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Background and purpose <p>Arterial Spin Labelling MRI is a neuroimaging technique able to evaluate brain perfusion, an indirect measure of brain metabolism and function. Arterial Spin Labelling MRI showed to have performances comparable to [<sup>18</sup>F]fluorodeoxyglucose-PET in in epilepsy, yet literature data is still lacking about its use in children and the value of voxel-based asymmetry index analysis. Purpose of the project is to compare the Arterial Spin Labelling MRI and [<sup>18</sup>F]fluorodeoxyglucose-PET ability to identify the epileptogenic zone before and after asymmetry index analysis in children.</p> Materials and methods <p>In this observational study, paediatric patients with focal onset drug-resistant epilepsy that underwent presurgical evaluation, including Arterial Spin Labelling MRI and [<sup>18</sup>F]fluorodeoxyglucose-PET, were enrolled. The epileptogenic zone was defined by anatomo-electroclinical correlation and post-surgical outcome, when feasible. The rates of concordance with the epileptogenic zone of Arterial Spin Labelling MRI and [<sup>18</sup>F]fluorodeoxyglucose-PET before (visual analysis) and after asymmetry index analysis, were calculated. Statistically significant differences between were determined using Mc Nemar’s test (<i>p</i> &lt; 0.05).</p> Results <p>28 paediatric patients (mean age 10.07 years, 15 females) with focal epilepsy were enrolled; 22 underwent epilepsy surgery (mean age 9.86 years, 12 females). When comparing the techniques, visual analysis of Arterial Spin Labelling MRI had a significantly lower rate of concordance with the epileptogenic zone (<i>p</i> &lt; 0.05).</p> Conclusion <p>Voxel-based asymmetry index analysis increased significantly the rate of concordance of Arterial Spin Labelling MRI with the epileptogenic zone, achieving results comparable with [<sup>18</sup>F]fluorodeoxyglucose-PET in a cohort of paediatric patients.</p>

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Head to head comparison between arterial spin labelling MRI and [18F]FDG-PET in presurgical evaluation of epilepsy in children: the role of voxel-based asymmetry index analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月27日

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  • Pietro Mattioli,
  • Giulia Nobile,
  • Matteo Cataldi,
  • Luca Bosisio,
  • Francesco Famà,
  • Andrea Rossi,
  • Alessandro Consales,
  • Stefano Raffa,
  • Flavio Villani,
  • Silvia Morbelli,
  • Dario Arnaldi,
  • Lino Nobili,
  • Domenico Tortora,
  • Alessandra Ferrari,
  • Stefano Francione,
  • Thea Giacomini,
  • Laura Giorgetti,
  • Mattia Losa,
  • Maria Margherita Mancardi,
  • Valentina Marazzotta,
  • Elisa Micalizzi,
  • Mattia Pacetti,
  • Irene Pappalardo,
  • Costanza Parodi,
  • Giulia Prato,
  • Mariasavina Severino,
  • Laura Siri,
  • Andrea Michele Wolfler

摘要

Background and purpose

Arterial Spin Labelling MRI is a neuroimaging technique able to evaluate brain perfusion, an indirect measure of brain metabolism and function. Arterial Spin Labelling MRI showed to have performances comparable to [18F]fluorodeoxyglucose-PET in in epilepsy, yet literature data is still lacking about its use in children and the value of voxel-based asymmetry index analysis. Purpose of the project is to compare the Arterial Spin Labelling MRI and [18F]fluorodeoxyglucose-PET ability to identify the epileptogenic zone before and after asymmetry index analysis in children.

Materials and methods

In this observational study, paediatric patients with focal onset drug-resistant epilepsy that underwent presurgical evaluation, including Arterial Spin Labelling MRI and [18F]fluorodeoxyglucose-PET, were enrolled. The epileptogenic zone was defined by anatomo-electroclinical correlation and post-surgical outcome, when feasible. The rates of concordance with the epileptogenic zone of Arterial Spin Labelling MRI and [18F]fluorodeoxyglucose-PET before (visual analysis) and after asymmetry index analysis, were calculated. Statistically significant differences between were determined using Mc Nemar’s test (p < 0.05).

Results

28 paediatric patients (mean age 10.07 years, 15 females) with focal epilepsy were enrolled; 22 underwent epilepsy surgery (mean age 9.86 years, 12 females). When comparing the techniques, visual analysis of Arterial Spin Labelling MRI had a significantly lower rate of concordance with the epileptogenic zone (p < 0.05).

Conclusion

Voxel-based asymmetry index analysis increased significantly the rate of concordance of Arterial Spin Labelling MRI with the epileptogenic zone, achieving results comparable with [18F]fluorodeoxyglucose-PET in a cohort of paediatric patients.