Initial Experience with SPECT Imaging of the Brain Using 1-123 p-lodoamphetamine in Focal Epilepsy

LaMANNA, Margaret M.; Sussman, Neil M.; Harner, Richard N.; Kaplan, Linda R.; Hershey, Beverly L.; Bernstein, D.R.; Goldstein, Phillip J.; Parker, J.A.; Wolodzko, John G.; Popky, George L.

doi:10.1097/00003072-198906000-00006

Cited by 25 publications

(8 citation statements)

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“…Five hundred thirty-nine patients were reported in the literature with interictal SPECT results and EEG, with each of these determinations in sufficient detail to analyze sensitivity and specificity for predicting the lobe of epileptogenicity (Stefan et al, 1987(Stefan et al, , 1990Denays et al, 1988;Lee et al, 1988;Ryding et al, 1988;Gelfand et al, 1989;Lamanna et al, 1989;Rowe et al, 1989Rowe et al, , 1991Smith et al, 1989;Anderson et al, 1990;Cordes et al, 1990;Shen et al, 1990;Abdel-Dayem et al, 1991;Dietrich et al, 1991;Grunwald et al, 1991;Hajek et al, 1991;Launes et al, 1992;Markand et al, 1992;Newton et al, 1992b;Ryvlin et al, 1992;Verhoeff et al, 1992;Coubes et al, 1993). Two hundred ninety-one patients were localized by SPECT to the temporal lobe, 65 to extratemporal locations, and 183 were unlocalized, a discrepancy that may reflect merely the higher frequency of temporal lobe epilepsy in general or of temporal lobe epilepsy among patients refractory to medications who are most likely to undergo SPECT as part of presurgical evaluation ( Table 2).…”

Section: Sensitivity and Specificitymentioning

confidence: 99%

The Relative Contributions of MRI, SPECT, and PET Imaging in Epilepsy

1994

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Functional and structural neuroimaging techniques are increasingly indispensable in the evaluation of epileptic patients for localization of the epileptic area as well as for understanding pathophysiology, propagation, and neurochemical correlates of chronic epilepsy. Although interictal single photon emission computed tomography (SPECT) imaging of cerebral blood flow is only moderately sensitive, ictal SPECT markedly improves yield. Positron emission tomography (PET) imaging of interictal cerebral metabolism is more sensitive than measurement of blood flow in temporal lobe epilepsy. Furthermore, PET has greater spatial resolution and versatility in that multiple tracers can image various aspects of cerebral function. Interpretation of all types of functional imaging studies is difficult and requires knowledge of time of most recent seizure activity and structural correlates. Only magnetic resonance imaging (MRI) can image the structural changes associated with the underlying epileptic process, and quantitative evidence of hippocampal volume loss has been highly correlated with seizure onset in medial temporal structures. Improved resolution and interpretation have made quantitative MRI more sensitive in temporal lobe epilepsy, as judged by pathology. When judged by electroencephalography (EEG), ictal SPECT and interictal PET have the highest sensitivity and specificity for temporal lobe epilepsy; these neuroimaging techniques have lower sensitivity and higher specificity for extratemporal EEG abnormalities. Regardless of the presence of structural abnormalities, functional imaging by PET or SPECT provides complementary information. Ideally these techniques should be used and interpreted together to improve the localization and understanding of epileptic brain.

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Section: Sensitivity and Specificitymentioning

confidence: 99%

The Relative Contributions of MRI, SPECT, and PET Imaging in Epilepsy

1994

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“…Interictal SPECT in patients with MI-CPS shows decreased rCBF in the epileptogenic temporal lobe, the yield ranging from 40% to 86% (6, [10][11][12][13][14][15][16][17]. In the study of Rowe et al (10) of 51 patients with medically intractable CPS, interictal SPECT showed ipsilateral hypoperfusion in 18 (39%) of the 46 patients with a unilateral focus and a contralateral perfusion in three.…”

Section: Resultsmentioning

confidence: 99%

Utility of interictal SPECT of rCBF for focal diagnosis of the epileptogenic zone(s)

Andersen

Rogvvi-Hansen

Dam

1994

Acta Neurologica Scandinavica

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With Single Photon Emission Computed Tomography (SPECT) of regional cerebral bloodflow (rCBF) ictally and interictally, regional changes of rCBF can be detected in many cases with medically intractable complex partial seizures. Interictal SPECT shows abnormal rCBF in the epileptogenic temporal lobe in 40% to 85% of the patients. A critical survey of the methodological problems considering isotopes, scanners, data analysis and patient population is presented here as well as a few semi‐quantitative studies including our own. It is concluded, that SPECT of rCBF is a useful, non‐invasive method of localizing the epileptogenic zone in patients with severe partial focal epilepsy. Ictal SPECT of rCBF has a higher predictive value and is more sensitive than interictal studies for localization of the seizure focus. Interictal SPECT using a high‐resolution system obtains an almost as high frequency of localization of the focus. With low resolution scanners, a minor frequency is observed. Both interictal and ictal SPECT recordings should be obtained for localization of the epileptogenic focus in presurgical cases as interictal hypoperfusion and ictal hyperperfusion demonstrated in the same focal area are highly characteristic of a seizure focus.

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“…Some regional abnormalities in blood flow SPECT were possibly related to neuropsychological defects 90,91 . Serial SPECT studies in the interictal, ictal and immediate post-ictal states were performed in 12 patients with refractory TLE to define the patterns and duration of peri-ictal CBF changes.…”

Section: Cerebral Blood Flow Tracersmentioning

confidence: 98%

CPD – Education and Self-assessment: Functional imaging in epilepsy

Richardson

2001

Seizure

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Functional imaging plays a growing role in the clinical assessment and research investigation of patients with epilepsy. This article reviews the literature on functional MRI (fMRI) investigation of EEG activity, fMRI evaluation of cognitive and motor functions, magnetic resonance spectroscopy (MRS), single photon emission computed tomography (SPECT) and positron emission tomography (PET) in epilepsy. The place of these techniques in clinical evaluation and their contribution to a better neurobiological understanding of epilepsy are discussed.

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Initial Experience with SPECT Imaging of the Brain Using 1-123 p-lodoamphetamine in Focal Epilepsy

Cited by 25 publications

References 0 publications

The Relative Contributions of MRI, SPECT, and PET Imaging in Epilepsy

The Relative Contributions of MRI, SPECT, and PET Imaging in Epilepsy

Utility of interictal SPECT of rCBF for focal diagnosis of the epileptogenic zone(s)

CPD – Education and Self-assessment: Functional imaging in epilepsy

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