No Evidence to Favor 99mTc-HMPAO or 99mTc-ECD for Ictal Brain Perfusion SPECT for Identification of the Seizure Onset Zone
| Autor: | Ralph Buchert, Tobias Martens, Matthias Lindenau, Susanne Klutmann, Jila Taherpour, Ivayla Apostolova, Berthold Voges, Stefan Stodieck, Mariam Jaber, Patrick M. House, Michael Lanz, Thomas Sauvigny |
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| Rok vydání: | 2021 |
| Předmět: |
genetic structures
Perfusion scanning Ictal-Interictal SPECT Analysis by SPM Lateralization of brain function Temporal lobe Epilepsy Technetium Tc 99m Exametazime Seizures medicine Humans Radiology Nuclear Medicine and imaging Epilepsy surgery Ictal Cysteine Retrospective Studies Tomography Emission-Computed Single-Photon business.industry Brain Electroencephalography General Medicine Organotechnetium Compounds medicine.disease Perfusion Epileptic seizure medicine.symptom business Nuclear medicine |
| Zdroj: | Clinical nuclear medicine. 46(11) |
| ISSN: | 1536-0229 |
| Popis: | PURPOSE Ictal brain perfusion SPECT with the tracer 99mTc-HMPAO or 99mTc-ECD is widely used for identification of the epileptic seizure onset zone (SOZ) in presurgical evaluation if standard pointers are uncertain or inconsistent. For both tracers, there are theoretical arguments to favor it over the other for this task. The aim of this study was to compare the performance of ictal brain perfusion SPECT between 99mTc-HMPAO and 99mTc-ECD in a rather large patient sample. PATIENTS AND METHODS The study retrospectively included 196 patients from clinical routine in whom ictal perfusion SPECT had been performed with stabilized 99mTc-HMPAO (n = 110) or 99mTc-ECD (n = 86). Lateralization and localization of the SOZ were obtained by the consensus of 2 independent readers based on visual inspection of the SPECT images. RESULTS The 99mTc-HMPAO group and the 99mTc-ECD group were well matched with respect to age, sex, age at first seizure, duration of disease, seizure frequency, history of previous brain surgery, and findings of presurgical MRI. The proportion of lateralizing ictal SPECT did not differ significantly between 99mTc-HMPAO and 99mTc-ECD (65.5% vs 72.1%, P = 0.36). Sensitivity of ictal perfusion SPECT (independent of the tracer) for correct localization of the SOZ in 62 patients with temporal lobe epilepsy and at least worthwhile improvement (Engel scale ≤ III) 12 months after temporal epilepsy surgery was 63%. CONCLUSIONS This study does not provide evidence to favor 99mTc-HMPAO or 99mTc-ECD for identification of the SOZ by ictal perfusion SPECT. |
| Databáze: | OpenAIRE |
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