Ictal and interictal SPECT with 99mTc‐HMPAO in presurgical epilepsy. I: Predictive value and methodological considerations
Abstract Objective This retrospective study investigates the predictive value of ictal subtraction single‐photon emission computed tomography (SPECT) co‐registered to magnetic resonance imaging (MRI) (SISCOM) for successful epilepsy surgery. Methods 57 patients examined with SISCOM as a part of epil...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-09-01
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| Series: | Epilepsia Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/epi4.12786 |
| _version_ | 1797729156111269888 |
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| author | Martin Prener Veronica Drejer Morten Ziebell Per Jensen Camilla Gøbel Madsen Svitlana Olsen Gerda Thomsen Lars H. Pinborg Olaf B. Paulson |
| author_facet | Martin Prener Veronica Drejer Morten Ziebell Per Jensen Camilla Gøbel Madsen Svitlana Olsen Gerda Thomsen Lars H. Pinborg Olaf B. Paulson |
| author_sort | Martin Prener |
| collection | DOAJ |
| description | Abstract Objective This retrospective study investigates the predictive value of ictal subtraction single‐photon emission computed tomography (SPECT) co‐registered to magnetic resonance imaging (MRI) (SISCOM) for successful epilepsy surgery. Methods 57 patients examined with SISCOM as a part of epilepsy surgery evaluation were divided into two groups based on seizure duration after tracer injection (group 1: Seizure duration above or equal to 30 s, group 2: Seizure duration under 30 s). SISCOM was compared to the surgical site and categorized as good or poor concordance. Subsequently, Odds ratios (ORs) and positive predictive values (PPVs) were calculated for each group for good surgical outcome, freedom from disabling seizures. Results The PPVs and ORs for good surgical outcome was 74.1% and 5.71 for group 1 and 40% and 0.22 for group 2. SISCOM had a similar positive predictive value regardless of whether the focus was in the same or neighboring lobe, but same hemisphere as the resection. Conclusion In conclusion, the implementation of a precise definition for a well‐executed ictal SPECT scan with respect to seizure duration after injection enhances the positive predictive value (PPV) and odds ratio (OR) for successful surgical outcome, surpassing previous findings, whether the focus in resected lobe or the neighboring. |
| first_indexed | 2024-03-12T11:24:58Z |
| format | Article |
| id | doaj.art-39293c377c874a759d9665cdb3ec8248 |
| institution | Directory Open Access Journal |
| issn | 2470-9239 |
| language | English |
| last_indexed | 2024-03-12T11:24:58Z |
| publishDate | 2023-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Epilepsia Open |
| spelling | doaj.art-39293c377c874a759d9665cdb3ec82482023-09-01T09:39:51ZengWileyEpilepsia Open2470-92392023-09-01831064107410.1002/epi4.12786Ictal and interictal SPECT with 99mTc‐HMPAO in presurgical epilepsy. I: Predictive value and methodological considerationsMartin Prener0Veronica Drejer1Morten Ziebell2Per Jensen3Camilla Gøbel Madsen4Svitlana Olsen5Gerda Thomsen6Lars H. Pinborg7Olaf B. Paulson8Department of Neurology, Neurobiology Research Unit Rigshospitalet Blegdamsvej Copenhagen DenmarkDepartment of Neurology, Neurobiology Research Unit Rigshospitalet Blegdamsvej Copenhagen DenmarkDepartment of Neurosurgery Rigshospitalet Copenhagen DenmarkDepartment of Neurology, Neurobiology Research Unit Rigshospitalet Blegdamsvej Copenhagen DenmarkDepartment of Radiology, Centre for Functional and Diagnostic imaging and Research Copenhagen University Hospital Amager and Hvidovre Hvidovre DenmarkDepartment of Neurology, Neurobiology Research Unit Rigshospitalet Blegdamsvej Copenhagen DenmarkDepartment of Neurology, Neurobiology Research Unit Rigshospitalet Blegdamsvej Copenhagen DenmarkDepartment of Neurology, Neurobiology Research Unit Rigshospitalet Blegdamsvej Copenhagen DenmarkDepartment of Neurology, Neurobiology Research Unit Rigshospitalet Blegdamsvej Copenhagen DenmarkAbstract Objective This retrospective study investigates the predictive value of ictal subtraction single‐photon emission computed tomography (SPECT) co‐registered to magnetic resonance imaging (MRI) (SISCOM) for successful epilepsy surgery. Methods 57 patients examined with SISCOM as a part of epilepsy surgery evaluation were divided into two groups based on seizure duration after tracer injection (group 1: Seizure duration above or equal to 30 s, group 2: Seizure duration under 30 s). SISCOM was compared to the surgical site and categorized as good or poor concordance. Subsequently, Odds ratios (ORs) and positive predictive values (PPVs) were calculated for each group for good surgical outcome, freedom from disabling seizures. Results The PPVs and ORs for good surgical outcome was 74.1% and 5.71 for group 1 and 40% and 0.22 for group 2. SISCOM had a similar positive predictive value regardless of whether the focus was in the same or neighboring lobe, but same hemisphere as the resection. Conclusion In conclusion, the implementation of a precise definition for a well‐executed ictal SPECT scan with respect to seizure duration after injection enhances the positive predictive value (PPV) and odds ratio (OR) for successful surgical outcome, surpassing previous findings, whether the focus in resected lobe or the neighboring.https://doi.org/10.1002/epi4.12786cerebral blood flowepilepsy surgeryneuroimagingsingle photon emission computed tomography |
| spellingShingle | Martin Prener Veronica Drejer Morten Ziebell Per Jensen Camilla Gøbel Madsen Svitlana Olsen Gerda Thomsen Lars H. Pinborg Olaf B. Paulson Ictal and interictal SPECT with 99mTc‐HMPAO in presurgical epilepsy. I: Predictive value and methodological considerations Epilepsia Open cerebral blood flow epilepsy surgery neuroimaging single photon emission computed tomography |
| title | Ictal and interictal SPECT with 99mTc‐HMPAO in presurgical epilepsy. I: Predictive value and methodological considerations |
| title_full | Ictal and interictal SPECT with 99mTc‐HMPAO in presurgical epilepsy. I: Predictive value and methodological considerations |
| title_fullStr | Ictal and interictal SPECT with 99mTc‐HMPAO in presurgical epilepsy. I: Predictive value and methodological considerations |
| title_full_unstemmed | Ictal and interictal SPECT with 99mTc‐HMPAO in presurgical epilepsy. I: Predictive value and methodological considerations |
| title_short | Ictal and interictal SPECT with 99mTc‐HMPAO in presurgical epilepsy. I: Predictive value and methodological considerations |
| title_sort | ictal and interictal spect with 99mtc hmpao in presurgical epilepsy i predictive value and methodological considerations |
| topic | cerebral blood flow epilepsy surgery neuroimaging single photon emission computed tomography |
| url | https://doi.org/10.1002/epi4.12786 |
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