123-I-Iomazenil-SPECT in Patients with Focal Epilepsies — A Comparative Study with 99mTc-HMPAO-SPECT, CT and MR

Ferstl, F. J.; Cordes, Michael; Cordes, I.; Henkes, Hans; Christe, W.; Eichstädt, H.; Barzen, G.; Schmitz, Bettina; Hasler, P. H.; Schubiger, P. August; Schmidt, Dieter; Félix, R.

doi:10.1007/978-1-4684-5907-4_35

Cited by 7 publications

(2 citation statements)

References 6 publications

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“…Only few authors have investigated B R D in medically refractory CPS patients: when pooling data from eight separate studies including 98 patients with severe CPS, the average frequency of B R D abnormalities was 78% (3,6,8,10,28,34,38,40). The lower frequency of abnormalities in temporal rCMRGlc, rCBF, and B R D in our patients as compared with medically refractory patients can best be explained by assuming that presurgical patients had a longer lasting epilepsy with more frequent and/or severe seizures leading to functional and macroscopic morphological changes in the temporal lobe.…”

Section: Discussionmentioning

confidence: 99%

PET and SPECT in Medically Non-Refractory Complex Partial Seizures

Matheja¹,

Kuwert²,

Stodieck³

et al. 1998

Nuklearmedizin

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Zusammenfassung Ziel: Im Gegensatz zu den medikamentös-refraktären komplex-fokalen Epilepsien (CPS) wurden zerebrale Perfusion und Metabolismus bei Patienten mit nichtrefraktären Epilepsien kaum untersucht. Ziel dieser Studie war die Untersuchung der Häufigkeit temporaler Asymmetrien des regionalen zerebralen Glukoseverbrauchs (rCMRGIc), der regionalen zerebralen Perfusion (rCBF) und der regionalen zerebralen Benzodi- azepin-Rezeptordichte (BRD) bei dieser Patientengruppe. Methoden: Es wurden 49 Patienten mit medikamentös-nichtrefraktären, kryptogenen CPS untersucht (Alter: 36,0 ± 16,1 Jahre). Der rCMRGIc wurde mit F-18-FDG-PET (FDG), der rCBF mit Tc-99m-ECD-SPECT (ECD) und die BRD mit 1-123-Jomazenil-SPECT (IMZ) untersucht. Alle drei Untersuchungen wurden interiktual und binnen vier Wochen bei jedem Patienten durchgeführt. Die Dauer der Epilepsie betrug zwischen 0,1 und 42 Jahre (Median 4,0 Jahre). Die SPECT-Studien wurden mit der Dreikopfkamera Multispect 3, die PET-Studien mit dem PET-System ECAT EXACT 47 durchgeführt. Mit Hilfe von Linienprofilen wurden rCMRGIc, rCBF und BRD in vier temporalen Regionen bestimmt; die daraus errechneten Asymmetrie-Indizes (ASY) wurden mit den 95%-Konfidenzin- tervallen von Kontrollpersonen verglichen. Ergebnisse: Von den 49 Patienten wiesen 35 (71%) einen signifikant pathologischen ASY in mindestens einer Region auf; der rCMRGIc war asymmetrisch bei 41 % der Patienten, die BRD bei 29%, und der rCBF bei 24%. Bei einem Patienten waren alle drei Variablen pathologisch, bei zwei der rCMRGIc und die BRD, bei drei der rCMRGIc und der rCBF und bei vier weiteren Patienten der rCBF und die BRD. Eine isolierte Asymmetrie des rCMRGIc fand sich in 14, der BRD in 7 und des rCBF in 4 Fällen. Es gab keine Diskrepanzen in der Latéralisation zwischen den drei Methoden. Schlußfolgerung: Die Mehrzahl der Patienten mit medikamentös- nichtrefraktären CPS weist eine Abnormalität des rCMRGIc, der BRD oder des rCBF auf. In diesem Patientenkollektiv zeigt FDG-PET am häufigsten eine temporale Auffälligkeit.

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Section: Discussionmentioning

confidence: 99%

PET and SPECT in Medically Non-Refractory Complex Partial Seizures

Matheja¹,

Kuwert²,

Stodieck³

et al. 1998

Nuklearmedizin

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“…Iomazenil-SPECT was found to be comparable or even better in some ways than HMPAO-SPECT in localising epileptic foci 2022 23 27 Iomazenil presumably reflects primary pathophysiological changes in the epileptic focus, compared with secondary changes in glucose consumption and rCBF seen with FDG and HMPAO, respectively. However, there is only one previous study comparing interictal iomazenil-SPECT with FDG-PET.…”

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confidence: 97%

Comparison of[18F]FDG-PET, [99mTc]-HMPAO-SPECT, and [123I]-iomazenil-SPECT in localising the epileptogenic cortex

Lamusuo

Ruottinen

Knuuti

et al. 1997

Journal of Neurology, Neurosurgery & Psychiatry

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Methods-Eighteen epileptic patients were studied with FDG-PET and iomazenil-SPECT. HMPAO-SPECT was performed in 11 of these 18 patients. Two references for localisation was used-ictal subdural EEG recordings (S-EEG) and the operated region. Results-Fifteen of 18 patients had localising findings in S-EEG. FDG-PET findings were in accordance with the references in 13 patients and iomazenil-SPECT in nine patients. HMPAO-SPECT visualised the focus less accurately than the two other methods. In three patients S-EEG showed independent bitemporal seizure onset. In these patients FDG-PET showed no lateralisation. However, iomazenil-SPECT showed temporal lobe lateralisation in two of them. Conclusion-FDG-PET seemed to localise the epileptogenic cortex more accurately than interictal iomazenil-SPECT in patients with complicated focal epilepsy.

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Delayed image of iodine-123 iomazenil as a relative map of benzodiazepine receptor binding: The optimal scan time

et al. 1996

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"Delayed" single-photon emission tomograpic (SPET) images after an intravenous bolus injection of iodine-123 iomazenil have been used as a relative map of benzodiazepine receptor binding. We determined the optimal scan time for obtaining such a map and assessed the errors of the map. SPET and blood data from six healthy volunteers and five patients were used. A three-compartment kinetic model was employed in simulation studies and analyses of actual data. The simulation studies suggested that, in the normal brain, the scan time at which a single SPET image best represented the relative receptor binding was 3.0-3.5 h post-injection. This finding was supported by actual data from the volunteers. The simulation studies also suggested that the optimal scan time was not greatly changed by the variability of the input functions, and that the error in the SPET image contrast in the vicinity of the optimal scan time was not increased by changes in the tracer kinetics in the entire brain. The SPET image contrast in the patients at 3.0 h post-injection agreed well with the reference receptor binding estimated by kinetic analysis, with a mean error of 3.6%. These findings support the use of a single SPET image after bolus injection of [123I]iomazenil as a relative map of benzodiazepine receptor binding. For this purpose, a SPET scan time of 3.0-3.5 h post-injection is recommended.

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123-I-Iomazenil-SPECT in Patients with Focal Epilepsies — A Comparative Study with 99mTc-HMPAO-SPECT, CT and MR

Cited by 7 publications

References 6 publications

PET and SPECT in Medically Non-Refractory Complex Partial Seizures

PET and SPECT in Medically Non-Refractory Complex Partial Seizures

Comparison of[18F]FDG-PET, [99mTc]-HMPAO-SPECT, and [123I]-iomazenil-SPECT in localising the epileptogenic cortex

Delayed image of iodine-123 iomazenil as a relative map of benzodiazepine receptor binding: The optimal scan time

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