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Epilepsy Behav. 2011 Oct;22(2):293-7. doi: 10.1016/j.yebeh.2011.06.022. Epub 2011 Jul 27.

Surgical decision making in temporal lobe epilepsy: a comparison of [(18)F]FDG-PET, MRI, and EEG.

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  • 1Nuclear Medicine Section, Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.



The goals of this work were (1) to determine the effect of [(18)F]fluorodeoxyglucose positron emission tomography (FDG-PET), MRI, and EEG on the decision to perform temporal lobe epilepsy (TLE) surgery, and (2) to determine if FDG-PET, MRI, or EEG predicts surgical outcome.


All PET scans ordered (2000-2010) for epilepsy or seizures were tabulated. Medical records were investigated to determine eligibility and collect data. Statistical analysis included odds ratios, κ statistics, univariate analysis, and logistic regression.


Of the 186 patients who underwent FDG-PET, 124 had TLE, 50 were surgical candidates, and 34 had surgery with post-operative follow-up. Median length of follow-up was 24 months. MRI, FDG-PET, and EEG were significant predictors of surgical candidacy (P<0.001) with odds ratios of 42.8, 20.4, and 6.3, respectively. FDG-PET was the only significant predictor of postoperative outcome (P<0.01).


MRI showed a trend toward having the most influence on surgical candidacy, but only FDG-PET predicted surgical outcome.

Copyright © 2011 Elsevier Inc. All rights reserved.

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