[18F]-Flumazenil: a γ-aminobutyric acid A–specific PET radiotracer for the localisation of drug resistant temporal lobe epilepsy

Simple item page
dc.contributor.authorVivash, Len_AU
dc.contributor.authorGrégoire, MCen_AU
dc.contributor.authorLau, EWen_AU
dc.contributor.authorWare, REen_AU
dc.contributor.authorBinns, Den_AU
dc.contributor.authorRoselt, Pen_AU
dc.contributor.authorBouilleret, Ven_AU
dc.contributor.authorMyers, DEen_AU
dc.contributor.authorCook, MJen_AU
dc.contributor.authorHicks, RJen_AU
dc.contributor.authorO’Brien, TJen_AU
dc.date.accessioned2014-12-22T03:27:19Zen_AU
dc.date.available2014-12-22T03:27:19Zen_AU
dc.date.issued2013-07-15en_AU
dc.date.statistics2014-12-22en_AU
dc.description.abstractStudies report that 11C-flumazenil (FMZ) PET more specifically localizes the epileptogenic zone in patients with medically refractory focal epilepsy than 18F-FDG PET. However, practical aspects of 11C use limit clinical application. We report a phase I/IIa study assessing the clinical use of 18F-FMZ PET for the localization of the epileptogenic zone in patients with drug-resistant temporal lobe epilepsy (TLE). Receptor binding was quantified using kinetic modeling that did not require arterial sampling. Methods: Dynamic 18F-FMZ PET and static interictal 18F-FDG PET scans were compared in healthy controls (n = 17 for 18F-FMZ and n = 20 for 18F-FDG) and TLE patients with mesial temporal sclerosis on MR imaging (MTS, n = 12) and with normal MR imaging (NL TLE, n = 19). Masked visual assessment of images was undertaken. Parametric images of 18F-FMZ binding potential (BPND) were generated using the simplified reference tissue model. Region-of-interest analysis on coregistered MR images and statistical parametric mapping were used to quantify 18F-FMZ BPND and 18F-FDG uptake in the temporal lobe. Results: The visual assessment of static standardized uptake value images showed 18F-FMZ PET to have high specificity (16/17 [94%]) and moderate sensitivity (21/31 [68%]) for the localization of the epileptogenic zone, with a more restricted abnormality than 18F-FDG PET. However, the 18F-FMZ standardized uptake value images were falsely localizing in 3 of 31 patients (10%). Region-of-interest analysis demonstrated reductions in ipsilateral hippocampal 18F-FMZ BPND in patients with either MTS or NL TLE, compared with controls subjects. Ipsilateral hippocampal 18F-FMZ BPND was independent of both hippocampal volume and 18F-FDG uptake, whereas ipsilateral hippocampal volume was correlated with 18F-FDG uptake (r2 = 0.69, P < 0.0001). Statistical parametric mapping analysis demonstrated decreased uptake in 14 of 31 (45%) cases with 18F-FMZ PET and 18 of 29 (62%) with 18F-FDG PET. Cluster size was significantly smaller on 18F-FMZ than 18F-FDG images (37 vs. 160 voxels, P < 0.01). Conclusion: 18F-FMZ PET has potential as a clinical tool for the localization of the epileptogenic zone in the presurgical evaluation of drug-resistant TLE, providing information complementary to 18F-FDG PET, with a more restricted region of abnormality. © 2013 by the Society of Nuclear Medicine and Molecular Imaging, Inc.en_AU
dc.identifier.citationVivash, L., Gregoire, M-C., Lau, E. W., Ware, R. E., Binns, D., Roselt, P., Bouilleret, V., Myers, D. E., Cook, M. J., Hicks, R. J., & O’Brien, T. J. (2013). [18F]-Flumazenil: a γ-aminobutyric acid A–specific PET radiotracer for the localisation of drug resistant temporal lobe epilepsy. Journal of Nuclear Medicine, 54(8), 1270-1277. doi:10.2967/jnumed.112.107359en_AU
dc.identifier.govdoc5756en_AU
dc.identifier.issn0161-5505en_AU
dc.identifier.issue8en_AU
dc.identifier.journaltitleJournal of Nuclear Medicineen_AU
dc.identifier.pagination1270-1277en_AU
dc.identifier.urihttp://dx.doi.org/10.2967/jnumed.112.107359en_AU
dc.identifier.urihttp://apo.ansto.gov.au/dspace/handle/10238/6099en_AU
dc.identifier.volume54en_AU
dc.language.isoenen_AU
dc.publisherSociety of Nuclear Medicine and Molecular Imagingen_AU
dc.subjectTomographyen_AU
dc.subjectDrugsen_AU
dc.subjectKineticsen_AU
dc.subjectEpilepsyen_AU
dc.subjectMappingen_AU
dc.subjectChargesen_AU
dc.title[18F]-Flumazenil: a γ-aminobutyric acid A–specific PET radiotracer for the localisation of drug resistant temporal lobe epilepsyen_AU
dc.typeJournal Articleen_AU
Files
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Journal Articles