SPECT Imaging of Epilepsy: An Overview and Comparison with F-18 FDG PET
Figure 10
Eleven-year-old male suffering from generalized tonic-clonic seizure disorder. (a) MRI scan of an-11-year old boy suffering from seizure disorder since the age of 7. The patient has tonic-clonic seizures. The MRI scan shows an arterial venous malformation in the right parietal lobe. (b) The interictal brain F-18 FDG PET scan shows an area of reduced metabolic activity in the right parietal lobe consistent with the location of the arterial venous malformation. (c) Images from an interictal Tc-99m ECD brain SPECT (top) as compared to an ictal technetium-99m ECD brain SPECT scan (bottom). One can see significant hyperemia anterior and inferior to the region of the arterial venous malformation on the ictal Tc-99m ECD brain SPECT scan as compared to the interictal brain SPECT scan. (d) SISCOM analysis where the ictal and interictal SPECT are compared and statistically significant differences between the two are mapped onto the patient’s MRI scan. One can see significantly increased differences in the ictal study as compared to the interictal study in the anterior region and in the location of the arterial venous malformation (highlighted yellow areas). The highlighted blue area shows areas of decreased uptake on the ictal scan as compared to the interictal scan, which can generally be seen positioned randomly throughout the cortex and do not have clinical or localizing significance.
