ArticleEuropean journal of nuclear medicine and molecular imaging2026
Quantitative dual-tracer
Article in European journal of nuclear medicine and molecular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPathological subtypes are key determinants of surgical strategy and prognosis in refractory mesial temporal lobe epilepsy (MTLE), with hippocampal sclerosis (HS) associated with better outcomes than gliosis only. Subtype-specific patterns of cerebral metabolism and neuroinflammation, which may inform lesion localization and subtype differentiation, remain poorly defined. This study aimed to delineate these patterns using ¹⁸F-FDG PET and translocator protein (TSPO) PET with ¹⁸F-DPA-714 for precise localization, with emphasis on the added value of quantitative analysis.
methodsPatients with unilateral refractory MTLE undergoing surgery were retrospectively included, and pathological subtypes were classified according to histological profiles (HS, n = 43; gliosis only, n = 41). Patients underwent sequential integrated dual-tracer PET/MR imaging within one week. Age- and sex-matched healthy controls (HC) were recruited. Whole-brain voxel-wise and temporal lobe subregional analyses were performed. Localization performance was assessed by visual inspection and quantitative analysis employing an asymmetry index (AI) derived from standardized uptake value ratios. Sensitivity and accuracy were calculated, with false discovery rate correction applied for multiple comparisons.
resultsIn total, 43 MTLE-HS and 41 MTLE-gliosis only were included. Compared with HC, both HS and gliosis exhibited significant
conclusionDual-tracer PET/MR combined with quantitative analysis may improve subtype-specific presurgical localization in refractory MTLE. TSPO-PET precisely localized the epileptogenic lesion, whereas FDG-PET facilitated differentiation of pathological subtypes.
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