18F-Flumazenil: A g-Aminobutyric Acid A–Specific PET Radiotracer for the Localization of Drug-Resistant Temporal Lobe Epilepsy

localizes the epileptogenic zone in patients with medically refractory focal epilepsy than 18F-FDG PET. However, practical aspects of 11C use limit clinical application. We report a phase I/IIa study assessing the clinical use of 18F-FMZ PET for the localization of the epilepto-genic zone in patients with drug-resistant temporal lobe epilepsy (TLE). Receptor binding was quantified using kinetic modeling that did not require arterial sampling. Methods: Dynamic 18F-FMZ PET and static interictal 18F-FDG PET scans were compared in healthy controls (n 5 17 for 18F-FMZ and n 5 20 for 18F-FDG) and TLE pa-tients with mesial temporal sclerosis on MR imaging (MTS, n 5 12) and with normal MR imaging (NL TLE, n 5 19). Masked visual as-sessment of images was undertaken. Parametric images of 18F-FMZ binding potential (BPND) were generated using the simplified reference tissue model. Region-of-interest analysis on coregistered MR images and statistical parametric mapping were used to quan