The value of resting-state functional magnetic resonance imaging for detecting epileptogenic zones in patients with focal epilepsy

ObjectiveTo determine the value of resting-state functional magnetic resonance imaging (RS-fMRI) based on the local analysis methods regional homogeneity (ReHo), amplitude of low-frequency fluctuations (ALFF), and fractional ALFF (fALFF), for detecting epileptogenic zones (EZs).MethodsA total of 42 consecutive patients with focal epilepsy were enrolled. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of visually assessed RS-fMRI, MRI, magnetic resonance spectroscopy (MRS), video electroencephalography (VEEG), and positron-emission tomography computed tomography (PET-CT) in EZ localization were evaluated to assess their diagnostic abilities. ReHo, ALFF, and fALFF were also compared for their diagnostic values.ResultsRS-fMRI showed comparable sensitivity to PET (83.3%) and specificity to VEEG (66.7%), respectively, for EZ localization in patients with focal epilepsy. There were no significant differences between RS-fMRI and the other localization techniques in terms of sensitivity, specificity, PPV, and NPV. The sensitivities of ReHo, ALFF, and fALFF were 69.4%, 52.8%, and 38.9%, respectively, and for specificities of 66.7%, 83.3%, and 66.7%, respectively. There were no significant differences among ReHo, ALFF, and fALFF, except that ReHo was more sensitive than fALFF.ConclusionsRS-fMRI may be an efficient tool for detecting EZs in focal epilepsy patients.