Emerging translocator protein–positron emission tomographic imaging improves detection of focal cortical dysplasia

作者：Zichen Qiao, Yingxue Yang, Yuanhong Chen, Linai Guo, Qing Xue, Lehong Gao, Jia Chen, Bixiao Cui, Jinghui Liu, Haoxun Yang, Xueyuan Wang, Y.-Z. Wang, Huaqiang Zhang, Cuiping Xu, Yicong Lin, Tao Yu, Yuping Wang, Yueshan Piao, Jie Lu, Liankun Ren · 发表于：Epilepsia · 年份：2025 · DOI：10.1111/epi.18351 · 被引用次数：7 · 研究领域：Glioma Diagnosis and Treatment、Epilepsy research and treatment、Neuroscience and Neuropharmacology Research

OBJECTIVE: The identification of epileptic lesions is crucial for improving surgical outcomes. Nevertheless, substantial focal cortical dysplasia (FCD) may be invisible on magnetic resonance imaging (MRI). We aimed to characterize the expression pattern of 18-kDa translocator protein (TSPO) in FCD and to evaluate the effectiveness of this inflammation-reflective molecular imaging technique for detecting FCD. METHODS: F-fluorodeoxyglucose (FDG) tracers. TSPO-PET activation patterns were qualitatively evaluated. Semiquantitative analysis using the Highlight Index (HI) was further performed to investigate its correlation with clinical characteristics. For patients who underwent stereo-EEG (SEEG) monitoring, the site of high-level TSPO-PET activation was compared with the seizure onset zone identified by SEEG. For patients who underwent resection surgery, the relationship between TSPO-PET uptake and histopathological findings was studied. RESULTS: Twenty-four patients were enrolled. Three groups were identified: MRI-positive with visible high-level TSPO-PET activation (six patients), MRI-negative with visible high-level TSPO-PET activation (thirteen patients), and MRI-positive with invisible low-level TSPO-PET activation (five patients). Regions of high-level TSPO-PET activation showed concordance with ictal discharges in five patients who underwent SEEG. Compared with FDG-PET, TSPO-PET exhibited a more prominent signal against the background (p = .0158). HI was correlated with s...