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Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 2/2003

01.02.2003 | Review Article

Is central benzodiazepine receptor imaging useful for the identification of epileptogenic foci in localization-related epilepsies?

verfasst von: Ingeborg Goethals, Christophe Van de Wiele, Paul Boon, Rudi Dierckx

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 2/2003

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Abstract

In the presurgical evaluation of patients with partial epilepsies, the most extensively studied functional neuro-imaging modality to define the origin of seizure onset is fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET). Generally, this technique reveals a widespread zone of interictal glucose hypometabolism in the region of the epileptogenic focus. However, the technique may miss the epileptogenic region and FDG PET abnormalities may extend beyond the seizure onset zone. Consequently, for the precise identification of epileptogenic regions more specific imaging probes than FDG are warranted. This review considers the clinical utility of iomazenil (IMZ) SPET and flumazenil (FMZ) PET for the precise localization of epileptogenic foci in partial epilepsy syndromes.
Literatur
1.
Zurück zum Zitat Berkovic SF, McIntosh AM, Kalnins RM, Jackson GD, Fabinyi GC, Brazenor GA, Bladin PF, Hopper JL. Preoperative MRI predicts outcome of temporal lobectomy: an actuarial analysis. Neurology 1995; 45:1358–1363.PubMed Berkovic SF, McIntosh AM, Kalnins RM, Jackson GD, Fabinyi GC, Brazenor GA, Bladin PF, Hopper JL. Preoperative MRI predicts outcome of temporal lobectomy: an actuarial analysis. Neurology 1995; 45:1358–1363.PubMed
2.
Zurück zum Zitat Babb TL, Brown WJ, Pretorius J, Davenport C, Lieb JP, Crandall PH. Temporal lobe volumetric cell densities in temporal lobe epilepsy. Epilepsia 1984; 25:729–740.PubMed Babb TL, Brown WJ, Pretorius J, Davenport C, Lieb JP, Crandall PH. Temporal lobe volumetric cell densities in temporal lobe epilepsy. Epilepsia 1984; 25:729–740.PubMed
3.
Zurück zum Zitat Van Paesschen W, Connelly A, King MD, Jackson GD, Duncan JS. The spectrum of hippocampal sclerosis: a quantitative magnetic resonance imaging study. Ann Neurol 1997; 41:41–51.PubMed Van Paesschen W, Connelly A, King MD, Jackson GD, Duncan JS. The spectrum of hippocampal sclerosis: a quantitative magnetic resonance imaging study. Ann Neurol 1997; 41:41–51.PubMed
4.
Zurück zum Zitat Zentner J, Hufnagel A, Ostertun B, Wolf HK, Behrens E, Campos MG, Solymosi L, Elger CE, Wiestler OD, Schramm J. Surgical treatment of extratemporal epilepsy: clinical, radiologic, and histopathologic findings in 60 patients. Epilepsia 1996; 37:1072–1080.PubMed Zentner J, Hufnagel A, Ostertun B, Wolf HK, Behrens E, Campos MG, Solymosi L, Elger CE, Wiestler OD, Schramm J. Surgical treatment of extratemporal epilepsy: clinical, radiologic, and histopathologic findings in 60 patients. Epilepsia 1996; 37:1072–1080.PubMed
5.
Zurück zum Zitat Arnold S, Schlaug G, Niemann H, Ebner A, Luders H, Witte OW, Seitz RJ. Topography of interictal glucose hypometabolism in unilateral mesiotemporal epilepsy. Neurology 1996; 46:1422–1430.PubMed Arnold S, Schlaug G, Niemann H, Ebner A, Luders H, Witte OW, Seitz RJ. Topography of interictal glucose hypometabolism in unilateral mesiotemporal epilepsy. Neurology 1996; 46:1422–1430.PubMed
6.
Zurück zum Zitat Savic I, Ingvar M, Stone-Elander S. Comparison of [11C]flumazenil and [18F]FDG as PET markers of epileptic foci. J Neurol Neurosurg Psychiatry 1993; 56:615–621.PubMed Savic I, Ingvar M, Stone-Elander S. Comparison of [11C]flumazenil and [18F]FDG as PET markers of epileptic foci. J Neurol Neurosurg Psychiatry 1993; 56:615–621.PubMed
7.
Zurück zum Zitat Henry TR, Frey KA, Sackellares JC, Gilman S, Koeppe RA, Brunberg JA, Ross DA, Berent S, Young AB, Kuhl DE. In vivo cerebral metabolism and central benzodiazepine-receptor binding in temporal lobe epilepsy. Neurology 1993; 43:1998–2006.PubMed Henry TR, Frey KA, Sackellares JC, Gilman S, Koeppe RA, Brunberg JA, Ross DA, Berent S, Young AB, Kuhl DE. In vivo cerebral metabolism and central benzodiazepine-receptor binding in temporal lobe epilepsy. Neurology 1993; 43:1998–2006.PubMed
8.
Zurück zum Zitat Henry TR, Mazziotta JC, Engel J Jr. Interictal metabolic anatomy of mesial temporal lobe epilepsy. Arch Neurol 1993; 50:582–589.PubMed Henry TR, Mazziotta JC, Engel J Jr. Interictal metabolic anatomy of mesial temporal lobe epilepsy. Arch Neurol 1993; 50:582–589.PubMed
9.
Zurück zum Zitat da Silva EA, Chugani DC, Muzik O, Chugani HT. Identification of frontal lobe epileptic foci in children using positron emission tomography. Epilepsia 1997; 38:1198–1208.PubMed da Silva EA, Chugani DC, Muzik O, Chugani HT. Identification of frontal lobe epileptic foci in children using positron emission tomography. Epilepsia 1997; 38:1198–1208.PubMed
10.
Zurück zum Zitat Theodore WH, Dorwart R, Holmes M, Porter RJ, DiChiro G. Neuroimaging in refractory partial seizures: comparison of PET, CT, and MRI. Neurology 1986; 36:750–759. Theodore WH, Dorwart R, Holmes M, Porter RJ, DiChiro G. Neuroimaging in refractory partial seizures: comparison of PET, CT, and MRI. Neurology 1986; 36:750–759.
11.
Zurück zum Zitat Swartz BE, Halgren E, Delgado-Escueta AV, Mandelkern M, Gee M, Quinones N, Blahd WH, Repchan J. Neuroimaging in patients with seizures of probable frontal lobe origin. Epilepsia 1989; 30:547–558.PubMed Swartz BE, Halgren E, Delgado-Escueta AV, Mandelkern M, Gee M, Quinones N, Blahd WH, Repchan J. Neuroimaging in patients with seizures of probable frontal lobe origin. Epilepsia 1989; 30:547–558.PubMed
12.
Zurück zum Zitat Duncan JS, Koepp MJ. PET: central benzodiazepine neuroreceptor mapping in localization- related epilepsies. Adv Neurol 2000; 83:131–136.PubMed Duncan JS, Koepp MJ. PET: central benzodiazepine neuroreceptor mapping in localization- related epilepsies. Adv Neurol 2000; 83:131–136.PubMed
13.
Zurück zum Zitat Pennell PB. PET: cholinergic neuroreceptor mapping. Adv Neurol 2000; 83:157–163.PubMed Pennell PB. PET: cholinergic neuroreceptor mapping. Adv Neurol 2000; 83:157–163.PubMed
14.
Zurück zum Zitat Koepp MJ, Duncan JS. PET: opiate neuroreceptor mapping. Adv Neurol 2000; 83:145–156.PubMed Koepp MJ, Duncan JS. PET: opiate neuroreceptor mapping. Adv Neurol 2000; 83:145–156.PubMed
15.
Zurück zum Zitat Olsen RW, McCabe RT, Wamsley JK. GABAA receptor subtypes: autoradiographic comparison of GABA, benzodiazepine, and convulsant binding sites in the rat central nervous system. J Chem Neuroanat 1990; 3:59–76.PubMed Olsen RW, McCabe RT, Wamsley JK. GABAA receptor subtypes: autoradiographic comparison of GABA, benzodiazepine, and convulsant binding sites in the rat central nervous system. J Chem Neuroanat 1990; 3:59–76.PubMed
16.
Zurück zum Zitat Torizuka K, Uemura K, Toru M, Shinohara Y, Nishimura T, Yonekura Y, Nakagawara J, Matsuda H, Sakai F, Matsuda K, Fukuyama H, Morimoto K. [A phase 3 clinical trial of 123I-iomazenil, a new central-type benzodiazepine receptor imaging agent (Part 1)—report on clinical usefulness in diagnosis of various brain diseases]. Kaku Igaku 1996; 33:293–301.PubMed Torizuka K, Uemura K, Toru M, Shinohara Y, Nishimura T, Yonekura Y, Nakagawara J, Matsuda H, Sakai F, Matsuda K, Fukuyama H, Morimoto K. [A phase 3 clinical trial of 123I-iomazenil, a new central-type benzodiazepine receptor imaging agent (Part 1)—report on clinical usefulness in diagnosis of various brain diseases]. Kaku Igaku 1996; 33:293–301.PubMed
17.
Zurück zum Zitat Savic I, Persson A, Roland P, Pauli S, Sedvall G, Widen L. In vivo demonstration of reduced benzodiazepine receptor binding in human epileptic foci. Lancet 1988; 2:863–866.PubMed Savic I, Persson A, Roland P, Pauli S, Sedvall G, Widen L. In vivo demonstration of reduced benzodiazepine receptor binding in human epileptic foci. Lancet 1988; 2:863–866.PubMed
18.
Zurück zum Zitat Hammers A, Koepp MJ, Labbe C, Brooks DJ, Thom M, Cunningham VJ, Duncan JS. Neocortical abnormalities of [11C]-flumazenil PET in mesial temporal lobe epilepsy. Neurology 2001; 56:897–906.PubMed Hammers A, Koepp MJ, Labbe C, Brooks DJ, Thom M, Cunningham VJ, Duncan JS. Neocortical abnormalities of [11C]-flumazenil PET in mesial temporal lobe epilepsy. Neurology 2001; 56:897–906.PubMed
19.
Zurück zum Zitat Torizuka K, Uemura K, Toru M, Shinohara Y, Nishimura T, Yonekura Y, Nakagawara J, Matsuda H, Sakai F, Matsuda K, Fukuyama H, Morimoto K. [A phase 3 clinical trial of 123I-iomazenil, a new central-type benzodiazepine receptor imaging agent (Part 3)—Report on clinical usefulness in epilepsy]. Kaku Igaku 1996; 33:319–328.PubMed Torizuka K, Uemura K, Toru M, Shinohara Y, Nishimura T, Yonekura Y, Nakagawara J, Matsuda H, Sakai F, Matsuda K, Fukuyama H, Morimoto K. [A phase 3 clinical trial of 123I-iomazenil, a new central-type benzodiazepine receptor imaging agent (Part 3)—Report on clinical usefulness in epilepsy]. Kaku Igaku 1996; 33:319–328.PubMed
20.
Zurück zum Zitat Szelies B, Weber-Luxenburger G, Pawlik G, Kessler J, Holthoff V, Mielke R, Herholz K, Bauer B, Wienhard K, Heiss WD. MRI-guided flumazenil- and FDG-PET in temporal lobe epilepsy. Neuroimage 1996; 3:109–118.CrossRefPubMed Szelies B, Weber-Luxenburger G, Pawlik G, Kessler J, Holthoff V, Mielke R, Herholz K, Bauer B, Wienhard K, Heiss WD. MRI-guided flumazenil- and FDG-PET in temporal lobe epilepsy. Neuroimage 1996; 3:109–118.CrossRefPubMed
21.
Zurück zum Zitat Debets RM, Sadzot B, van Isselt JW, Brekelmans GJ, Meiners LC, van Huffelen AO, Franck G, van Veelen CW. Is 11C-flumazenil PET superior to 18FDG PET and 123I-iomazenil SPECT in presurgical evaluation of temporal lobe epilepsy? J Neurol Neurosurg Psychiatry 1997; 62:141–150.PubMed Debets RM, Sadzot B, van Isselt JW, Brekelmans GJ, Meiners LC, van Huffelen AO, Franck G, van Veelen CW. Is 11C-flumazenil PET superior to 18FDG PET and 123I-iomazenil SPECT in presurgical evaluation of temporal lobe epilepsy? J Neurol Neurosurg Psychiatry 1997; 62:141–150.PubMed
22.
Zurück zum Zitat Lamusuo S, Ruottinen HM, Knuuti J, Harkonen R, Ruotsalainen U, Bergman J, Haaparanta M, Solin O, Mervaala E, Nousiainen U, Jaaskelainen S, Ylinen A, Kalviainen R, Rinne JK, Vapalahti M, Rinne JO. Comparison of [18F]FDG-PET, [99mTc]-HMPAO-SPECT, and [123I]-iomazenil-SPECT in localising the epileptogenic cortex. J Neurol Neurosurg Psychiatry 1997; 63:743–748.PubMed Lamusuo S, Ruottinen HM, Knuuti J, Harkonen R, Ruotsalainen U, Bergman J, Haaparanta M, Solin O, Mervaala E, Nousiainen U, Jaaskelainen S, Ylinen A, Kalviainen R, Rinne JK, Vapalahti M, Rinne JO. Comparison of [18F]FDG-PET, [99mTc]-HMPAO-SPECT, and [123I]-iomazenil-SPECT in localising the epileptogenic cortex. J Neurol Neurosurg Psychiatry 1997; 63:743–748.PubMed
23.
Zurück zum Zitat Sjoholm H, Rosen I, Elmqvist D. Role of I-123-iomazenil SPECT imaging in drug resistant epilepsy with complex partial seizures. Acta Neurol Scand 1995; 92:41–48.PubMed Sjoholm H, Rosen I, Elmqvist D. Role of I-123-iomazenil SPECT imaging in drug resistant epilepsy with complex partial seizures. Acta Neurol Scand 1995; 92:41–48.PubMed
24.
Zurück zum Zitat van Huffelen AC, van Isselt JW, van Veelen CW, van Rijk PP, van Bentum AM, Dive D, Maquet P, Franck G, Velis DN, van Emde BW. Identification of the side of epileptic focus with 123I-Iomazenil SPECT. A comparison with 18FDG-PET and ictal EEG findings in patients with medically intractable complex partial seizures. Acta Neurochir Suppl (Wien) 1990; 50:95–99. van Huffelen AC, van Isselt JW, van Veelen CW, van Rijk PP, van Bentum AM, Dive D, Maquet P, Franck G, Velis DN, van Emde BW. Identification of the side of epileptic focus with 123I-Iomazenil SPECT. A comparison with 18FDG-PET and ictal EEG findings in patients with medically intractable complex partial seizures. Acta Neurochir Suppl (Wien) 1990; 50:95–99.
25.
Zurück zum Zitat Tanaka F, Yonekura Y, Ikeda A, Terada K, Mikuni N, Nishizawa S, Ishizu K, Okazawa H, Hattori N, Shibasaki H, Konishi J, Onishi Y. Presurgical identification of epileptic foci with iodine-123 iomazenil SPET: comparison with brain perfusion SPET and FDG PET. Eur J Nucl Med 1997; 24:27–34. Tanaka F, Yonekura Y, Ikeda A, Terada K, Mikuni N, Nishizawa S, Ishizu K, Okazawa H, Hattori N, Shibasaki H, Konishi J, Onishi Y. Presurgical identification of epileptic foci with iodine-123 iomazenil SPET: comparison with brain perfusion SPET and FDG PET. Eur J Nucl Med 1997; 24:27–34.
26.
Zurück zum Zitat Koepp MJ, Richardson MP, Brooks DJ, Poline JB, Van Paesschen W, Friston KJ, Duncan JS. Cerebral benzodiazepine receptors in hippocampal sclerosis. An objective in vivo analysis. Brain 1996; 119 Pt 5:1677–1687. Koepp MJ, Richardson MP, Brooks DJ, Poline JB, Van Paesschen W, Friston KJ, Duncan JS. Cerebral benzodiazepine receptors in hippocampal sclerosis. An objective in vivo analysis. Brain 1996; 119 Pt 5:1677–1687.
27.
Zurück zum Zitat Koepp MJ, Labbe C, Richardson MP, Brooks DJ, Van Paesschen W, Cunningham VJ, Duncan JS. Regional hippocampal [11C]flumazenil PET in temporal lobe epilepsy with unilateral and bilateral hippocampal sclerosis. Brain 1997; 120 Pt 10:1865–1876. Koepp MJ, Labbe C, Richardson MP, Brooks DJ, Van Paesschen W, Cunningham VJ, Duncan JS. Regional hippocampal [11C]flumazenil PET in temporal lobe epilepsy with unilateral and bilateral hippocampal sclerosis. Brain 1997; 120 Pt 10:1865–1876.
28.
Zurück zum Zitat Koepp MJ, Richardson MP, Labbe C, Brooks DJ, Cunningham VJ, Ashburner J, Van Paesschen W, Revesz T, Duncan JS. 11C-flumazenil PET, volumetric MRI, and quantitative pathology in mesial temporal lobe epilepsy. Neurology 1997; 49:764–773.PubMed Koepp MJ, Richardson MP, Labbe C, Brooks DJ, Cunningham VJ, Ashburner J, Van Paesschen W, Revesz T, Duncan JS. 11C-flumazenil PET, volumetric MRI, and quantitative pathology in mesial temporal lobe epilepsy. Neurology 1997; 49:764–773.PubMed
29.
Zurück zum Zitat Sisodiya SM, Moran N, Free SL, Kitchen ND, Stevens JM, Harkness WF, Fish DR, Shorvon SD. Correlation of widespread preoperative magnetic resonance imaging changes with unsuccessful surgery for hippocampal sclerosis. Ann Neurol 1997; 41:490–496.PubMed Sisodiya SM, Moran N, Free SL, Kitchen ND, Stevens JM, Harkness WF, Fish DR, Shorvon SD. Correlation of widespread preoperative magnetic resonance imaging changes with unsuccessful surgery for hippocampal sclerosis. Ann Neurol 1997; 41:490–496.PubMed
30.
Zurück zum Zitat Koepp MJ, Hammers A, Labbe C, Woermann FG, Brooks DJ, Duncan JS. 11C-flumazenil PET in patients with refractory temporal lobe epilepsy and normal MRI. Neurology 2000; 54:332–339.PubMed Koepp MJ, Hammers A, Labbe C, Woermann FG, Brooks DJ, Duncan JS. 11C-flumazenil PET in patients with refractory temporal lobe epilepsy and normal MRI. Neurology 2000; 54:332–339.PubMed
31.
Zurück zum Zitat Richardson MP, Koepp MJ, Brooks DJ, Fish DR, Duncan JS. Benzodiazepine receptors in focal epilepsy with cortical dysgenesis: an 11C-flumazenil PET study. Ann Neurol 1996; 40:188–198.PubMed Richardson MP, Koepp MJ, Brooks DJ, Fish DR, Duncan JS. Benzodiazepine receptors in focal epilepsy with cortical dysgenesis: an 11C-flumazenil PET study. Ann Neurol 1996; 40:188–198.PubMed
32.
Zurück zum Zitat Richardson MP, Friston KJ, Sisodiya SM, Koepp MJ, Ashburner J, Free SL, Brooks DJ, Duncan JS. Cortical grey matter and benzodiazepine receptors in malformations of cortical development. A voxel-based comparison of structural and functional imaging data. Brain 1997; 120 Pt 11:1961–1973. Richardson MP, Friston KJ, Sisodiya SM, Koepp MJ, Ashburner J, Free SL, Brooks DJ, Duncan JS. Cortical grey matter and benzodiazepine receptors in malformations of cortical development. A voxel-based comparison of structural and functional imaging data. Brain 1997; 120 Pt 11:1961–1973.
33.
Zurück zum Zitat Ryvlin P, Bouvard S, Le Bars D, De Lamerie G, Gregoire MC, Kahane P, Froment JC, Mauguiere F. Clinical utility of flumazenil-PET versus [18F]fluorodeoxyglucose-PET and MRI in refractory partial epilepsy. A prospective study in 100 patients. Brain 1998; 121 Pt 11:2067–2081. Ryvlin P, Bouvard S, Le Bars D, De Lamerie G, Gregoire MC, Kahane P, Froment JC, Mauguiere F. Clinical utility of flumazenil-PET versus [18F]fluorodeoxyglucose-PET and MRI in refractory partial epilepsy. A prospective study in 100 patients. Brain 1998; 121 Pt 11:2067–2081.
34.
Zurück zum Zitat Savic I, Thorell JO, Roland P. [11C]flumazenil positron emission tomography visualizes frontal epileptogenic regions. Epilepsia 1995; 36:1225–1232.PubMed Savic I, Thorell JO, Roland P. [11C]flumazenil positron emission tomography visualizes frontal epileptogenic regions. Epilepsia 1995; 36:1225–1232.PubMed
35.
Zurück zum Zitat Muzik O, da Silva EA, Juhasz C, Chugani DC, Shah J, Nagy F, Canady A, von Stockhausen HM, Herholz K, Gates J, Frost M, Ritter F, Watson C, Chugani HT. Intracranial EEG versus flumazenil and glucose PET in children with extratemporal lobe epilepsy. Neurology 2000; 54:171–179.PubMed Muzik O, da Silva EA, Juhasz C, Chugani DC, Shah J, Nagy F, Canady A, von Stockhausen HM, Herholz K, Gates J, Frost M, Ritter F, Watson C, Chugani HT. Intracranial EEG versus flumazenil and glucose PET in children with extratemporal lobe epilepsy. Neurology 2000; 54:171–179.PubMed
36.
Zurück zum Zitat Juhasz C, Chugani DC, Muzik O, Shah A, Shah J, Watson C, Canady A, Chugani HT. Relationship of flumazenil and glucose PET abnormalities to neocortical epilepsy surgery outcome. Neurology 2001; 56:1650–1658.PubMed Juhasz C, Chugani DC, Muzik O, Shah A, Shah J, Watson C, Canady A, Chugani HT. Relationship of flumazenil and glucose PET abnormalities to neocortical epilepsy surgery outcome. Neurology 2001; 56:1650–1658.PubMed
37.
Zurück zum Zitat Ryvlin P, Guénot M, Isnard J, Sindou M, et al. The role of the temporopolar cortex in temporal lobe epilepsy [abstract]. Stereotact Funct Neurosurg 1997; 67:143. Ryvlin P, Guénot M, Isnard J, Sindou M, et al. The role of the temporopolar cortex in temporal lobe epilepsy [abstract]. Stereotact Funct Neurosurg 1997; 67:143.
38.
Zurück zum Zitat Morrell F. Secondary epileptogenesis in man. Arch Neurol 1985; 42:318–335.PubMed Morrell F. Secondary epileptogenesis in man. Arch Neurol 1985; 42:318–335.PubMed
39.
Zurück zum Zitat Savic I, Blomqvist G, Halldin C, Litton JE, Gulyas B. Regional increases in [11C]flumazenil binding after epilepsy surgery. Acta Neurol Scand 1998; 97:279–286.PubMed Savic I, Blomqvist G, Halldin C, Litton JE, Gulyas B. Regional increases in [11C]flumazenil binding after epilepsy surgery. Acta Neurol Scand 1998; 97:279–286.PubMed
40.
Zurück zum Zitat Niimura K, Muzik O, Chugani DC, Shen C, Chugani HT. [11C]flumazenil PET: activity images versus parametric images for the detection of neocortical epileptic foci. J Nucl Med 1999; 40:1985–1991.PubMed Niimura K, Muzik O, Chugani DC, Shen C, Chugani HT. [11C]flumazenil PET: activity images versus parametric images for the detection of neocortical epileptic foci. J Nucl Med 1999; 40:1985–1991.PubMed
Metadaten
Titel
Is central benzodiazepine receptor imaging useful for the identification of epileptogenic foci in localization-related epilepsies?
verfasst von
Ingeborg Goethals
Christophe Van de Wiele
Paul Boon
Rudi Dierckx
Publikationsdatum
01.02.2003
Verlag
Springer-Verlag
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 2/2003
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-002-1083-z

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