Comparison of T2 relaxometry and PET CT in the evaluation of patients with mesial temporal lobe epilepsy using video EEG as the reference standard

Introduction
Our study aimed to compare the sensitivity of T2 relaxometry and positron emission tomography – computed tomography (PET/CT) in patients with a history suggestive of mesial temporal lobe epilepsy using video electroencephalography (EEG) as the reference standard.

Material and methods
In our study, 35 patients with a history suggestive of mesial temporal lobe epilepsy were subjected to conventional magnetic resonance imaging (MRI), T2 relaxometry, and PET/CT. The results of each of the studies were compared with video EEG findings. Analyses were performed by using statistical software (SPSS version 20.0 for windows), and the sensitivity of conventional MRI, T2 relaxometry, and PET/CT were calculated.

Results
The sensitivity of qualitative MRI (atrophy and T2 hyperintensity), quantitative MRI (T2 relaxometry), and PET/CT in lateralizing the seizure focus were 68.6% (n = 24), 85.7% (n = 30), and 88.6% (n = 31), respectively.

Conclusions
The sensitivity of MRI in lateralization and localization of seizure focus in temporal lobe epilepsy can be increased by adding the quantitative parameter (T2 relaxometry) with the conventional sequences. T2 Relaxometry is comparable to PET/CT for localization and lateralization of seizure focus and is a useful tool in the workup of TLE patients.