Department of Radiology and Biomedical Imaging, PET Center, Yale University, New Haven, Connecticut, USA.
Department of Neurology, Yale University, New Haven, Connecticut, USA.
Epilepsia. 2020 Oct;61(10):2183-2193. doi: 10.1111/epi.16653. Epub 2020 Sep 18.
In this positron emission tomography (PET) study with [ C]UCB-J, we evaluated synaptic vesicle glycoprotein 2A (SV2A) binding, which is decreased in resected brain tissues from epilepsy patients, in subjects with temporal lobe epilepsy (TLE) and compared the regional binding pattern to [ F]fluorodeoxyglucose (FDG) uptake.
Twelve TLE subjects and 12 control subjects were examined. Regional [ C]UCB-J binding potential (BP ) values were estimated using the centrum semiovale as a reference region. [ F]FDG uptake in TLE subjects was quantified using mean radioactivity values. Asymmetry in outcome measures was assessed by comparison of ipsilateral and contralateral regions. Partial volume correction (PVC) with the iterative Yang algorithm was applied based on the FreeSurfer segmentation.
In 11 TLE subjects with medial temporal lobe sclerosis (MTS), the hippocampal volumetric asymmetry was 25 ± 11%. After PVC, [ C]UCB-J BP asymmetry indices were 37 ± 19% in the hippocampus, with very limited asymmetry in other brain regions. Reductions in [ C]UCB-J BP values were restricted to the sclerotic hippocampus when compared to control subjects. The corresponding asymmetry in hippocampal [ F]FDG uptake was 22 ± 7% and correlated with that of [ C]UCB-J BP across subjects (R = .38). Hippocampal asymmetries in [ C]UCB-J binding were 1.7-fold larger than those of [ F]FDG uptake.
[ C]UCB-J binding is reduced in the seizure onset zone of TLE subjects with MTS. PET imaging of SV2A may be a promising biomarker approach in the presurgical selection and evaluation of TLE patients and may improve the sensitivity of molecular imaging for seizure focus detection.
在这项使用 [ C]UCB-J 的正电子发射断层扫描 (PET) 研究中，我们评估了突触小泡糖蛋白 2A (SV2A) 的结合，该结合在癫痫患者切除的脑组织中减少，在颞叶癫痫 (TLE) 患者中进行评估，并比较了与 [ F]氟脱氧葡萄糖 (FDG) 摄取的区域结合模式。
检查了 12 例 TLE 患者和 12 例对照受试者。使用半卵圆中心作为参考区域来估计区域 [ C]UCB-J 结合潜能 (BP) 值。使用放射性活度的平均值定量评估 TLE 患者的 [ F]FDG 摄取。通过比较同侧和对侧区域来评估结果测量的不对称性。应用迭代 Yang 算法的部分体积校正 (PVC) 基于 FreeSurfer 分割。
在 11 例有内侧颞叶硬化 (MTS) 的 TLE 患者中，海马的体积不对称性为 25 ± 11%。经 PVC 校正后，[ C]UCB-J BP 不对称指数在海马体中为 37 ± 19%，而其他脑区的不对称性非常有限。与对照组相比，[ C]UCB-J BP 值的降低仅限于硬化的海马体。相应的 [ F]FDG 摄取的海马体不对称性为 22 ± 7%，并与受试者之间的 [ C]UCB-J BP 相关 (R =.38)。[ C]UCB-J 结合的海马不对称性是 [ F]FDG 摄取的 1.7 倍。
MTS 的 TLE 患者的发作起始区 [ C]UCB-J 结合减少。SV2A 的 PET 成像可能是 TLE 患者术前选择和评估的有前途的生物标志物方法，并可能提高分子成像对癫痫灶检测的敏感性。
