AI Article Synopsis
- - The study investigates the effectiveness of adding F-18 FDG-PET imaging to standard MRI in diagnosing autoimmune epilepsy (AE), focusing on its impact on antibody prevalence scoring.
- - In a retrospective analysis of 60 patients, combining PET and MRI improved diagnosis rates from 57% with MRI alone to 77% for antibody-negative patients, and from 35% to 60% for antibody-positive patients.
- - The results suggest that incorporating PET imaging enhances diagnostic accuracy for AE, particularly in patients without detectable antibodies, indicating a need for larger studies to establish it as a standard practice.
Article Abstract
Objective: We evaluate the potential utility of F-18 FDG-PET in addition to MRI in the diagnostic work-up of patients with autoimmune epilepsy (AE) and propose the inclusion of functional imaging in the antibody prevalence in epilepsy (APE) scoring system.
Methods: This was a retrospective analysis in 60 patients, diagnosed and treated for AE, of whom 40 were antibody negative (presumed AE) and 20 were antibody positive (definitive AE). All patients had undergone a dedicated brain and whole body FDG-PET in the department of Nuclear Medicine.
Results: In the antibody negative group, MRI supported a diagnosis of AE in 23 patients. Both MRI and PET were indicative in 12 cases, and standalone PET was positive in 8. While MRI alone was diagnostic in 57% (23/40), the combined yield of both modalities was 77% (31/40). When PET scores were added to assign the APE score in MRI negative cases, average APE score was 5.4. In the antibody positive group, MRI supported the diagnosis of AE in 7 patients. Both MRI and PET were positive in 4 patients and standalone PET was positive in 5 patients. While MRI alone was diagnostic in 35% (7/20), the combined yield of both modalities was 60% (12/20). When PET scores were added to assign the APE score in MRI negative cases, average APE score was 6.1.
Conclusion: The inclusion of metabolic information from PET distinctly improved (the sensitivity of) APE scores to predict autoimmune origin even in antibody negative cases. A larger prospective study of similar type could justify adoption of FDG-PET into the standard diagnostic procedure.
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| http://dx.doi.org/10.1111/ane.13346 | DOI Listing |
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