Diagnostic Value of Hybrid 18F-FDG and 18F-DPA-714 PET/MR in Refractory Epilepsy

Motivation: Surgery is the only curative option for a third of refractory epilepsy patients, yet successful outcomes rely on the precise but challenging localization of the epileptogenic zone (EZ). Goal(s): To assess EZ localization accuracy of hybrid 18F-DPA-714 and 18F-FDG PET/MR imaging in refractory epilepsy. Approach: This retrospective study included 33 EZ resection patients, comparing preoperative 18F-DPA-714 and 18F-FDG PET/MR visual scores and asymmetry index with pathology using statistics. Results: 18F-DPA-714 PET/MR had a higher visual score but a lower AI score than 18F-FDG (P < 0.01). The accuracies of localization with MRI, 18F-FDG and 18F-DPA-714 PET/MR were 63.6%(21/33), 84.8%(28/33), 78.8%(26/33). Impact: Compared to MRI and 18F-FDG PET/MR, 18F-DPA-714 PET/MR offers clearer and more precise delineation of lesion borders while maintaining the high positive detection rate, thus providing valuable guidance for preoperative localization.