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I-123 Iofetamine SPECT scan in children with neurological disorders
J R Flamini1, R J Konkol, R G Wells
1Department of Neurology, Medical College of Wisconsin, Milwaukee.
Insights
I-123 Iofetamine (IMP) SPECT brain imaging effectively detects and localizes cerebral metabolic abnormalities in children with neurological diseases, particularly seizure disorders. Correlating IMP-SPECT with CT/MRI is crucial for accurate interpretation.
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Nuclear Medicine
Background:
- Neurological diseases in children require accurate diagnostic tools.
- I-123 Iofetamine (IMP) SPECT is a neuroimaging technique used to assess cerebral metabolic activity.
- Comparison with electroencephalography (EEG), computed tomography (CT), and magnetic resonance imaging (MRI) is essential for validation.
Purpose of the Study:
- To evaluate the utility of I-123 Iofetamine (IMP) single photon emission computed tomography (SPECT) brain imaging in pediatric patients with neurological diseases.
- To compare IMP-SPECT findings with EEG, CT, and MRI results.
- To determine the diagnostic value of IMP-SPECT for detecting and localizing cerebral abnormalities.
Main Methods:
- 42 pediatric patients (14 days to 23 years) with neurological diseases underwent I-123 Iofetamine (IMP) SPECT brain imaging.
- All patients had concurrent EEG and at least one structural imaging study (CT or MRI).
- IMP-SPECT results were correlated with EEG, CT, and MRI findings.
Main Results:
- IMP-SPECT accurately detected and localized cerebral metabolic abnormalities, especially in patients with seizure disorders.
- Normal EEG and CT/MRI generally predicted normal IMP-SPECT findings.
- IMP-SPECT demonstrated cortical structural abnormalities well but struggled with white matter lesions; it identified deep brain abnormalities not seen on EEG.
Conclusions:
- I-123 Iofetamine (IMP) SPECT imaging is a valuable tool for detecting and localizing abnormal cerebral metabolic activity in children with seizure disorders.
- Correlation with CT or MRI is essential for the proper interpretation of IMP-SPECT findings.
- IMP-SPECT complements structural imaging and EEG in the pediatric neurological workup.
Abstract:
I-123 Iofetamine (IMP) single photon emission computed tomography (SPECT) imaging of the brain in 42 patients (ages 14 days to 23 years) was compared with other localizing studies in children with neurological diseases. All had an EEG and at least one imaging study of the brain (computed tomography (CT) or magnetic resonance imaging (MRI), or both). Seventy-eight percent of the patients had an EEG within 24-72 hours of the IMP-SPECT scan. Thirty-five (83%) had a history of seizures, and the remainder had other neurological conditions without a history of seizures. In most cases, a normal EEG reading with normal CT or MRI result predicted a normal SPECT study. When the EEG was abnormal the majority of the IMP-SPECT scans were abnormal and localized the abnormality to the same region. A comparison with CT and MRI showed that structural abnormalities involving the cortex were usually well demonstrated with IMP-SPECT imaging. Structural lesions confined to the white matter were generally not detectable with IMP-SPECT. In a few cases, SPECT scans revealed abnormalities in deep brain areas not identified by EEG. IMP-SPECT imaging is a valuable technique for the detection and localization of abnormal cerebral metabolic activity in children with seizure disorders. A correlation with CT or MRI is essential for proper interpretation of abnormalities detected with IMP SPECT imaging.