ArticleNeuroImage. Clinical2016
Cerebral metabolism and perfusion in MR-negative individuals with refractory focal epilepsy assessed by simultaneous acquisition of (18)F-FDG PET and arterial spin labeling.
Article in NeuroImage. Clinical, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 3 of them syntheses that pooled it.
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Who cites it
50 citing papers in PubMed, 3 syntheses or guidelines pooled it, 91 citations in OpenAlex.
- EANM practice guidelines for an appropriate use of PET and SPECT for patients with epilepsy.European journal of nuclear medicine and molecular imaging · 2024Guideline
- Resting-state fMRI seizure onset localization meta-analysis: comparing rs-fMRI to other modalities including surgical outcomes.Frontiers in neuroimaging · 2024Pooled it
- Nuclear imaging for localization and surgical outcome prediction in epilepsy: A review of latest discoveries and future perspectives.Frontiers in neurology · 2022Pooled it
- Voxel-based morphometry and task functional magnetic resonance imaging in essential tremor: evidence for a disrupted brain network.Scientific reports · 2020Trial
- Arterial spin labeling performs comparably to 2-[Epilepsia · 2026Article
- Arterial spin labeling MRI with multiple post-labeling delays reveals interictal hypo- and hyper-perfusion patterns in epilepsy: A proof of concept.Journal of neuroradiology = Journal de neuroradiologie · 2026Article
- Head to head comparison between arterial spin labelling MRI and [Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Observational
- Multimodal neuroimaging fusion in presurgical evaluation of drug-resistant epilepsy: current evidence, clinical integration, and future directions.Frontiers in neuroscience · 2026Review
- Molecular imaging based biophysical changes of striatum closely associated with cognitive impairment in childhood self-limited epilepsy with centrotemporal spikes.European journal of nuclear medicine and molecular imaging · 2025Article
- Elevated Thalamic Blood Flow in Self-Limited Epilepsy with Centrotemporal Spikes.bioRxiv : the preprint server for biology · 2025Article
- Does arterial spin labelling represent a valid alternative to other MR perfusion techniques in neuro-oncology?La Radiologia medica · 2025Review
- Clinical Performance of Analog and Digital 18F-FDG PET/CT in Pediatric Epileptogenic Zone Localization: Preliminary Results.Biomedicines · 2025Article
- ILAE neuroimaging task force highlight: The utility of multimodal neuroimaging in diagnostic and presurgical workup of drug-resistant focal epilepsy.Epileptic disorders : international epilepsy journal with videotape · 2025Article
- Epilepsy Diagnosis When the Routine Ancillary Tests Are Normal.Neurology international · 2025Review
- Long-term trends in total administered radiation dose from brain [European journal of nuclear medicine and molecular imaging · 2025Article
- Arterial spin labeling perfusion MRI applications in drug-resistant epilepsy and epileptic emergency.Acta epileptologica · 2023Review
- Lateralization of interictal temporal lobe hypoperfusion in lesional and non-lesional temporal lobe epilepsy using arterial spin labeling MRI.Epilepsy research · 2023Article
- Seizure-induced neutrophil adhesion in brain capillaries leads to a decrease in postictal cerebral blood flow.iScience · 2023Article
- Current state and guidance on arterial spin labeling perfusion MRI in clinical neuroimaging.Magnetic resonance in medicine · 2023Article
- Altered metabolic-functional coupling in the epileptogenic network could predict surgical outcomes of mesial temporal lobe epilepsy.Frontiers in neuroscience · 2023Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The major challenge in pre-surgical epileptic patient evaluation is the correct identification of the seizure onset area, especially in MR-negative patients. In this study, we aimed to: (1) assess the concordance between perfusion, from ASL, and metabolism, from (18)F-FDG, acquired simultaneously on PET/MR; (2) verify the utility of a statistical approach as supportive diagnostic tool for clinical readers. Secondarily, we compared (18)F-FDG PET data from the hybrid PET/MR system with those acquired with PET/CT, with the purpose of validate the reliability of (18)F-FDG PET/MR data. Twenty patients with refractory focal epilepsy, negative MR and a defined electro-clinical diagnosis underwent PET/MR, immediately followed by PET/CT. Standardized uptake value ratio (SUVr) and cerebral blood flow (CBF) maps were calculated for PET/CT-PET/MR and ASL, respectively. For all techniques, z-score of the asymmetry index (zAI) was applied for depicting significant Right/Left differences. SUVr and CBF images were firstly visually assessed by two neuroimaging readers, who then re-assessed them considering zAI for reaching a final diagnosis. High agreement between (18)F-FDG PET/MR and ASL was found, showing hypometabolism and hypoperfusion in the same hemisphere in 18/20 patients, while the remaining were normal. They were completely concordant in 14/18, concordant in at least one lobe in the remaining. zAI maps improved readers' confidence in 12/20 and 15/20 patients for (18)F-FDG PET/MR and ASL, respectively. (18)F-FDG PET/CT-PET/MR showed high agreement, especially when zAI was considered. The simultaneous metabolism-perfusion acquisition provides excellent concordance on focus lateralisation and good concordance on localisation, determining useful complementary information.
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