Objective method for localization of cortical asymmetries using positron emission tomography to aid surgical resection of epileptic foci

Otto Muzik, Diane C. Chugani, Chenggang Shen, Ednea A. Da Silva, Jagdish Shah, Aashit Shah, Alexa Canady, Craig Watson, Harry T. Chugani

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

We designed a semiautomated method for the objective detection of abnormal regions of tracer accumulation in the brain. The purpose of the present study was to examine the diagnostic performance of this method by applying it to patients with clinically intractable epilepsy of unilateral origin; they underwent [F-18] deoxyglucose positron emission tomography (PET) prior to surgical resection of epileptic foci. A semiautomated method for assessment of asymmetries in the brain cortex was developed that compares activity concentrations in homotopic cortical areas. When these differences exceeded a predefined threshold, the areas with lower activity were marked and 3-dimensional surface rendered images were created to guide placement of intracranial electrodes (ECoG) followed by surgical resection. The normal amount of asymmetry between small (0.5-0.7 cm2) homotopic cortical regions was determined as 5.9 ± 4.0% (mean ± SD). The false-positive fraction was determined for cutoff thresholds of 1 SD (10%), 1.5 SD (12%), and 2 SD (15%) outside the mean and was found to be 89, 44, and 0%, respectively. The obtained sensitivity-specificity pairs for correct localization of epileptogenic lobes based on the ECoG results were best for the 15% threshold (80/94%, accuracy 0.90). This objective PET method allows the accurate determination of cortical asymmetries, and it proved to be highly efficient in guiding epilepsy surgery.

Original languageEnglish (US)
Pages (from-to)74-82
Number of pages9
JournalComputer Aided Surgery
Volume3
Issue number2
DOIs
StatePublished - 1998
Externally publishedYes

Fingerprint

Positron emission tomography
Positron-Emission Tomography
Brain
Surgery
Electrodes
Deoxyglucose
Epilepsy
Sensitivity and Specificity

Keywords

  • Epileptic focus
  • Image data analysis
  • Positron emission tomography
  • Positron emission tomography guided surgery
  • Tracer asymmetries

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Surgery
  • Medicine (miscellaneous)

Cite this

Objective method for localization of cortical asymmetries using positron emission tomography to aid surgical resection of epileptic foci. / Muzik, Otto; Chugani, Diane C.; Shen, Chenggang; Da Silva, Ednea A.; Shah, Jagdish; Shah, Aashit; Canady, Alexa; Watson, Craig; Chugani, Harry T.

In: Computer Aided Surgery, Vol. 3, No. 2, 1998, p. 74-82.

Research output: Contribution to journalArticle

Muzik, Otto ; Chugani, Diane C. ; Shen, Chenggang ; Da Silva, Ednea A. ; Shah, Jagdish ; Shah, Aashit ; Canady, Alexa ; Watson, Craig ; Chugani, Harry T. / Objective method for localization of cortical asymmetries using positron emission tomography to aid surgical resection of epileptic foci. In: Computer Aided Surgery. 1998 ; Vol. 3, No. 2. pp. 74-82.
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