Positron emission tomography and single photon emission computed tomography in epilepsy care

Thomas R. Henry, Ronald L. Van Heertum

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

Radiopharmaceutical brain imaging is clinically applied in planning resective epilepsy surgery. Cerebral sites of seizure generation-propagation are highly associated with regions of hyperperfusion during seizures, and with glucose hypometabolism interictally. For surgical planning in epilepsy, the functional imaging modalities currently established are ictal single photon emission computed tomography (SPECT) with [99mTc]technetium-hexamethylpropyleneamine oxime (HMPAO) or with [99mTc]technetium-ethylene cysteine dimer (ECD), and interictal positron emission tomography (PET) with 2-[18F]fluoro-2-deoxyglucose (FDG). Ictal SPECT and interictal FDG PET can be used in presurgical epilepsy evaluations to reliably: 1) determine the side of anterior temporal lobectomy, and in children the area of multilobar resection, without intracranial electroencephalographic recording of seizures; 2) select high-probability sites of intracranial electrode placement for recording ictal onsets; and, 3) determine the prognosis for complete seizure control following anterior temporal lobe resection. Coregistration of a patient's structural (magnetic resonance) and functional images, and statistical comparison of a patient's data with a normal data set, can increase the sensitivity and specificity of these SPECT and PET applications to the presurgical evaluation.

Original languageEnglish (US)
Pages (from-to)88-104
Number of pages17
JournalSeminars in Nuclear Medicine
Volume33
Issue number2
DOIs
StatePublished - Apr 2003

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