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

OBJECTIVE To 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). METHODS A 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. RESULTS RS-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. CONCLUSIONS RS-fMRI may be an efficient tool for detecting EZs in focal epilepsy patients.