1. Surgical decision making in temporal lobe epilepsy: A comparison of [18F]FDG-PET, MRI, and EEG
- Author
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Struck, Aaron F., Hall, Lance T., Floberg, John M., Perlman, Scott B., and Dulli, Douglas A.
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BRAIN surgery , *TEMPORAL lobe epilepsy , *MAGNETIC resonance imaging , *ELECTROENCEPHALOGRAPHY , *POSITRON emission tomography , *SPASMS , *QUANTITATIVE research , *FOLLOW-up studies (Medicine) , *TREATMENT effectiveness , *UNIVARIATE analysis , *LOGISTIC regression analysis , *THERAPEUTICS - Abstract
Abstract: Objectives: The goals of this work were (1) to determine the effect of [18F]fluorodeoxyglucose positron emission tomography (FDG-PET), MRI, and EEG on the decision to perform temporal lobe epilepsy (TLE) surgery, and (2) to determine if FDG-PET, MRI, or EEG predicts surgical outcome. Methods: All PET scans ordered (2000–2010) for epilepsy or seizures were tabulated. Medical records were investigated to determine eligibility and collect data. Statistical analysis included odds ratios, κ statistics, univariate analysis, and logistic regression. Results: Of the 186 patients who underwent FDG-PET, 124 had TLE, 50 were surgical candidates, and 34 had surgery with post-operative follow-up. Median length of follow-up was 24months. MRI, FDG-PET, and EEG were significant predictors of surgical candidacy (P <0.001) with odds ratios of 42.8, 20.4, and 6.3, respectively. FDG-PET was the only significant predictor of postoperative outcome (P <0.01). Conclusion: MRI showed a trend toward having the most influence on surgical candidacy, but only FDG-PET predicted surgical outcome. [Copyright &y& Elsevier]
- Published
- 2011
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