Ictal SPECT success rate using a single SPECT session protocol

Lee ZY 1 , Lim KS 2 , Fong SL 1 , Rahmat K 3 , Mon KY 4 , Tan CT 1

Affiliations 

  • 1 Division of Neurology, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
  • 2 Division of Neurology, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia. Electronic address: kslimum@gmail.com
  • 3 Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya Research Imaging Centre, Kuala Lumpur, Malaysia
  • 4 Department of Neurology, University of Medicine (1), Yangon, Myanmar
Clin Neurol Neurosurg, 2025 Jan 28;249:108766.
PMID: 39904105 DOI: 10.1016/j.clineuro.2025.108766

Abstract

INTRODUCTION: Ictal single-photon emission computed tomography (SPECT) provides additional information on the localisation of the epileptogenic zone. However, ictal SPECT is labour-intensive and expensive. We have developed a more affordable protocol with a single SPECT radiotracer session during a 48-hour video-EEG monitoring (VEM). This study aimed to determine the success rate of ictal SPECT with a single SPECT session (HMPAO or ECD).

METHODS: This retrospective observational study included all VEM cases performed in the University Malaya Medical Centre, Kuala Lumpur, Malaysia from 1st January 2011 to 30th April 2024, with SPECT as part of the pre-surgical evaluation.

RESULTS: A total of 189 cases were included. The mean age was 33.3 years old (range 9-68), and 105 (55.6 %) were male. The mean baseline seizure frequency before VEM was 21.8 per month. The mean number of seizures recorded during a 48-hour VEM was 10.9. A total of 44 (23.3 %) patients had ictal SPECT with a single SPECT session. Ictal SPECT was significantly associated with a higher number of seizures during 48-hour VEM (31.5 ± 58.7 vs 4.4 ± 6.3, p 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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