New advanced PET approach helps surgeons stop epileptic seizures

A new advanced PET imaging technique can help surgeons identify and remove areas in the brain responsible for triggering harmful epileptic seizures, according to the results of a small pilot study.

Researchers at the University of Virginia School of Medicine say their approach measures glucose utilization in the brain to determine what regions are causing seizures. With the help of this parametric dynamic FDG-PET imaging development, physicians can surgically remove those spots, the UVA team explained.

“This imaging approach is significant as it creates 4D brain maps which offer additional sensitivity over standard-of-care imaging by revealing rates of glucose uptake rather than final absolute glucose uptake,” Bijoy Kundu, PhD, of UVA’s Department of Radiology and Medical Imaging along with its Department of Biomedical Engineering, said on Monday.

The team, backed by the UVA Brain Institute, launched an initial study with seven participants whose traditional PET scans had failed to identify a treatment target. Kundu et al. performed the new imaging exams on these individuals with encouraging results.

In all seven, p-dFDG-PET located the correct seizure-activating brain spot. And in one participant who underwent successful surgery, imaging predicted the exact target. In another whose procedure was unsuccessful, however, novel PET scans pointed to an alternate surgical target, the researchers explained.

The group first presented their findings in October at the World Molecular Imaging Congress but indicated a larger study will be required to fully assess the new method.

If their initial successes are confirmed, the UVA clinicians say the technique could be used at any hospital with a PET scanner and open up surgical options for many more patients with epilepsy.

“Too often patients with intractable epilepsy turn away from transformative epilepsy surgery when invasive procedures are required to locate the ‘bad spot’ or the epileptic focus,” co-investigator Mark Quigg, MD, a neurologist at UVA, added. “Dynamic PET, as an addition to the noninvasive toolkit, can expand the number of epilepsy surgery candidates.”

""

Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.

Around the web

The new technology shows early potential to make a significant impact on imaging workflows and patient care. 

Richard Heller III, MD, RSNA board member and senior VP of policy at Radiology Partners, offers an overview of policies in Congress that are directly impacting imaging.
 

The two companies aim to improve patient access to high-quality MRI scans by combining their artificial intelligence capabilities.