PISCOM: a new procedure for epilepsy combining ictal SPECT and interictal PET.
Por:
Perissinotti A, Niñerola-Baizán A, Rubí S, Carreño M, Marti-Fuster B, Aparicio J, Mayoral M, Donaire A, Sanchez-Izquierdo N, Bargalló N, Rumiá J, Boget T, Pons-Gimeno F, Lomeña F, Ros D, Pavía J and Setoain X
Publicada:
1 dic 2018
Ahead of Print:
1 ago 2018
Resumen:
PURPOSE: We present a modified version of the SISCOM procedure that uses interictal PET instead of interictal SPECT for seizure onset zone localization. We called this new nuclear imaging processing technique PISCOM (PET interictal subtracted ictal SPECT coregistered with MRI). METHODS: We retrospectively studied 23 patients (age range 4-61 years) with medically refractory epilepsy who had undergone MRI, ictal SPECT, interictal SPECT and interictal FDG PET and who had been seizure-free for at least 2 years after surgical treatment. FDG PET images were reprocessed (rFDG PET) to assimilate SPECT features for image subtraction. Interictal SPECT and rFDG PET were compared using statistical parametric mapping (SPM). PISCOM and SISCOM images were evaluated visually and using an automated volume of interest-based analysis. The results of the two studies were compared with each other and with the known surgical resection site. RESULTS: SPM showed no significant differences in cortical activity between SPECT and rFDG PET images. PISCOM and SISCOM showed equivalent results in 17 of 23 patients (74%). The seizure onset zone was successfully identified in 19 patients (83%) by PISCOM and in 17 (74%) by SISCOM: in 15 patients (65%) the two techniques showed concordant successful results. The volume of interest-based analysis showed no significant differences between PISCOM and SISCOM in identifying the extension of the seizure onset zone. However, PISCOM showed a lower amount of indeterminate activity due to propagation, background or artefacts. CONCLUSION: Preliminary findings of this initial proof-of-concept study suggest that perfusion and glucose metabolism in the cerebral cortex can be correlated and that PISCOM may be a valid technique for identification of the seizure onset zone. However, further studies are needed to validate these results.
Filiaciones:
Perissinotti A:
Department of Nuclear Medicine, Hospital Clínic, C/Villarroel 170, 08036, Barcelona, Spain
Niñerola-Baizán A:
Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
University of Barcelona, Barcelona, Spain
Rubí S:
Nuclear Medicine Department, Hospital Universitari Son Espases, Palma, Spain
Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Spain
Carreño M:
Department of Neurology, Hospital Clinic, Barcelona, Spain
Marti-Fuster B:
Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
University of Barcelona, Barcelona, Spain
Aparicio J:
Department of Neurology, Hospital Sant Joan de Déu, Barcelona, Spain
Mayoral M:
Department of Nuclear Medicine, Hospital Clínic, C/Villarroel 170, 08036, Barcelona, Spain
Donaire A:
Department of Neurology, Hospital Clinic, Barcelona, Spain
Sanchez-Izquierdo N:
Department of Nuclear Medicine, Hospital Clínic, C/Villarroel 170, 08036, Barcelona, Spain
Bargalló N:
Department of Radiology, Hospital Clínic, Barcelona, Spain
Rumiá J:
Department of Neurosurgery, Hospital Clínic, Barcelona, Spain
Boget T:
Department of Psychiatry and Psychology, Hospital Clínic, Barcelona, Spain
Pons-Gimeno F:
Department of Nuclear Medicine, Hospital Clínic, C/Villarroel 170, 08036, Barcelona, Spain
University of Barcelona, Barcelona, Spain
Lomeña F:
Department of Nuclear Medicine, Hospital Clínic, C/Villarroel 170, 08036, Barcelona, Spain
Ros D:
Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
University of Barcelona, Barcelona, Spain
Pavía J:
Department of Nuclear Medicine, Hospital Clínic, C/Villarroel 170, 08036, Barcelona, Spain
Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
Setoain X:
Department of Nuclear Medicine, Hospital Clínic, C/Villarroel 170, 08036, Barcelona, Spain.
Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain.
University of Barcelona, Barcelona, Spain.
Open Access
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