becomes significantly lower (from 60 to 90% to 20?65%). Hybrid FDG-PET/MRI may provide additional information for identifying the epileptogenic zone. We aimed to investigate the possible effect of the introduction of hybrid FDG-PET/MRI into the algorithm of the decision-making in both lesional and non-lesional drug-resistant epileptic patients. Methods: In a prospective study of patients suffering from drug-resistant focal epilepsy, 30 nonlesional and 30 lesional cases with discordant presurgical results were evaluated using hybrid FDG-PET/MRI. Results: The hybrid imaging revealed morphological lesion in 18 patients and glucose hypometabolism in 29 patients within the nonlesional group. In the MRI positive group, 4 patients were found to be nonlesional, and in 9 patients at least one more epileptogenic lesion was discovered, while in another 17 cases the original lesion was confirmed by means of hybrid FDG-PET/MRI. As to the therapeutic decision-making, these results helped to indicate resective surgery instead of intracranial EEG (iEEG) monitoring in 2 cases, to avoid any further invasive diagnostic procedures in 7 patients, and to refer 21 patients for iEEG in the nonlesional group. Hybrid FDG-PET/MRI has also significantly changed the original therapeutic plans in the lesional group. Prior to the hybrid imaging, a resective surgery was considered in 3 patients, and iEEG was planned in 27 patients. However, 3 patients became eligible for resective surgery, 6 patients proved to be inoperable instead of iEEG, and 18 cases remained candidates for iEEG due to the hybrid FDG-PET/MRI. Two patients remained candidates for resective surgery and one patient became not eligible for any further invasive intervention. Conclusions: The results of hybrid FDG-PET/MRI significantly altered the original plans in 19 of 60 cases. The introduction of hybrid FDG-PET/MRI into the presurgical evaluation process had a potential modifying effect on clinical decision-making.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Drug-resistant epilepsy PET/MRI Hybrid FDG-PET/MRI Clinical decision-making, Preoperative workflow Epilepsy surgery
Megjelenés:	BMC Neurology. - 21 : 1 (2021), p. 1-20. -
További szerzők:	Barsi Péter Tóth Zoltán Borbély Katalin Lückl János Emri Miklós (1962-) (fizikus) Repa Imre (1950-) (radiológus) Janszky József Dóczi Tamás Horváth Zsolt Halász Péter Juhos Vera Gyimesi Csilla Bóné Beáta Kuperczkó Diána Horváth Réka Nagy Ferenc (neurológus Kaposvár) Kelemen Anna Jordán Zsófia Újvári Ákos Hagiwara, Koichi Isnard, Jean Pál Endre Fekésházy Attila Fabó Dániel Vajda Zsolt
Pályázati támogatás:	GINOP-2.3.3-15- 2016-00032 GINOP EFOP-3.6.2-16-2017-00008 EFOP 2017- 1.2.1-NKP-2017-00002 Egyéb
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