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18F-fluorodeoxyglucose and 18F-flumazenil positron emission tomography in patients with refractory epilepsy Cover

18F-fluorodeoxyglucose and 18F-flumazenil positron emission tomography in patients with refractory epilepsy

Radiology and Oncology
Volume 50 (2016): Issue 3 (September 2016)
By: Marina Hodolic,  Raffi Topakian and  Robert Pichler  
Free to read
|Jul 2016

Figures & Tables

Figure 1

Focal epilepsy in 17 year old male patient. Interictal 18F-FDG PET (A): physiological distribution of 18F-FDG in the brain. Ictal 18F-FDG PET (B): hypermetabolism frontolateral in the right hemisphere (arrow).
Focal epilepsy in 17 year old male patient. Interictal 18F-FDG PET (A): physiological distribution of 18F-FDG in the brain. Ictal 18F-FDG PET (B): hypermetabolism frontolateral in the right hemisphere (arrow).

Figure 2

18F-FDG PET (B)scan vs. 18F-Flumazenil PET (C)in a 19 year old female patient with bilateral hippocampal sclerosis as shown by MRI (A). Both PET modalities present low temporomesial uptake being larger on the left side, but benzodiazepinereceptor imaging appears sharper and presents a focal defect.
18F-FDG PET (B)scan vs. 18F-Flumazenil PET (C)in a 19 year old female patient with bilateral hippocampal sclerosis as shown by MRI (A). Both PET modalities present low temporomesial uptake being larger on the left side, but benzodiazepinereceptor imaging appears sharper and presents a focal defect.

Figure 3

Focal epilepsy in 56 year old male patient. (A)MRI: astrogliosis of the right hippocampus (later proven by histology); (B)18F-FDG PET: minal temporomesial hypometabolism of both sides; (C)18F-Flumazenil PET: focal defect of tracer uptake at the right hippocampus.
Focal epilepsy in 56 year old male patient. (A)MRI: astrogliosis of the right hippocampus (later proven by histology); (B)18F-FDG PET: minal temporomesial hypometabolism of both sides; (C)18F-Flumazenil PET: focal defect of tracer uptake at the right hippocampus.

Some PET tracers used for imaging of epileptic focus and PET scan findings

PET scanFindings on PET scan
18F-FDG interictalDecreased metabolism
18F-FDG ictalIncreased and decreased metabolism (complex pattern)
18F-FDG postictalIncreased and decreased metabolism (complex pattern)
Serotonin receptor (e.g. 18F-Mefway)Reduced binding
Dopamine receptor (e.g. 18F-Fallypride)Reduced binding
18F-Flumazenil (GABA receptor)Decreased binding
15O-H2O interictalReduced perfusion
15O-H2O ictalIncreased perfusion
DOI: https://doi.org/10.1515/raon-2016-0032 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
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Language: English
Page range: 247 - 253
Submitted on: Feb 23, 2016
|
Accepted on: Apr 29, 2016
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Published on: Jul 19, 2016
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
epilepsy,
nuclear medicine,
PET/CT,
18F-FDG,
18F-Flumazenil
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Haematology, oncology,
Radiology

© 2016 Marina Hodolic, Raffi Topakian, Robert Pichler, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons License.

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