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Title: Visual and quantitative analysis of interictal SPECT with technetium-99m-HMPAO in temporal lobe epilepsy.
Authors: Rowe, Christopher C;Berkovic, Samuel F;Austin, M C;Saling, Michael M;Kalnins, Renate M;McKay, W J;Bladin, Peter F
Affiliation: Comprehensive Epilepsy Program, Austin Hospital, Heidelberg, Victoria, Australia
Issue Date: 1-Sep-1991
Citation: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine; 32(9): 1688-94
Abstract: Interictal 99mTc-HMPAO SPECT images were compared to ictal EEG localization in 51 patients with intractable temporal lobe epilepsy to determine their usefulness for preoperative seizure focus localization. Both quantified temporal lobe asymmetry and blinded visual detection of temporal lobe hypoperfusion were employed. Visual analysis detected ipsilateral hypoperfusion in 18 (39%) of the 46 patients with a unilateral focus and contralateral hypoperfusion in 3. None of the five patients with bitemporal foci had unilateral hypoperfusion. The positive predictive value of unilateral temporal lobe hypoperfusion was 86% (18/21). Quantified anterior temporal lobe asymmetry, greater than a previously derived normal range, correctly identified the focus in 22 (48%) but gave the wrong side in 5, resulting in a predictive value of 81%. The degree of asymmetry correlated inversely with age of seizure onset, but not with other clinical parameters, histology, or verbal and nonverbal memory. The usefulness of interictal 99mTc-HMPAO SPECT for pre-operative seizure focus localization is limited by low sensitivity when performed with a conventional rotating gamma camera. This suggests that ictal or immediate postictal imaging may be necessary for this purpose.
Internal ID Number: 1880570
Type: Journal Article
Subjects: Adult
Epilepsy, Temporal Lobe.diagnosis.radionuclide
Organotechnetium Compounds.diagnostic use
Oximes.diagnostic use
Preoperative Care
Technetium Tc 99m Exametazime
Tomography, Emission-Computed, Single-Photon
Appears in Collections:Journal articles

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