IEC 2023 | MRI/PET co-registration in epileptogenic focus detection

Nirmeen Kishk, MD, Kasr Alainy Hospital, Cairo University, Cairo, Egypt, shares the findings of a study assessing the value of PET/MRI co-registration in decision-making for patients with drug resistant epilepsy. Accurate detection of an epileptogenic focus is challenging, with EEG providing low sensitivity and MRI sometimes inconclusive. To test the benefit of MRI/PET co-registration in epileptogenic focus detection, 40 patients with focal onset epilepsy underwent ictal/interictal EEG, MRI protocol for epilepsy, and PET imaging. In cases where clinical semiology, EEG, and MRI were concordant (30%), PET findings were also concordant. In patients with non-concordance between different assessment modalities (42.5%), PET added value in 4/17. Notably, PET showed concordance with clinical semiology and EEG in 6/11 patients who were MRI-negative. Overall, this multimodal approach appears to aid localization and therefore support proper decision making in patients with focal onset epilepsy. This interview took place at the International Epilepsy Congress 2023 in Dublin, Ireland.

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