Limited value of interictal brain perfusion SPECT for detection of epileptic foci: high resolution SPECT studies in comparison with FDG-PET.
Accurate localization of epileptic foci is important for pre-surgical evaluation of patients with medically intractable epilepsy, and F-18 FDG PET has been proved to be a valuable method for this purpose. To examine the clinical value with interictal brain perfusion SPECT, we performed brain perfusion SPECT of Tc-99m HMPAO by means of a high resolution SPECT camera, and compared the results with F-18 FDG PET images and MRI in 10 patients with medically intractable epilepsy. In 9 of 10 patients (90%), FDG PET images showed focal hypo-metabolism in the area corresponding with the results of electroencephalography (EEG). SPECT images, however, demonstrated hypo-perfused lesions which corresponded with hypo-metabolic lesions on FDG PET images in only 6 cases (60%). Although MRI showed abnormal findings in 8 cases, the lesions were not directly related to epileptic foci in 2 cases. In conclusion, FDG PET is a valuable tool for accurate localization of epileptic foci. Brain perfusion SPECT, however, may not always be paralleled to metabolism visualized on FDG PET images.
Nagata
T
T
Department of Radiology, Shiga University of Medical Science, Otsu, Japan.
Tanaka
F
F
Yonekura
Y
Y
Ikeda
A
A
Nishizawa
S
S
Ishizu
K
K
Okazawa
H
H
Terada
K
K
Mikuni
N
N
Yamamoto
I
I
D000293:Adolescent; D000328:Adult; D003847:Deoxyglucose / Q000031:analogs & derivatives; D004827:Epilepsy / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010091:Oximes; D011859:Radiography; D019690:Technetium Tc 99m Exametazime; D014055:Tomography, Emission-Computed; D015899:Tomography, Emission-Computed, Single-Photon
D015609:Organotechnetium Compounds; D010091:Oximes; D019788:Fluorodeoxyglucose F18; D019690:Technetium Tc 99m Exametazime; D003847:Deoxyglucose