Evaluation of the need to combine ۱۸F-FDG PET imaging modality with other imaging modalities in preoperative evaluation of drug-resistant epilepsy patients

Background: PET imaging systems often have a wider distribution than seizure foci that can show both the center and areas of seizure prediction activity, but despite the high sensitivity, do not provide acceptable results alone. This review examines whether FDG-PET in combination with other methods is useful in preoperative evaluation.Method: The present review study was conducted by searching the Pubmed, Sciense Direct, Google Scholar, Magiran and SID databases in Persian and English since ۲۰۱۴. Finally, among the searched articles, ۲۵ articles were used based on the study criteria.Results: The results include the following:۱) The need for intracranial EEG monitoring is reduced due to increased confidence in localization before surgery.۲)The addition of SISCOM is useful in cases where the epileptic lesion is undiagnosed and the MRI findings are abnormal.۳)It is useful for accurately guiding (SEEG) electrode implantation.۴) Helps to better understand the pathophysiology of epilepsy, shows focal abnormal metabolic regions, classifies the functional state of the brain, and defines its functional integrity.Conclusion: The use of multimodal imaging at the same time, with better patient selection, lower cost, lower risk, and better surgical outcomes, will help as part of preoperative evaluation in patients evaluated for refractory epilepsy surgery. Finally, the proper use of these tests, combined with more comprehensive functional mapping of the brain, may lead to the evaluation of completely non-invasive epilepsy surgery

Keywords:

resistant epilepsy , pre-surgery , Multimodal imaging , ۱۸F-FDG PET , Review.