18 F-FDG PET/CT semi-quantitative method has a high diagnostic value and evaluation of drug efficacy for temporal lobe epilepsy

WANG Chunmei; ZHAO Yujia; WU Xin'ai; NIU Ruilong; BAO Baoliang; WANG Cheng

doi:10.12122/j.issn.1674-4500.2025.05.10

Abstract：Objective To explore the diagnostic value and evaluation of drug efficacy of the 18F-FDG PET/CT semi-quantitative method for interictal temporal lobe epilepsy.Methods A total of 43 adolescent patients with epilepsy symptoms and signs,abnormal video electroencephalogram(VEEG),and normal brain MRI who were diagnosed clinically at the Affiliated Hospital of Inner Mongolia Medical University from January 2019 to December 2023 were analyzed,including 19 males and 24 females,aged 6-40 years.All the patients underwent 18F-FDG PET/CT imaging before and 1-2 years after antiepileptic drug treatment.Visual and semi-quantitative analysis using MIMneuro software was employed to determine the location of the epileptic foci,measure the standard uptake value(SUV)mean of the epileptic foci and the contralateral side,and analyze the differences between them.The changes in the SUVmean of the epileptic foci before and after treatment were analyzed to evaluate the value of SUVmean in localizing temporal lobe epileptic foci and assessing drug efficacy.Results All the patients had epilepsy symptoms and signs,abnormal VEEG,and were clinically diagnosed with temporal lobe epilepsy.The epileptic foci on PET showed reduced uptake of the tracer.The comparison of SUVmean between the epileptic foci and the contralateral side was statistically significant(P<0.05).After 1-2 years of antiepileptic drug treatment,the clinical symptoms and signs disappeared or alleviated.PET/CT was re-examined,and the SUVmean of the epileptic foci increased after drug treatment.The comparison of SUVmean of the epileptic foci before and after treatment was statistically significant(P<0.05).There was no statistically significant difference in the SUVmean between the epileptic foci and the contralateral side after treatment(P>0.05).There was no statistically significant difference in the SUVmean of the contralateral side before and after treatment(P>0.05).39 patients had no epilepsy symptoms and signs after stopping or reducing antiepileptic drugs,while 4 patients had a recurrence of epilepsy after stopping or reducing antiepileptic drugs.Conclusion The 18F-FDG PET/CT semi-quantitative indicator SUVmean has a high diagnostic value and evaluation of drug efficacy for temporal lobe epileptic foci.