Impact of ictal subtraction SPECT and PET in presurgical evaluation.
Adolescent
Adult
Drug Resistant Epilepsy
/ diagnostic imaging
Electroencephalography
/ methods
Epilepsies, Partial
/ diagnostic imaging
Female
Fluorodeoxyglucose F18
Humans
Intraoperative Neurophysiological Monitoring
Magnetic Resonance Imaging
/ methods
Male
Middle Aged
Neuroimaging
/ methods
Positron Emission Tomography Computed Tomography
/ methods
Prognosis
Retrospective Studies
Surgery, Computer-Assisted
Tomography, Emission-Computed, Single-Photon
/ methods
FDG-PET
Ictal subtraction SPECT
concordance
epilepsy surgery
Journal
Acta neurologica Scandinavica
ISSN: 1600-0404
Titre abrégé: Acta Neurol Scand
Pays: Denmark
ID NLM: 0370336
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
19
07
2020
revised:
17
09
2020
accepted:
09
10
2020
pubmed:
16
10
2020
medline:
7
4
2021
entrez:
15
10
2020
Statut:
ppublish
Résumé
To assess the relative contribution of ictal subtraction single-photon emission computed tomography (ISSPECT) and A retrospective 3-year study of consecutive patients with resistant focal epilepsy who underwent ISSPECT and PET to evaluate to what extent these modalities influence decisions in epilepsy surgery and outcomes. ISSPECT imaging was performed in 106 patients and 58 (55%) had PET also. The clinical consensus (ClinC) was the final arbiter for decisions. Post-surgical outcomes were collected from follow-up clinics. Non-parametric statistics were used to assess association and logistic regression to evaluate prediction of outcomes. Of 106 patients, 60 were males (57%). MRI was non-lesional in 46 (43%). Concordance with ClinC was seen in 80 patients (76%) for ISSPECT, in 46 patients (79%) for PET, and in 37 patients (64%) for ISSPECT + PET. Fifty-six patients (53%) were planned for intracranial video-electroencephalography monitoring (IVEM). Those with ClinC-PET concordance were likely to proceed to IVEM (p = 0.02). ClinC-PET concordance and ClinC-ISSPECT concordance did not predict decision to proceed to surgery, but VEM-MRI concordance did in lesional cases (p = 0.018). Forty-five (42%) underwent surgery of which 29 had minimum follow-up for 1 year (mean, 20 months; SD, 8) and 22 (76%) had Engel class I outcomes. ClinC-ISSPECT concordance (p = 0.024) and VEM-MRI concordance (p = 0.016) predicted Engel class I outcomes. Those with ClinC-PET concordance were more likely to proceed with IVEM. ClinC-ISSPECT concordance and VEM-MRI concordance predicted good surgical outcomes.
Substances chimiques
Fluorodeoxyglucose F18
0Z5B2CJX4D
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
271-280Informations de copyright
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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