Ictal and interictal SPECT with 99m Tc-HMPAO in presurgical epilepsy. I: Predictive value and methodological considerations.
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Ictal and interictal SPECT with 99m Tc-HMPAO in presurgical epilepsy. I : Predictive value and methodological considerations. / Prener, Martin; Drejer, Veronica; Ziebell, Morten; Jensen, Per; Madsen, Camilla Gøbel; Olsen, Svitlana; Thomsen, Gerda; Pinborg, Lars H; Paulson, Olaf B.
In: Epilepsia open, Vol. 8, No. 3, 18.07.2023, p. 1064-1074.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Ictal and interictal SPECT with 99m Tc-HMPAO in presurgical epilepsy. I
T2 - Predictive value and methodological considerations.
AU - Prener, Martin
AU - Drejer, Veronica
AU - Ziebell, Morten
AU - Jensen, Per
AU - Madsen, Camilla Gøbel
AU - Olsen, Svitlana
AU - Thomsen, Gerda
AU - Pinborg, Lars H
AU - Paulson, Olaf B
N1 - © 2023 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.
PY - 2023/7/18
Y1 - 2023/7/18
N2 - OBJECTIVE: This retrospective study investigates the predictive value of ictal subtraction single-photon emission computed tomography (SPECT) co-registered to magnetic resonance imaging (MRI) (SISCOM) for successful epilepsy surgery.METHODS: 57 patients examined with SISCOM as a part of epilepsy surgery evaluation were divided into two groups based on seizure duration after tracer injection (group 1: Seizure duration above or equal to 30 s, group 2: Seizure duration under 30 s). SISCOM was compared to the surgical site and categorized as good or poor concordance. Subsequently, Odds ratios (ORs) and positive predictive values (PPVs) were calculated for each group for good surgical outcome, freedom from disabling seizures.RESULTS: The PPVs and ORs for good surgical outcome was 74.1% and 5.71 for group 1 and 40% and 0.22 for group 2. SISCOM had a similar positive predictive value regardless of whether the focus was in the same or neighboring lobe, but same hemisphere as the resection.CONCLUSION: In conclusion, the implementation of a precise definition for a well-executed ictal SPECT scan with respect to seizure duration after injection enhances the positive predictive value (PPV) and odds ratio (OR) for successful surgical outcome, surpassing previous findings, whether the focus in resected lobe or the neighboring.
AB - OBJECTIVE: This retrospective study investigates the predictive value of ictal subtraction single-photon emission computed tomography (SPECT) co-registered to magnetic resonance imaging (MRI) (SISCOM) for successful epilepsy surgery.METHODS: 57 patients examined with SISCOM as a part of epilepsy surgery evaluation were divided into two groups based on seizure duration after tracer injection (group 1: Seizure duration above or equal to 30 s, group 2: Seizure duration under 30 s). SISCOM was compared to the surgical site and categorized as good or poor concordance. Subsequently, Odds ratios (ORs) and positive predictive values (PPVs) were calculated for each group for good surgical outcome, freedom from disabling seizures.RESULTS: The PPVs and ORs for good surgical outcome was 74.1% and 5.71 for group 1 and 40% and 0.22 for group 2. SISCOM had a similar positive predictive value regardless of whether the focus was in the same or neighboring lobe, but same hemisphere as the resection.CONCLUSION: In conclusion, the implementation of a precise definition for a well-executed ictal SPECT scan with respect to seizure duration after injection enhances the positive predictive value (PPV) and odds ratio (OR) for successful surgical outcome, surpassing previous findings, whether the focus in resected lobe or the neighboring.
U2 - 10.1002/epi4.12786
DO - 10.1002/epi4.12786
M3 - Journal article
C2 - 37464953
VL - 8
SP - 1064
EP - 1074
JO - Epilepsia open
JF - Epilepsia open
SN - 2470-9239
IS - 3
ER -
ID: 363900743