AUTHOR=Sukprakun Chanan , Tepmongkol Supatporn 

TITLE=Nuclear imaging for localization and surgical outcome prediction in epilepsy: A review of latest discoveries and future perspectives

JOURNAL=Frontiers in Neurology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.1083775

DOI=10.3389/fneur.2022.1083775

ISSN=1664-2295

ABSTRACT=Background
Epilepsy is one of the most common neurological disorders. About one-third of patients with epilepsy have seizures refractory to antiepileptic drugs and further require surgical removal of the epileptogenic region. In the last decade, there have been many recent developments in radiopharmaceuticals, novel image analysis techniques, and new software for epileptogenic zone (EZ) localization.
Objectives
We provide the latest discoveries, current challenges, and future perspectives in the field of positron emission tomography (PET) and single-photon emission computed tomography (SPECT) in epilepsy in recently.
Methods
We searched for the relevant articles published in MEDLINE and CENTRAL from July 2012 to July 2022. A systematic literature review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis was conducted using the keywords “Epilepsy” and “PET or SPECT.” We included both prospective and retrospective studies. Studies with preclinical subjects or not focusing on EZ localization or surgical outcome prediction using recently developed PET radiopharmaceuticals, novel image analysis techniques, or new software were excluded from the review. The remaining 162 studies were reviewed.
Results
We first present recent findings and developments in PET radiopharmaceuticals. Second, we present novel image analysis techniques and new software in the last decade for EZ localization. Finally, we summarize the overall findings and discuss future perspectives in the field of PET and SPECT in epilepsy.
Conclusions
Combining new radiopharmaceuticals development, new indications, new techniques, and software improves EZ localization and provides better understanding of epilepsy. These have proven not to only predict prognosis but also improve the outcome of epilepsy surgery.