Usefulness of [18F]fluorodeoxyglucose positron emission tomography in pediatric epilepsy surgery

O. Carter Snead, Lan Chen, Wendy G. Mitchell, Sylvia R. Kongelbeck, Cory Raffel, Floyd H. Gilles, Marvin D. Nelson

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

We sought to analyze our experience with pediatric epilepsy surgery patients to determine the place of [18F]fluorodeoxyglucose (FDG) positron emission tomography (FDG-PET) in the preoperative evaluation of such children relative to chronic invasive intracranial monitoring. Fifty-six children who received an interictal FDG-PET as part of a phase 1 epilepsy surgery evaluation were compared with 44 children who did not have this study in a retrospective analysis of 100 patients accrued over a 4-year period. There was no significant difference between the two groups of children in terms of age or follow-up or was there a significant difference between the FDG-PET group and the no-FDG-PET group in regard to the numbers of children who had surgery, the type of procedure done, whether chronic invasive intracranial monitoring was performed, or outcome. The hypometabolic area demonstrated on interictal FDG-PET was concordant with that of the epileptogenic zone as mapped out with ictal recordings from subdural electrodes in 2 of 13 patients in whom a complete data set was available for comparison. In the other 11 children there was either poor agreement between interictal FDG-PET and ictal electrocorticographic data or the interictal FDG-PET was normal in the face of an epileptogenic focus which was successfully mapped by invasive electrophysiologic techniques and excised. We conclude that one cannot exclude a child with intractable partial seizures from surgical consideration because the interictal FDG-PET is normal; nor is there sufficient correlation between the interictal hypometabolic area on FDG-PET and the epileptogenic zone in terms of anatomic location and size to justify forgoing chronic invasive intracranial monitoring in children with intractable partial seizures being evaluated for epilepsy surgery unless there is absolute concordance between all neuroimaging, clinical, and video-electroencephalographic data.

Original languageEnglish (US)
Pages (from-to)98-107
Number of pages10
JournalPediatric Neurology
Volume14
Issue number2
DOIs
StatePublished - Feb 1996
Externally publishedYes

Fingerprint

Fluorodeoxyglucose F18
Positron-Emission Tomography
Epilepsy
Pediatrics
Seizures
Stroke
Neuroimaging
Electrodes

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health
  • Developmental Neuroscience
  • Neurology

Cite this

Snead, O. C., Chen, L., Mitchell, W. G., Kongelbeck, S. R., Raffel, C., Gilles, F. H., & Nelson, M. D. (1996). Usefulness of [18F]fluorodeoxyglucose positron emission tomography in pediatric epilepsy surgery. Pediatric Neurology, 14(2), 98-107. https://doi.org/10.1016/0887-8994(96)00001-X

Usefulness of [18F]fluorodeoxyglucose positron emission tomography in pediatric epilepsy surgery. / Snead, O. Carter; Chen, Lan; Mitchell, Wendy G.; Kongelbeck, Sylvia R.; Raffel, Cory; Gilles, Floyd H.; Nelson, Marvin D.

In: Pediatric Neurology, Vol. 14, No. 2, 02.1996, p. 98-107.

Research output: Contribution to journalArticle

Snead, OC, Chen, L, Mitchell, WG, Kongelbeck, SR, Raffel, C, Gilles, FH & Nelson, MD 1996, 'Usefulness of [18F]fluorodeoxyglucose positron emission tomography in pediatric epilepsy surgery', Pediatric Neurology, vol. 14, no. 2, pp. 98-107. https://doi.org/10.1016/0887-8994(96)00001-X
Snead, O. Carter ; Chen, Lan ; Mitchell, Wendy G. ; Kongelbeck, Sylvia R. ; Raffel, Cory ; Gilles, Floyd H. ; Nelson, Marvin D. / Usefulness of [18F]fluorodeoxyglucose positron emission tomography in pediatric epilepsy surgery. In: Pediatric Neurology. 1996 ; Vol. 14, No. 2. pp. 98-107.
@article{dae8bf6378624bbc83bf505bb20537a9,
title = "Usefulness of [18F]fluorodeoxyglucose positron emission tomography in pediatric epilepsy surgery",
abstract = "We sought to analyze our experience with pediatric epilepsy surgery patients to determine the place of [18F]fluorodeoxyglucose (FDG) positron emission tomography (FDG-PET) in the preoperative evaluation of such children relative to chronic invasive intracranial monitoring. Fifty-six children who received an interictal FDG-PET as part of a phase 1 epilepsy surgery evaluation were compared with 44 children who did not have this study in a retrospective analysis of 100 patients accrued over a 4-year period. There was no significant difference between the two groups of children in terms of age or follow-up or was there a significant difference between the FDG-PET group and the no-FDG-PET group in regard to the numbers of children who had surgery, the type of procedure done, whether chronic invasive intracranial monitoring was performed, or outcome. The hypometabolic area demonstrated on interictal FDG-PET was concordant with that of the epileptogenic zone as mapped out with ictal recordings from subdural electrodes in 2 of 13 patients in whom a complete data set was available for comparison. In the other 11 children there was either poor agreement between interictal FDG-PET and ictal electrocorticographic data or the interictal FDG-PET was normal in the face of an epileptogenic focus which was successfully mapped by invasive electrophysiologic techniques and excised. We conclude that one cannot exclude a child with intractable partial seizures from surgical consideration because the interictal FDG-PET is normal; nor is there sufficient correlation between the interictal hypometabolic area on FDG-PET and the epileptogenic zone in terms of anatomic location and size to justify forgoing chronic invasive intracranial monitoring in children with intractable partial seizures being evaluated for epilepsy surgery unless there is absolute concordance between all neuroimaging, clinical, and video-electroencephalographic data.",
author = "Snead, {O. Carter} and Lan Chen and Mitchell, {Wendy G.} and Kongelbeck, {Sylvia R.} and Cory Raffel and Gilles, {Floyd H.} and Nelson, {Marvin D.}",
year = "1996",
month = "2",
doi = "10.1016/0887-8994(96)00001-X",
language = "English (US)",
volume = "14",
pages = "98--107",
journal = "Pediatric Neurology",
issn = "0887-8994",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Usefulness of [18F]fluorodeoxyglucose positron emission tomography in pediatric epilepsy surgery

AU - Snead, O. Carter

AU - Chen, Lan

AU - Mitchell, Wendy G.

AU - Kongelbeck, Sylvia R.

AU - Raffel, Cory

AU - Gilles, Floyd H.

AU - Nelson, Marvin D.

PY - 1996/2

Y1 - 1996/2

N2 - We sought to analyze our experience with pediatric epilepsy surgery patients to determine the place of [18F]fluorodeoxyglucose (FDG) positron emission tomography (FDG-PET) in the preoperative evaluation of such children relative to chronic invasive intracranial monitoring. Fifty-six children who received an interictal FDG-PET as part of a phase 1 epilepsy surgery evaluation were compared with 44 children who did not have this study in a retrospective analysis of 100 patients accrued over a 4-year period. There was no significant difference between the two groups of children in terms of age or follow-up or was there a significant difference between the FDG-PET group and the no-FDG-PET group in regard to the numbers of children who had surgery, the type of procedure done, whether chronic invasive intracranial monitoring was performed, or outcome. The hypometabolic area demonstrated on interictal FDG-PET was concordant with that of the epileptogenic zone as mapped out with ictal recordings from subdural electrodes in 2 of 13 patients in whom a complete data set was available for comparison. In the other 11 children there was either poor agreement between interictal FDG-PET and ictal electrocorticographic data or the interictal FDG-PET was normal in the face of an epileptogenic focus which was successfully mapped by invasive electrophysiologic techniques and excised. We conclude that one cannot exclude a child with intractable partial seizures from surgical consideration because the interictal FDG-PET is normal; nor is there sufficient correlation between the interictal hypometabolic area on FDG-PET and the epileptogenic zone in terms of anatomic location and size to justify forgoing chronic invasive intracranial monitoring in children with intractable partial seizures being evaluated for epilepsy surgery unless there is absolute concordance between all neuroimaging, clinical, and video-electroencephalographic data.

AB - We sought to analyze our experience with pediatric epilepsy surgery patients to determine the place of [18F]fluorodeoxyglucose (FDG) positron emission tomography (FDG-PET) in the preoperative evaluation of such children relative to chronic invasive intracranial monitoring. Fifty-six children who received an interictal FDG-PET as part of a phase 1 epilepsy surgery evaluation were compared with 44 children who did not have this study in a retrospective analysis of 100 patients accrued over a 4-year period. There was no significant difference between the two groups of children in terms of age or follow-up or was there a significant difference between the FDG-PET group and the no-FDG-PET group in regard to the numbers of children who had surgery, the type of procedure done, whether chronic invasive intracranial monitoring was performed, or outcome. The hypometabolic area demonstrated on interictal FDG-PET was concordant with that of the epileptogenic zone as mapped out with ictal recordings from subdural electrodes in 2 of 13 patients in whom a complete data set was available for comparison. In the other 11 children there was either poor agreement between interictal FDG-PET and ictal electrocorticographic data or the interictal FDG-PET was normal in the face of an epileptogenic focus which was successfully mapped by invasive electrophysiologic techniques and excised. We conclude that one cannot exclude a child with intractable partial seizures from surgical consideration because the interictal FDG-PET is normal; nor is there sufficient correlation between the interictal hypometabolic area on FDG-PET and the epileptogenic zone in terms of anatomic location and size to justify forgoing chronic invasive intracranial monitoring in children with intractable partial seizures being evaluated for epilepsy surgery unless there is absolute concordance between all neuroimaging, clinical, and video-electroencephalographic data.

UR - http://www.scopus.com/inward/record.url?scp=0029666204&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029666204&partnerID=8YFLogxK

U2 - 10.1016/0887-8994(96)00001-X

DO - 10.1016/0887-8994(96)00001-X

M3 - Article

VL - 14

SP - 98

EP - 107

JO - Pediatric Neurology

JF - Pediatric Neurology

SN - 0887-8994

IS - 2

ER -