ArticleEuropean journal of nuclear medicine and molecular imaging2026
Individual 18F-FDG PET and arterial spin labeling coupling based on simultaneous PET/MRI predicting anti-seizure medication response in temporal lobe epilepsy patients.
Article in European journal of nuclear medicine and molecular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- AlEuropean journal of nuclear medicine and molecular imaging · 2026Article
- Comparison of Iodine-123 Metaiodobenzylguanidine scintigraphy with SPECT/CT and Fluorine-18-aluminum fluoride-1,4,7-triazacyclononane-1,4,7-triacetic acid-octreotide PET/CT in recurrent High-risk neuroblastoma after complete remission.European journal of nuclear medicine and molecular imaging · 2026Article
- Prognostic value of baseline [68Ga]Ga‑DOTA‑NOC PET/CT in paediatric neuroblastoma.European journal of nuclear medicine and molecular imaging · 2026Article
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Authors and funding
11 authors.
Funding
Abstract
aimsDespite advances in epilepsy management, reliable prediction of anti-seizure medication (ASM) response remains an unmet need in temporal lobe epilepsy (TLE). Emerging evidence indicates that neurovascular decoupling (NVD), defined as the mismatch between neuronal activity and cerebral hemodynamics, may function as an imaging biomarker that reflects dysfunction within the epileptogenic network. This prospective study uses simultaneous 18 F-FDG PET/MRI to characterize patterns of metabolic-perfusion dissociation and to evaluate their value in predicting ASM outcomes in TLE.
methodsThis prospective cohort enrolled 52 unilateral TLE patients before initiation of standardized ASM regimens. Simultaneous 18 F-FDG PET/MRI was conducted before treatment to measure cerebral glucose metabolism through standardized uptake value (SUV) and hemodynamics through arterial spin labeling-derived cerebral blood flow (CBF). Participants were classified into ASM-responsive (N = 27) and ASM-resistant (N = 25) groups according to seizure recurrence at 12-month follow-up. Multimodal normalization was performed using age-matched healthy controls (N = 23) to generate z-score maps for metabolic (SUV_z) and perfusion (CBF_z) parameters. Neurovascular coupling was quantified using the SUV-CBF ratio at the whole-brain voxel level. Regions of interest (ROIs) were defined based on regions showing significant differences, and predictive performance was assessed with receiver operating characteristic (ROC) curve analysis.
resultsThe analysis identified distinct neurovascular decoupling gradients in TLE. The SUV-CBF ratio decreased in the temporal lobe and cerebellum, whereas it increased in the frontal and occipital lobes compared with healthy controls. In the ASM-resistant group, the SUV-CBF ratio z-score was lower in the posterior cingulate gyrus and higher in the frontotemporal parietal occipital cortex compared with responders. The posterior cingulate cortex was chosen as the primary ROI. Prediction of ASM response based on SUV, CBF, and the SUV-CBF ratio in the posterior cingulate cortex yielded AUCs of 0.553, 0.676, and 0.836, respectively.
conclusionsNeurovascular decoupling characteristics derived from 18 F-FDG PET/MR may serve as a promising biomarker for identifying patients at risk of ASM-resistant outcomes.
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