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European Journal of Nuclear Medicine and Molecular Imaging

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Open Access 01-04-2022 | Epilepsy | Original Article

High-resolution pediatric age–specific ¹⁸F-FDG PET template: a pilot study in epileptogenic focus localization

Authors: Teng Zhang, Yuting Li, Shuilin Zhao, Yuanfan Xu, Xiaohui Zhang, Shuang Wu, Xiaofeng Dou, Congcong Yu, Jianhua Feng, Yao Ding, Junming Zhu, Zexin Chen, Hong Zhang, Mei Tian

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 5/2022

Abstract

Background

PET imaging has been widely used in diagnosis of neurological disorders; however, its application to pediatric population is limited due to lacking pediatric age–specific PET template. This study aims to develop a pediatric age–specific PET template (PAPT) and conduct a pilot study of epileptogenic focus localization in pediatric epilepsy.

Methods

We recruited 130 pediatric patients with epilepsy and 102 age-matched controls who underwent ¹⁸F-FDG PET examination. High-resolution PAPT was developed by an iterative nonlinear registration-averaging optimization approach for two age ranges: 6–10 years (n = 17) and 11–18 years (n = 50), respectively. Spatial normalization to the PAPT was evaluated by registration similarities of 35 validation controls, followed by estimation of potential registration biases. In a pilot study, epileptogenic focus was localized by PAPT-based voxel-wise statistical analysis, compared with multi-disciplinary team (MDT) diagnosis, and validated by follow-up of patients who underwent epilepsy surgery. Furthermore, epileptogenic focus localization results were compared among three templates (PAPT, conventional adult template, and a previously reported pediatric linear template).

Results

Spatial normalization to the PAPT significantly improved registration similarities (P < 0.001), and nearly eliminated regions of potential biases (< 2% of whole brain volume). The PAPT-based epileptogenic focus localization achieved a substantial agreement with MDT diagnosis (Kappa = 0.757), significantly outperforming localization based on the adult template (Kappa = 0.496) and linear template (Kappa = 0.569) (P < 0.05). The PAPT-based localization achieved the highest detection rate (89.2%) and accuracy (80.0%). In postsurgical seizure-free patients (n = 40), the PAPT-based localization also achieved a substantial agreement with resection areas (Kappa = 0.743), and the highest detection rate (95%) and accuracy (80.0%).

Conclusion

The PAPT can significantly improve spatial normalization and epileptogenic focus localization in pediatric epilepsy. Future pediatric neuroimaging studies can also benefit from the unbiased spatial normalization by PAPT.

Trial registration.

NCT04725162: https://clinicaltrials.gov/ct2/show/NCT04725162

Available only for authorised users

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Title: High-resolution pediatric age–specific 18F-FDG PET template: a pilot study in epileptogenic focus localization
Authors: Teng Zhang
Yuting Li
Shuilin Zhao
Yuanfan Xu
Xiaohui Zhang
Shuang Wu
Xiaofeng Dou
Congcong Yu
Jianhua Feng
Yao Ding
Junming Zhu
Zexin Chen
Hong Zhang
Mei Tian
Publication date: 01-04-2022
Publisher: Springer Berlin Heidelberg
Keywords: Epilepsy
Positron Emission Tomography
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 5/2022
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-021-05611-w

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

High-resolution pediatric age–specific ¹⁸F-FDG PET template: a pilot study in epileptogenic focus localization

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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