title: Statistical parametric mapping of interictal 123I-iomazenil SPECT in temporal lobe epilepsy surgery.
abstract: Brain single photon emission computed tomography (SPECT) for epilepsy is divided into two types (using three radionuclide tracers)-perfusion SPECT (123I-IMP or 99 mTc-ECD), identifying epileptogenic foci by detecting abnormality in regional cerebral blood flow, and 123I-iomazenil SPECT, identifying epileptogenic foci based on distribution of central benzodiazepine receptors. This study aimed to statistically evaluate and compare the SPECT effectiveness for the three tracers. Statistical parametric mapping (SPM) analysis was performed on 30 mesial temporal lobe epilepsy (mTLE) patients. The radionuclide and patient data were categorized as follows: abnormality in the medial temporal lobe on the operated hemisphere (AAA), in the entire temporal lobe on the operated hemisphere (AA), in the dominantly affected temporal lobe on the operated hemisphere (A), in bilateral temporal lobes (B), with no abnormalities in bilateral temporal lobes (C), and with abnormality in the temporal lobe on the nonoperated hemisphere (D). For analyses of (AAA), (AA), and (A), examining the hemisphere containing epileptogenic foci, IMP-SPECT was significantly superior to ECD-SPECT (P<0.05). For (AAA), indicating localization, IMZ-SPECT was significantly superior to the other two (P<0.05). IMP-SPECT was superior for lateralizing and IMZ-SPECT was useful for localizing epileptogenic foci in mTLE patients though the applicability of the results in extratemporal lobe epilepsy is unknown.
authors.affiliation: Japanese Red Cross Nagoya First Hospital, Michishita-cho 3-35, Nakamura-ku, Nagoya City, Aichi, Japan. shigeru_f717@nyc.odn.ne.jp
authors.forename: Shigeru
authors.initials: S
authors.lastname: Fujitani
authors.forename: Kazumi
authors.initials: K
authors.lastname: Matsuda
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Nakamura
authors.forename: Koichi
authors.initials: K
authors.lastname: Baba
authors.forename: Naotaka
authors.initials: N
authors.lastname: Usui
authors.forename: Takayasu
authors.initials: T
authors.lastname: Tottori
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Mihara
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Terada
authors.forename: Keiko
authors.initials: K
authors.lastname: Usui
authors.forename: Yushi
authors.initials: Y
authors.lastname: Inoue
authors.forename: Yasukazu
authors.initials: Y
authors.lastname: Kajita
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Wakabayashi
mesh_terms: D000293:Adolescent; D000328:Adult; D001931:Brain Mapping; D004351:Drug Resistance; D004833:Epilepsy, Temporal Lobe / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D005442:Flumazenil / Q000031:analogs & derivatives; D007839:Functional Laterality; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012640:Seizures / Q000000981:diagnostic imaging* / Q000601:surgery; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D005442:Flumazenil; C063038:iomazenil
keywords: 123I-iomazenil; Benzodiazepine receptor; Epileptogenic foci; Single photon emission computed tomography; Statistical parametric mapping; Temporal lobe epilepsy