Comparison of Diagnostic Performance between Interictal F-18-FDG PET and Ictal Tc-99m-HMPAO SPECT in Occipital Lobe Epilepsy.
- Author:
Myung Chul LEE
;
June Key CHUNG
;
Dong Soo LEE
;
Jae Min JEONG
;
Sang Kun LEE
;
Jeong Seok YEO
;
Seok Ki KIM
;
Joo Yong KIM
- Publication Type:Original Article
- Keywords:
Occipital lobe epilepsy;
Tc-99m-HMPAO;
Ictal perfusion SPECT;
F-18-FDG;
PET;
SPECT
- MeSH:
Electroencephalography;
Epilepsies, Partial*;
Epilepsy, Frontal Lobe;
Humans;
Magnetic Resonance Imaging;
Occipital Lobe*;
Perfusion;
Tomography, Emission-Computed, Single-Photon*
- From:Korean Journal of Nuclear Medicine
1999;33(3):262-272
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Interictal F-18-fluorodeoxyglucose (FDG) PET and ictal Tc-99m-HMPAO SPECT are found to be useful in localizing epileptogenic zones in neocortical lateral temporal or frontal lobe epilepsy. We investigated whether interictal F-18-FDG PET or ictal Tc-99m-HMPAO SPECT was useful to find epileptogenic zones in occipital lobe epilepsy (OLE). MATERIALS AND METHODS: We reviewed patterns of hypometabolism in interictal F-18-FDG PET and of hyperperfusion in ictal Tc-99m-HMPAO SPECT in 17 OLE patients (mean age=27+/-6.8 year, M:F=10:7, injection time=30+/-17 sec). OLE was diagnosed based on invasive electroencephalography (EEG) study, surgery and post-surgical outcome (Engel class I in all for average 14 months). RESULTS: Epileptogenic zones were correctly localized in 9 (60%) out of 15 patients by interictal F-18-FDG PET. Epiletogenic hemispheres were correctly lateralized in 14 patients (93%). By ictal Tc-99m-HMPAO SPECT, epileptogenic hemispheres were correctly lateralized in 13 patients (76%), but localization was possible only in 3 patients (18%). Among patients who showed no abnormality with MR imaging and no correct localization with ictal Tc-99m-HMPAO SPECT, interictal F-18-FDG PET was helpful in 2 patients. CONCLUSION:: Ictal Tc-99m-HMPAO SPECT was helpful in lateralization but not in localization in OLE. Interictal F-18-FDG PET was helpful for localization of epileptogenic zones even in patients with ambiguous MR or ictal SPECT findings. Key KW: Occipital lobe epilepsy, Tc-99m-HMPAO, Ictal perfusion SPECT, F-18-FDG, PET, SPECT
