The utility of FDG PET in epilepsy

Abstract

Selected cases of partial epilepsy patients whom are non-responsive to pharmacotherapy may benefit from surgery. 18F-Fluorodeoxyglucose positron emission tomography (FDG PET) imaging of brain glucose metabolism is a widely available technique in presurgical assessment in patients with drug-resistant focal epilepsy if magnetic resonance imaging and electroencephalography do not localize the seizure onset zone or are discordant. FDG PET was useful in localizing and lateralizing of the epileptogenic zone, delineating the extent of the epileptogenic zone. FDG PET also provide additional important information on the functional status of the rest of the brain. In addition, the pattern of PET findings can aid in predicting surgical outcome. PET images are usually obtained in interictal phase. The previous MRI images are used to fuse with PET images to determine the anatomical location. This article introduces FDG brain PET imaging protocol, interpretation criteria and role of FDG PET scan in presurgical epilepsy evaluation in a resource-limited setting in Vietnam.