Zhang Siqi, Hu Jie, Qi Zhigang, Yao Chenyang, Cui Bixiao, Wang Jingjuan, Wang Zhenming, Lu Jie
Department of Radiology and Nuclear Medicine, Xuanwu Hospital Capital Medical University, Beijing, China.
Department of Radiation Oncology, Xuanwu Hospital, Capital Medical University, Beijing, China.
CNS Neurosci Ther. 2025 Feb;31(2):e70251. doi: 10.1111/cns.70251.
Surgery remains the only curative option for a third of refractory epilepsy patients, though success depends on precise localization of the epileptogenic zone (EZ). This study aims to assess the clinical value of hybrid F-FDG and F-DPA-714 PET/MRI for accurate localization and precise boundary delineation.
The refractory epilepsy patients who underwent surgery at Xuanwu Hospital from November 2022 to November 2023 were retrospectively recruited. Preoperative simultaneous F-FDG and F-DPA-714 PET/MRI imaging were analyzed using the asymmetry index (AI) and a 4-point visual score, with the surgical site and pathological findings serving as the gold standard.
A total of 43 patients (mean age: 26.30 ± 8.37 years, male: 28) were included in this study. Lesion localization accuracy within the EZ was 76.7% for F-FDG PET/MRI, 69.8% for F-DPA-714 PET/MRI, and 60.5% for conventional MRI (p = 0.26). In 26 MRI-positive cases, conventional MRI accurately localized all lesions within the EZ, with three cases showing negative findings on F-FDG images and six on F-DPA-714. Among 17 MRI-negative patients, thirteen demonstrated positive results on hybrid PET/MRI. Additionally, F-DPA-714 PET/MRI proved more effective in delineating lesion boundaries. Compared to F-FDG, the AI score was significantly lower (0.25 ± 0.18 vs. 0.46 ± 0.19, p < 0.001), while the visual score was higher (4.00 ± 2.00 vs. 3.00 ± 0.00, p = 0.01).
F-DPA-714 PET/MRI can effectively complement conventional MRI in the preoperative assessment of refractory epilepsy, with localization accuracy on par with F-FDG and enhanced capability in delineating lesion boundaries.
手术仍然是三分之一难治性癫痫患者的唯一治愈选择，尽管手术成功取决于癫痫病灶区（EZ）的精确定位。本研究旨在评估F-FDG和F-DPA-714混合PET/MRI在精确定位和精确边界划定方面的临床价值。
回顾性招募2022年11月至2023年11月在宣武医院接受手术的难治性癫痫患者。术前同步进行F-FDG和F-DPA-714 PET/MRI成像，采用不对称指数（AI）和4分视觉评分进行分析，以手术部位和病理结果作为金标准。
本研究共纳入43例患者（平均年龄：26.30±8.37岁，男性28例）。F-FDG PET/MRI在EZ内的病灶定位准确率为76.7%，F-DPA-714 PET/MRI为69.8%，传统MRI为60.5%（p = 0.26）。在26例MRI阳性病例中，传统MRI准确地定位了EZ内的所有病灶，3例在F-FDG图像上显示阴性结果，6例在F-DPA-714图像上显示阴性结果。在17例MRI阴性患者中，13例在混合PET/MRI上显示阳性结果。此外，F-DPA-714 PET/MRI在划定病灶边界方面更有效。与F-FDG相比，AI评分显著更低（0.25±0.18 vs. 0.46±0.19，p < 0.001），而视觉评分更高（4.00±2.00 vs. 3.00±0.00，p = 0.01）。
F-DPA-714 PET/MRI在难治性癫痫的术前评估中可有效补充传统MRI，其定位准确率与F-FDG相当，且在划定病灶边界方面能力更强。
Zotero 插件