Comparative Analysis of Epileptogenic Changes Detected on the PET/CT, EEG and MRI Scans and Their Correlation with Post-Surgery Outcomes

Budrys, Tomas; Basevicius, Algidas; Gleizniene, Rymante; Jurkeviciene, Giedre; Kulakiene, Ilona; Jurevicius, Tomas; Monastyreckiene, Egle; Skaudickas, Darijus; Veikutis, Vincentas

doi:10.15388/Informatica.2018.174

Informatica

Comparative Analysis of Epileptogenic Changes Detected on the PET/CT, EEG and MRI Scans and Their Correlation with Post-Surgery Outcomes

Volume 29, Issue 3 (2018), pp. 421–438

Tomas Budrys Algidas Basevicius Rymante Gleizniene Giedre Jurkeviciene Ilona Kulakiene Tomas Jurevicius Egle Monastyreckiene Darijus Skaudickas Vincentas Veikutis

https://doi.org/10.15388/Informatica.2018.174

Pub. online: 1 January 2018 Type: Research Article

Open Access

Received
1 March 2018

Accepted
1 August 2018

Published
1 January 2018

Abstract

We attempted to determine the most common localizations of epileptogenic foci by using common functional (EEG and PET/CT) and structural (MRI) imaging methods. Also, we compared the number of epileptogenic foci detected with all diagnostic methods and determined the success rate of surgery in the operated patients when the epileptogenic foci coincided on all three imaging methods. 35 patients (including children) with clinically proven refractory epilepsy were included into the study. All patients underwent an MRI scan with epilepsy protocol, Fluorodeoxyglucose-18-PET/CT scan, and an EEG prior to a PET study. 14 patients underwent neurosurgery for removal of epileptogenic foci. We found a statistically significant difference between the number of epileptogenic foci which were found in PET/CT and EEG studies but there was no significant difference between MRI and PET/CT lesion numbers. The most common localization of epileptogenic activity on EEG was right temporal lobe (54.3%); the most common lobe with structural changes on MRI was right temporal lobe (42.9%); the most common hypometabolism zone on PET/CT was in right temporal lobe (45.7%). 10 out of 14 patients who underwent surgery demonstrated excellent postsurgical outcomes, with no epileptic seizures one year or more after the operation; 3/14 patients had 1–2 seizures after surgery and one patient had the same count or more epileptic seizures in duration of one year or more. The measure of Agreement Kappa between PET/CT and EEG value was 0.613 $(p<0.05)$. Between PET/CT and MRI the value was 0.035 $(p>0.05)$. Surgical treatment may offer hope for patients with intractable epileptic seizures. PET/CT was an extremely useful imaging method to assist in the localization of epileptogenic zones. The dynamic functional information that brain PET/CT provides is complementary to anatomical imaging of MRI and functional information of EEG.

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Biographies

Budrys Tomas

tomas.budrys@lsmuni.lt

T. Budrys, radiologist. Has graduated from Vilnius University, medicine faculty. Fields of interest are neuroradiology and nuclear medicine. Mostly specializes in radiological epilepsy diagnostics, PET and MRI imaging methods. Currently in his doctorate studies and an assistant at Lithuanian University of Health sciences.

Basevicius Algidas

algidas.basevicius@kaunoklinikos.lt

A. Basevicius, MD, PhD. Radiologist. Has graduated from Lithuanian University of Health Sciences. Head of the Radiology department. Field of interest is abdominal radiology.

Gleizniene Rymante

rymangleiz@gmail.com

R. Gleizniene, MD, PhD. Radiologist. Has graduated from Lithuanian University of Health Sciences. Fields of interest are experimental and clinical investigations in neuroradiology, especially epilepsy, Parkinson’s disease.

Jurkeviciene Giedre

giedre.jurkeviciene@gmail.com

G. Jurkeviciene, MD, PhD. Neurologist. Has graduated from Lithuanian University of Health Sciences. Fields of interest are experimental and clinical investigations in neurology, epilepsy research.

Kulakiene Ilona

kulakiene@dr.com

I. Kulakiene, MD, PhD. Radiologist. Has graduated from Lithuanian University of Health Sciences. Fields of interest are optimization of diagnostic procedures in nuclear medicine, especially PET/CT.

Jurevicius Tomas

eglemonastyreckiene@gmail.com

T. Jurevicius, radiologist. Has graduated from Lithuanian University of Health Sciences. Fields of interest are vascular and emergency radiology, mathematics and statistics. Currently works as an assistant at Lithuanian University of Health sciences.

Monastyreckiene Egle

tomasjurs@gmail.com

E. Monastyreckiene, received MD degree in 2000 from Lithuanian University of Health Sciences, Kaunas, Lithuania. Now she is professor in Lithuanian University of Health Sciences. Her current research activity includes experimental and clinical investigations in field of neuro and musculoskeletal imaging.

Skaudickas Darijus

darijusskaudickas@gmail.com

D. Skaudickas, MD, PhD. Urologist. Has graduated from Lithuanian University of Health Sciences. Fields of interest are neuromodularity association of pelvic and CNS nervous pathways.

Veikutis Vincentas

vincentas.veikutis@lsmuni.lt

V. Veikutis, MD, PhD. Cardiologist. Has graduated from Lithuanian University of Health Sciences. Fields of interest are experimental and clinical investigations in destructive energies (RF, US, Laser) using and optimization of efficacy.

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Keywords

epilepsy MRI PET-CT concordance electroencephalography surgery outcomes

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