{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T16:31:56Z","timestamp":1789835516654,"version":"4.0.1"},"reference-count":37,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2013,10,28]],"date-time":"2013-10-28T00:00:00Z","timestamp":1382918400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Fundaci\u00f3 Universit\u00e0ria Agust\u00ed Pedro i Pons, Universitat de Barcelona"},{"name":"NIHR Biomedical Research Centre funding scheme"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2013,12]]},"abstract":"Summary<\/jats:title>Objective<\/jats:title>Tuberous sclerosis complex (TSC<\/jats:styled-content>) is often associated with cerebral tubers and medically intractable epilepsy. We reevaluated whether increased uptake of \u03b1\u2010[11<\/jats:sup>C]methyl\u2010l<\/jats:sc>\u2010tryptophan (AMT<\/jats:styled-content>) in cerebral tubers is associated with tuber epileptogenicity.<\/jats:p><\/jats:sec>Methods<\/jats:title>We included 12 patients (six male, 4\u201353\u00a0years old) withTSC<\/jats:styled-content>and refractory seizures who were evaluated for epilepsy surgery in our center, including video\u2010electroencephalographic (EEG<\/jats:styled-content>) monitoring, fluid\u2010attenuated inversion recovery magnetic resonance imaging (FLAIR MRI<\/jats:styled-content>), and positron emission tomography (PET<\/jats:styled-content>) with \u03b1\u2010[11<\/jats:sup>C]methyl\u2010l<\/jats:sc>\u2010tryptophan (AMT<\/jats:styled-content>\u2010PET<\/jats:styled-content>). Nine of these 12 patients also underwent intracerebralEEG<\/jats:styled-content>recording.AMT<\/jats:styled-content>uptake in each tuber was visually evaluated onPET<\/jats:styled-content>coregistered withMRI<\/jats:styled-content>. AnAMT<\/jats:styled-content>uptake index based on lesional\/healthy cortex ratio was also calculated. Sensitivity and specificity values ofAMT<\/jats:styled-content>\u2010PET<\/jats:styled-content>in the detection of epileptogenic lesions were obtained, using the available electroclinical and neuroimaging evidence as the gold standard for epileptogenicity.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 126 tubers were identified. Two of 12 patients demonstrated a tuber with clearly increasedAMT<\/jats:styled-content>uptake, one of whom also showed a subtle increasedAMT<\/jats:styled-content>uptake in another contralateral tuber. Four other patients showed only subtle increasedAMT<\/jats:styled-content>uptake. The only two tubers with clearly increasedAMT<\/jats:styled-content>uptake proved to be epileptogenic based on intracerebralEEG<\/jats:styled-content>data, whereas none of the tubers associated with subtle increasedAMT<\/jats:styled-content>uptake were involved at ictal onset. In a per\u2010patient approach, this yielded a sensitivity of clearly increasedAMT<\/jats:styled-content>uptake in detecting tuber epileptogenicity of 17% (2\/12 patients), whereas the per\u2010lesion sensitivity and specificity were 12% (95% confidence interval [CI<\/jats:styled-content>]: 3\u201334%) and 100% (95%CI<\/jats:styled-content>: 97\u2013100%), respectively.<\/jats:p><\/jats:sec>Significance<\/jats:title>AMT<\/jats:styled-content>\u2010PET<\/jats:styled-content>is a specific neuroimaging technique in the identification of epileptogenic tubers inTSC<\/jats:styled-content>. Despite its low sensitivity, the clinical usefulness ofAMT<\/jats:styled-content>\u2010PET<\/jats:styled-content>still deserves to be considered according to the challenging complexity of epilepsy surgery in tuberous sclerosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.12412","type":"journal-article","created":{"date-parts":[[2013,10,28]],"date-time":"2013-10-28T14:26:43Z","timestamp":1382970403000},"page":"2143-2150","source":"Crossref","is-referenced-by-count":40,"title":["Positron emission tomography with \u03b1\u2010[11<\/sup>C<\/scp>]methyl\u2010l<\/scp>\u2010tryptophan in tuberous sclerosis complex\u2013related epilepsy"],"prefix":"10.1111","volume":"54","author":[{"given":"Sebasti\u00e0","family":"Rub\u00ed","sequence":"first","affiliation":[{"name":"Nuclear Medicine Department Hospital Clinic Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Costes","sequence":"additional","affiliation":[{"name":"CERMEP \u2010 Imagerie du 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