Article

This review aims to synthesize all the available data on brain molecular imaging,
such as single-photon emission computed tomography (SPECT) and interictal
fluorodeoxyglucose positron emission tomography (FDG-PET), in focal epilepsies.
SPECT imaging is able to measure regional cerebral blood flow and its major
innovation remains its ictal imaging value. On the other hand, FDG-PET, which has
higher spatial resolution and lower background activity than SPECT, enables
glycolytic metabolism to be identified in interictal states. Therefore,
interictal FDG-PET has greater sensitivity than interictal SPECT, especially in
temporal lobe epilepsies (TLEs). Thus, (18)F-FDG-PET is a necessary step in the
presurgical evaluation of TLEs, but also of extratemporal epilepsies (ETEs),
contributing to >30% of the decision to undertake surgery. In addition, FDG-PET
has particular diagnostic value in focal epilepsies showing normal magnetic
resonance imaging (MRI). PET also has good prognostic value for post-surgical
outcomes as well as cognitive impairment, especially in cases where the
hypometabolism extent is limited. Moreover, the notion of an epileptic network is
well highlighted by functional PET imaging, allowing better understanding of the
pathological substrates of these disorders. Future development of quantitative
analysis software and of novel radiotracers and cameras will certainly enhance
its clinical usefulness.
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Langue : ANGLAIS