Excising epileptic foci (EF) is the most efficient approach for treating drug-resistant epilepsy (DRE). However, owing to the vast heterogeneity of epilepsies, EF in one-third of patients cannot be accurately located, even after exhausting all current diagnostic strategies. Therefore, identifying biomarkers that truly represent the status of epilepsy and fabricating probes with high targeting specificity are prerequisites for identifying the “concealed” EF. However, no systematic summary of this topic has been published. Herein, the potential biomarkers of EF are first summarized and classified into three categories: functional, molecular, and structural aberrances during epileptogenesis, a procedure of nonepileptic brain biasing toward epileptic tissue. The materials used to fabricate these imaging probes and their performance in defining the EF in preclinical and clinical studies are highlighted. Finally, perspectives for developing the next generation of probes and their challenges in clinical translation are discussed. In general, this review can be helpful in guiding the development of imaging probes defining EF with improved accuracy and holds promise for increasing the number of DRE patients who are eligible for surgical intervention.

中文翻译：

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为癫痫成像定制材料：从生物标志物到成像探针

切除癫痫病灶（EF）是治疗耐药性癫痫（DRE）最有效的方法。然而，由于癫痫的巨大异质性，即使在用尽所有当前诊断策略后，仍有三分之一的患者无法准确定位 EF。因此，识别真正代表癫痫状态的生物标志物并制造具有高靶向特异性的探针是识别“隐藏”EF的先决条件。然而，尚未发表对该主题的系统总结。在此，首先总结 EF 的潜在生物标志物并将其分为三类：癫痫发生过程中的功能、分子和结构异常，这是一种非癫痫脑偏向癫痫组织的过程。重点介绍了用于制造这些成像探针的材料及其在临床前和临床研究中定义 EF 的性能。最后，讨论了开发下一代探针的前景及其在临床转化中的挑战。总体而言，本综述有助于指导以更高的准确性定义 EF 的成像探针的开发，并有望增加符合手术干预条件的 DRE 患者的数量。