The impact of positron emission tomography imaging on the clinical management of patients with epilepsy

Abstract

Clinical positron emission tomography (PET) imaging of human epilepsy has a 30-year history, but it is still searching for its exact role among rapidly advancing neuroimaging techniques. The vast majority of epilepsy PET studies used this technique to improve detection of epileptic foci for surgical resection. Here, we review the main trends emerging from three decades of PET research in epilepsy, with a particular emphasis on how PET imaging has impacted on the clinical management of patients with intractable epilepsy. While reviewing the latest studies, we also present an argument for a changing role of PET and molecular imaging in the future, with an increasing focus on epileptogenesis and newly discovered molecular mechanisms of epilepsy. These new applications will be facilitated by technological advances, such as the use of integrated PET/MRI systems and utilization of novel radiotracers, which may also enhance phenotype–genotype correlations and assist rational, individualized treatment strategies.

Keywords::

• 2-deoxy-2[¹⁸F]fluoro-d-glucose
• α-[¹¹C]methyl-l-tryptophan
• cortical dysplasia
• epilepsy
• epilepsy surgery
• flumazenil
• infantile spasms
• neuroinflammation
• positron emission tomography

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or mater ials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.