A 20-year-old female with drug-resistant epilepsy since early childhood underwent comprehensive pre-surgical neuroimaging evaluation.
Advanced imaging strategy at Scan4Health: The evaluation included
1. FDG-PET brain
2. HArNESS-based epilepsy MRI with Connectomics-driven neural network mapping
3. PET–MR integration
What changed everything?
FDG-PET revealed focal hypometabolism in the left insular cortex (volume: 1.7 cc). This metabolic abnormality triggered a highly targeted structural re-evaluation of the left insula, leading to identification of an extremely subtle focal cortical dysplasia (FCD)—with only ~1 mm cortical thickening compared to the contralateral side.
Why this mattered surgically?
The insula is a high-risk surgical zone due to its deep location and close relationship with M2/M3 branches of the middle cerebral artery and perforators. Consequently, meticulous presurgical planning is critical to balance seizure control with vascular and functional safety.
Precise PET–MR localization:
– Enabled confident surgical targeting in a traditionally avoided region
– Provided a quantitative estimate of epileptogenic tissue volume to guide extent of resection
-Supported connectomics-based network mapping, clarified relationship to the arcuate fasciculus and eloquent language networks
Intraoperative validation: Despite resection of the temporal lobe (4 cm above the temporal pole), electrocorticography continued to show epileptiform firing. Only after resection of the left insular cortex did the firing cease—validating the PET–MR hypothesis.
Outcome: The patient is now seizure-free.
Take away message:
At Scan4Health, PET and MRI are performed under one roof, powered by harmonized (HArNESS-based) epilepsy protocol and multidisciplinary expert collaboration. In this case, seamless PET–MR integration directly shaped surgical decision-making and enabled a targeted intervention that prevented epileptic seizures—delivering a truly life-changing outcome for the patient.
For patients with drug-resistant epilepsy, this level of imaging precision is not just a technical achievement—it is life-changing because Every Seizure-Free Life Matters.
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