Sequential 123-I-iododexetimide scans in temporal lobe epilepsy: comparison with neuroimaging scans (MR imaging and 18-F-FDG-PET imaging)

Mohamed, Armin, Eberl, Stefan, Fulham, Michael J., Kassiou, Michael, Zaman, Aysha, Henderson, David, Beveridge, Scott, Constable, Chris and Lo, Sing Kai 2005, Sequential 123-I-iododexetimide scans in temporal lobe epilepsy: comparison with neuroimaging scans (MR imaging and 18-F-FDG-PET imaging), European journal of nuclear medicine and molecular imaging, vol. 32, no. 2, pp. 180-185.

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Title Sequential 123-I-iododexetimide scans in temporal lobe epilepsy: comparison with neuroimaging scans (MR imaging and 18-F-FDG-PET imaging)
Author(s) Mohamed, Armin
Eberl, Stefan
Fulham, Michael J.
Kassiou, Michael
Zaman, Aysha
Henderson, David
Beveridge, Scott
Constable, Chris
Lo, Sing Kai
Journal name European journal of nuclear medicine and molecular imaging
Volume number 32
Issue number 2
Start page 180
End page 185
Publisher Springer-Verlag
Place of publication Berlin, Germany
Publication date 2005-02
ISSN 1619-7070
1619-7089
Keyword(s) temporal lobe epilepsy
radionuclide imaging
muscarinic acetylcholine receptors
iododexetimide
SPECT
Summary Purpose Muscarinic acetylcholine receptors (mAChRs) play an important role in the generation of seizures. Single-photon emission computed tomography (SPECT) with 123I-iododexetimide (IDEX) depicts tracer uptake by mAChRs. Our aims were to: (a) determine the optimum time for interictal IDEX SPECT imaging; (b) determine the accuracy of IDEX scans in the localisation of seizure foci when compared with video EEG and MR imaging in patients with temporal lobe epilepsy (TLE); (c) characterise the distribution of IDEX binding in the temporal lobes and (d) compare IDEX SPECT and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in identifying seizure foci.
Methods We performed sequential scans using IDEX SPECT imaging at 0, 3, 6 and 24 h in 12 consecutive patients with refractory TLE undergoing assessment for epilepsy surgery. Visual and region of interest analyses of the mesial, lateral and polar regions of the temporal lobes were used to compare IDEX SPECT, FDG PET and MR imaging in seizure onset localisation.
Results The 6-h IDEX scan (92%; κappa=0.83, p=0.003) was superior to the 0-h (36%; kappa=0.01, p>0.05), 3-h (55%;κappa=0.13, p>0.05) and 24-h IDEX scans in identifying the temporal lobe of seizure origin. The 6-h IDEX scan correctly predicted the temporal lobe of seizure origin in two patients who required intracranial EEG recordings to define the seizure onset. Reduced ligand binding was most marked at the temporal pole and mesial temporal structures. IDEX SPECT was superior to interictal FDG PET (75%; κappa=0.66, p=0.023) in seizure onset localisation. MR imaging was non-localising in two patients in whom it was normal and in another patient in whom there was bilateral symmetrical hippocampal atrophy.
Conclusion The 6-h IDEX SPECT scan is a viable alternative to FDG PET imaging in seizure onset localisation in TLE.
Notes Published online: 23 September 2004
Language eng
Field of Research 110903 Central Nervous System
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2004, Springer-Verlag
Persistent URL http://hdl.handle.net/10536/DRO/DU:30009334

Document type: Journal Article
Collection: Faculty of Health
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