Neurology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Correspondence:
Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Knowlton, R. C.
Right arrow Articles by Kuzniecky, R. I.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Knowlton, R. C.
Right arrow Articles by Kuzniecky, R. I.
Related Collections
Right arrow SPECT
Right arrow All Epilepsy/Seizures
Right arrow Cortical localization
NEUROLOGY 2004;63:10-15
© 2004 American Academy of Neurology
Views & Reviews

Ictal SPECT analysis in epilepsy

Subtraction and statistical parametric mapping techniques

Robert C. Knowlton, MD, Nicholas D. Lawn, FRACP, James M. Mountz, MD and Ruben I. Kuzniecky, MD

From the Department of Neurology (Dr. Knowlton), University of Alabama at Birmingham Epilepsy Center, AL; Department of Neurology (Dr. Lawn), Royal Perth Hospital, Australia; PET Facility, Department of Radiology (Dr. Mountz), University of Pittsburgh Medical Center, PA; and NYU Epilepsy Center (Dr. Kuzniecky), New York University Medical School, New York, NY.

Address correspondence and reprint requests to Dr. Robert C. Knowlton, UAB Epilepsy Center, 312 Civitan International Research Center, 1719 6th Avenue South, Birmingham, AL 35294; e-mail: knowlton{at}uab.edu

Seizures are associated with an increase in regional cerebral blood flow (rCBF). In partial seizures the increased blood flow closely corresponds with the site of seizure origin. Using tracers that accumulate and remain "fixed" in different areas of the brain proportional to rCBF at the time of injection, ictal SPECT is now an important tool for localization of seizures in a presurgical evaluation. However, the best methods for interpretation of partial seizure-induced changes in rCBF remain unclear. Numerous computer-aided tools have been used to increase objectivity and accuracy of ictal SPECT analysis. This review examines the uses of ictal-interictal subtraction methods and statistical parametric mapping (SPM) to enhance interpretation and utility of ictal SPECT. The review covers the evolution of advanced ictal SPECT imaging analysis techniques and the authors’ clinical experience with the use of subtraction and SPM methods. The authors discuss the impact of ictal SPECT subtraction or difference imaging methods and the initial evidence for proof-of-principle that SPM can be used to provide objective, accurate analysis of ictal SPECT scans in patients with temporal and extratemporal lobe epilepsy. The limitations of both methodologies are discussed, and suggestions for further study of validation, improvement, and routine clinical implementation of advanced analysis methods are provided.

Received July 2, 2003. Accepted in final form February 11, 2004.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2004 by AAN Enterprises, Inc.