QPET combined with MAP processing MRI imaging recognition bureau lesions

Ref: Lin Y,et al.
 Epilepsia2018 May 30doi: 10.1111/epi.14474Most magnetic resonance (MRI) negative epilepsy, or non-lesionepilep, is usually caused by poor development of the ventritary cortex (FCD), but cannot be detected and located before surgery due to the smallnessof the lesionsYicong Lin of the Department of Neurology at Xuanwu Hospital, Capital Medical University, and others used quantitative positron emission tomography (QPET) in combination with morphological analysis procedures (MAPS) to re-process and identify FCD for MRI imaging to improve the prognosis of epilepsy surgery, published online may 2018 in Epilepsiathe study included 104 mrI-negative epilepsy patients, all of whom underwent imaging evaluation and surgical treatment before surgeryThe morphological analysis program processes the T1 weighted sequence and qPET analysis on PET-CT scanning data, both of which are compared with normal database dataThe consistency between MAP and QPET was evaluated at the overall level, and the consistency of QPET-MAP plus abnormality was tested through postoperative seizures and histopathologyThe QPET threshold for QPET analysis is determined with the QPET threshold of standard deviation (SD) of -1, -2, -3 and -4104 patients, when the QPET threshold of SD-1, -2 and -3 was used, the non-seizure rate of the complete-cut group was significantly improved compared to the QPET-MAP-region partial excision group and the non-cut group (P-0.023, P-0.001, P-0.006; The best results were shown at SD-2: 55% positive rate, sensitivity 0.68, specific00 0.88, positive prediction value 0.88 and negative prediction value 0.69Histopathology testresults in the excision QPET-MAP plus area were mainly FCD Type I (Figure 1)At SD-2, 12% of patients had multiple QPET-MAP-plus areasTherefore, QPET combined with MAP can effectively detect small preoperative lesions of the terrocotal cortex, improving the surgical prognosis of MRI-negative patientsFigure 15 patients cut the image of the QPET-MAP-plus areaUsing SD-2 as the QPET threshold, QPET-MAP-plus abnormalities were identified by a neuroradiologist assessmentThe crosshairs represent the MAP plus candidate positionfirst column: MRI-T1 weighted imageThe second column: Gray-white binding area z-score data, from the first column of T1-weighted image processed by MAPThird column: T2 weighted water suppression image to depict the MAP-plus candidate positionThe arrow indicates that there is a change area in the MAP plus candidate position that is accompanied by the T2-weighted water suppression imageColumn 4: QPET image, obtained by quantitative analysis of F-deoxygenglucose (FDG)-PET image in column 5The blue area indicates a decrease in metabolism, which is within a range of MAP-plus candidate positionsColumn 5: FDG-PET images of the original attenuation correction used during preoperative evaluationColumn 6: Postoperative magnetic resonance imaging indicates the scope of excisionA, BQPET-MAP plus regions of the frontal lobe; CQPET-MAP-region of the temporal lobe; D and EIsland Cover QPET-MAP-region5 cases of QPET-MAP plus area were completely removed, and the patient had no seizures at 12 months Pathological results: A Bureau-based cortical dysplasia (FCD) Type IIa; (First Hospital of Fuzhou Serena compiled, Fudan University affiliated Huashan Hospital Dr Shou Jiajun review, "Outside information" editor-in-chief, Fudan University affiliated Huashan Hospital Chen Chengcheng Professor Final Appeal) related links