Seizure Outcome After Surgery for Refractory Epilepsy Diagnosed by 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET/MRI): A Systematic Review and Meta-Analysis

作者：Jia Guo, Mujie Guo, Ruihan Liu, Yu Kong, Xibin Hu, Lei Yao, Shaomin Lv, Jiahua Lv, Xinyu Wang, Qingxia Kong · 发表于：World Neurosurgery · 年份：2023 · DOI：10.1016/j.wneu.2023.01.114 · 被引用次数：11 · 研究领域：Epilepsy research and treatment、Glioma Diagnosis and Treatment、Pharmacological Effects and Toxicity Studies

When magnetic resonance imaging (MRI) fails to detect an underlying epileptogenic lesion, the odds of a good outcome after epilepsy surgery are significantly lower (20%–65% compared with 60%–90% if a lesion is detected). We investigated the possible effects of introducing hybrid 18F-FDG PET/MRI into the decision algorithm for patients with lesioned and non-lesioned drug-resistant epilepsy. Three databases were searched from January 1990 to October 2022. We registered the protocol with INPLASY (International Platform of Registered Systematic Review and Meta-analysis Protocols). Studies in which 18F-FDG PET/MRI was conducted with ≥12 months of post-surgical follow-up in patients with refractory epilepsy. Random-effects meta-analysis was used to calculate the proportion of patients with good outcomes. Meta-regression was used to investigate sources of heterogeneity. We identified 8105 studies, of which 23 (1292 patients in total) were included. The overall good postoperative outcome rate was 71% (95% confidence interval [CI] 63.6–74.9). Good outcome was associated with the location of the refractory epileptic lesion (temporal lobe or extratemporal; risk ratio [RR] 1.27 [95% CI 1.01–1.52], p = 0.009); Length of postoperative follow-up ≥40 months included in the same study accounted for 0.6% of the observed heterogeneity. Seventy-one percent of patients with refractory epilepsy and 18F-FDG PET/MRI epileptogenic lesion features had a good outcome of epilepsy after surgery. Our find...