Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Hwang, S.-I. Articles by Chang, K.-H. Search for Related Content PubMed PubMed Citation Articles by Hwang, S.-I. Articles by Chang, K.-H.

American Journal of Neuroradiology 22:937-946 (5 2001)
© 2001 American Society of Neuroradiology

ARTICLE

Comparative Analysis of MR Imaging, Positron Emission Tomography, and Ictal Single-photon Emission CT in Patients with Neocortical Epilepsy

Sung-Il Hwang^a, Jae Hyoung Kim^a, Sun Won Park^a, Moon Hee Han^a, In Kyu Yu^a, Sang Hyun Lee^a, Dong Soo Lee^a, Sang Kun Lee^a, Chun-Kee Chung^a and Kee-Hyun Chang^,a

^a From the Departments of Radiology (S.-I.H., S.W. P., M.H.H., I.K.Y., S.H.L., K.-H.C.), Nuclear Medicine (D.S.L.), Neurology (S.K.L.), and Neurosurgery (C-K.C.), Seoul National University College of Medicine, Seoul; the Institute of Radiation Medicine SNUMRC (M.H.H., K.-H.C.), Seoul; and the Department of Radiology (J.H.K.), Gyeongsang National University College of Medicine, Chinju, Korea.

BACKGROUND AND PURPOSE: MR imaging, positron emission tomography (PET), and single-photon emission CT (SPECT) play important roles in presurgical localization of epileptic foci. However, comparative study of these imaging methods for cases of neocortical epilepsy has been limited. The purpose of this study was to compare the sensitivities of these three imaging methods for presurgical localization of neocortical epileptogenic foci.

METHODS: We studied 117 consecutive patients who underwent surgery for intractable neocortical epilepsy. The pathologic substrates were neuronal migration disorder (n = 77), tumor (n = 15), and others (n = 25). MR imaging was compared retrospectively with ¹⁸F-fluorodeoxyglucose PET and ictal technetium-99m hexamethylpropyleneamine oxime SPECT regarding their capability to correctly localize the epileptogenic foci. The pathologic findings were used as the standard of reference.

RESULTS: Overall, MR imaging, PET, and ictal SPECT correctly localized the lesions for 59.8%, 77.7%, and 70.3% of the patients, respectively, with a 38% concordance rate among the three methods. PET was most sensitive (71–100%) in detecting all substrates. MR imaging was as sensitive (100%) as PET in detecting tumor but was least sensitive (48.1%) in detecting neuronal migration disorder. Ictal SPECT was more sensitive (75.8%) than MR imaging in detecting neuronal migration disorder. Patients with imaging abnormalities achieved good outcomes in 81.4% of the cases, in contrast to 59.5% for those without imaging abnormalities (P < .05).

CONCLUSION: PET and ictal SPECT were overall more sensitive than was MR imaging, despite the low concordance rate and variable sensitivity depending on substrates. The detection of abnormalities by MR imaging was associated with good outcome. PET or ictal SPECT can be well used as complementary tools, particularly in cases of negative MR imaging findings.

This article has been cited by other articles:

				R. C. Knowlton, N. D. Lawn, J. M. Mountz, and R. I. Kuzniecky Ictal SPECT analysis in epilepsy: Subtraction and statistical parametric mapping techniques Neurology, July 13, 2004; 63(1): 10 - 15. [Abstract] [Full Text] [PDF]

				Y. K. Kim, D. S. Lee, S. K. Lee, S.-K. Kim, C. K. Chung, K. H. Chang, K. Y. Choi, J.-K. Chung, and M. C. Lee Differential Features of Metabolic Abnormalities Between Medial and Lateral Temporal Lobe Epilepsy: Quantitative Analysis of 18F-FDG PET Using SPM J. Nucl. Med., July 1, 2003; 44(7): 1006 - 1012. [Abstract] [Full Text] [PDF]

				V. Bouilleret, M. P. Valenti, E. Hirsch, F. Semah, and I. J. Namer Correlation Between PET and SISCOM in Temporal Lobe Epilepsy J. Nucl. Med., August 1, 2002; 43(8): 991 - 998. [Abstract] [Full Text] [PDF]