Arterial Spin Labeling is a Useful MRI Method for Presurgical Evaluation in MRI-Negative Focal Epilepsy

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Authors

KOJAN Martin GAJDOŠ Martin ŘÍHA Pavel DOLEŽALOVÁ Irena ŘEHÁK Zdeněk REKTOR Ivan

Year of publication 2021
Type Article in Periodical
Magazine / Source Brain Topography
MU Faculty or unit

Central European Institute of Technology

Citation
Web https://link.springer.com/article/10.1007%2Fs10548-021-00833-5
Doi http://dx.doi.org/10.1007/s10548-021-00833-5
Keywords PET; MRI; ASL; CBF; Epilepsy surgery
Description Arterial spin labeling (ASL) is an MRI technique measuring brain perfusion using magnetically labeled blood as a tracer. The clinical utility of ASL for presurgical evaluation in non-lesional epilepsy as compared with the quantitative analysis of interictal [F-18] fluorodeoxyglucose PET (FDG-PET) was studied. In 10 patients (4 female; median age 29 years) who underwent a complete presurgical evaluation followed by surgical resection, the presurgical FDG-PET and ASL scans were compared with the resection masks using asymmetry index (AI) maps. The positive predictive value (PPV) and sensitivity (SEN), were calculated from the number of voxels inside the mask (true positive), and outside the mask (false positive). The comparison of the PPVs showed better PPV in 6 patients using ASL and in 2 patients with PET. SEN was better in 4 patients using ASL and in 5 patients with PET. According to the Wilcoxon signed rank test for PPV (p = 0.74) and for SEN (p = 0.43), these methods have similar predictive power. ASL is a useful method for presurgical evaluation in non-lesional epilepsy. The main benefits of ASL over PET are that it avoids radiation exposure for patients, and it offers lower costs, higher availability, and better time efficiency.
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