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SPECT (single photon emission computed tomography) in pediatrics.

Catherine Chiron1

  • 1INSERM UMR663, Université Paris Descartes, Paris and CEA, France; Hôpital Necker-Enfants Malades, Paris, France.

Handbook of Clinical Neurology
|April 30, 2013
PubMed
Summary

Single-photon emission computed tomography (SPECT) aids in localizing seizure onset zones for pediatric focal epilepsies. Advanced techniques like SISCOM improve surgical planning and predict seizure-free outcomes.

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Area of Science:

  • Neuroscience
  • Medical Imaging
  • Pediatric Neurology

Background:

  • Focal epilepsies in children often require surgical intervention.
  • Accurate localization of the seizure onset zone is crucial for successful epilepsy surgery.
  • Noninvasive functional imaging plays a key role in presurgical evaluation.

Purpose of the Study:

  • To evaluate the role of SPECT in presurgical localization of seizure onset zones in pediatric focal epilepsies.
  • To assess the utility of peri-ictal SPECT and multimodal imaging (SISCOM) in surgical planning and outcome prediction.
  • To explore the potential of interictal SPECT in evaluating cortical maturation and learning disorders.

Main Methods:

  • Utilized SPECT, including peri-ictal (ictal and postictal) and interictal scans.
  • Employed video-electroencephalography (video-EEG) in conjunction with SPECT.
  • Applied SISCOM (subtraction of interictal from peri-ictal SPECT superimposed on MRI) to enhance sensitivity.

Main Results:

  • Peri-ictal SPECT is valuable when video-EEG is inconclusive or MRI findings are normal/ambiguous.
  • SISCOM significantly increases the sensitivity of peri-ictal SPECT (approx. 70%) and predicts seizure-free outcomes.
  • Interictal SPECT may offer insights into functional cortical maturation and learning difficulties.

Conclusions:

  • SPECT, particularly when combined with video-EEG and advanced techniques like SISCOM, is a vital tool in the presurgical workup of pediatric focal epilepsies.
  • SISCOM enhances the predictive value of SPECT for successful surgical outcomes.
  • Interictal SPECT may provide additional diagnostic information beyond seizure localization.