Keywords
pediatrics
neuroimaging
asymmetry index
epileptogenic focus
How to Cite
Abstract
In press
Background. Drug-Resistant Epilepsy (DRE) in the pediatric population remains a challenging diagnostic problem, as traditional neuroimaging methods do not always reflect functional changes in the brain. The use of Positron Emission Tomography with 18F-FluoroDeoxyGlucose in combination with Computed Tomography (18F-FDG PET/CT) opens up new possibilities for the early detection of epileptogenic zones through quantitative assessment of metabolic asymmetry.
Aim. To summarize current data on the comprehensive assessment of brain metabolic asymmetry using positron emission tomography with 18F-fluorodeoxyglucose in combination with computed tomography in children with drug-resistant epilepsy and to determine scientifically-based parameters for its assessment.
Materials and Methods. The study used methods of theoretical generalization, analysis, and synthesis of results, bibliosemantic method. The search for works was conducted in the scientometric databases Scopus, Web of Science, PubMed and Google Scholar. This study was conducted as a private initiative by the author.
Research Ethics. During the study, publications were selected, the authors of which adhered to modern bioethical standards.
Results. The study showed that metabolic asymmetry of the brain is a quantitatively measurable, statistically significant marker of epileptogenic focus activity. Metabolic asymmetry correlates with neuroontogenetic markers and the localization of the epileptogenic focus, which is of practical importance for planning more targeted surgical procedures. The combination of PET/CT with neuroimaging methods yielded more stable and repeatable results in identifying areas with impaired metabolism compared to each method alone. The results indicate the potential for using metabolic asymmetry as an additional biomarker for selecting candidates for surgical interventions, as well as for monitoring the effectiveness and prognosis of surgical treatment of DRE in children. It complements structural imaging methods and neuropsychological assessments, facilitating a personalized approach to each patient and improving the effectiveness of surgical treatment of children with DRE.
Conclusions. 18F-FDG PET/CT is a reliable tool for quantitative assessment of brain metabolic asymmetry in children with DRE. The asymmetry index can serve as an objective biomarker for the lateralization of the epileptogenic zone and the prognosis of treatment effectiveness. Standardization of analysis methods and the creation of age-referenced databases are key conditions for increasing the clinical value of PET/CT in pediatric practice.
Keywords: medical radiology, pediatrics, neuroimaging, asymmetry index, epileptogenic focus.
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