To Evaluate The Valution Of Epileptogenic Focus Location Of Intractable Epilepsy By PET/CT And Efficacy Of Gamma Knife Guiding By PET/CT

Objective 1. To compare the diagnostic value of PET/CT , EEG and MRI for foci localization with refractory epilepsy.2. To evaluate the efficacy of Gamma Knife treatment after the location of epileptogenic focus and conceivable focus by PET/CT. Methods Fifty-five patients with refractory epilepsy patients from December 2007 to September 2010 in our hospital (male 19 cases and 36 female, mean age 29.00±10.73 years, the average duration of 8.22±6.00 years)were performed PET / CT scan during seizure phase and intermittent phase. All the patients were performed EEG, 48 cases were performed MRI. 46 of 55 patients were treated by Gamma Knife who were divided into low metabolism group and high metabolism group according to lesions metabolism by PET/CT. The low metabolism group was divided into single lesion group and multi-site group according to the number of epileptie foci. Follow-up for 6-24 months was performed to evalate the effect of Gamma Knife treatment .Results①Among the 55 imageings by PET/CT,8 cases were high metabolism and 44 cases were low metabolism,3 cases were nomal. 25 cases showed a single lesion and 19 cases showed multi-site in the low metabolism group. The rate of location by PET/CT was 60.0%(33/55).②PET/CT positive rate was94.5%(52/55), EEG positive rate was 61.8%( 34/55) , MRI positive rate was 37.5 %(18/48). Consistency of foci diagnostic localization between PET/CT and EEG was 36.4 % . Consistency of foci diagnostic localization between PET/CT and MRI was 16.7 %. Consistency of foci diagnostic localization between MRI and EEG was 12.5 %.③. To evaluate the efficacy of Gamma Knife treatment: In high metabolism group,the cure rate was 87.5%cases(7/8),the efficacy rate was 12.5% (1/8) and the inefficacy rate was 0; In low metabolism group,the cure rate was 44.7%(17/38) and the efficacy rate was 34.2% (13/38) and the inefficacy rate was 21.1%(8/38);in single lesion focus group ,the cure rate was 59.1% (13/22) and the efficacy rate was 31.8%(7/22) and the inefficacy rate was 9.1%(2/22); in muti-site lesion foci group,the cure rate was 25.0%(4/16) and the efficacy rate was 37.5%(6/16) and the inefficacy rate was 37.5%(6/16).Conclusion:①The sensitivity of the PET/CT imaging in localizing the seizure focus are significantly higher than those of EEG and MRI.②The treatment of Gamma Knife on the intractable epilepsy is effective through the location by PET/CT, the efficacy of high metabolism group is more apparent than that of low metabolism group, and the treatment effectiveness of single lesion focus group is better than muti-site lesion foci group.