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Published on: June 13, 2016
Comparison of SPECT/CT, AEEG, and 3D-pCASL in people with epilepsy
Rong Chen1, Qing Zhang2, Yajun Li3
1Department of Neuroelectrophysiology, Cardiovascular and Cerebrovascular Disease Hospital Branch, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China.
Objective:
To analyze the clinical value of single-photon emission computed tomography (SPECT)/computed tomography (CT), ambulatory electroencephalogram (AEEG) and three-dimensional pseudo-continuous arterial spin labeling (3D-pCASL) in people with epilepsy (PWE).
Methods:
The study included 98 PWE who were treated in The General Hospital of Ningxia Medical University from December 2021 to September 2023. The positive detection rates and characteristics of SPECT/CT, AEEG and 3D-pCASL were compared. Additionally, the agreement between SPECT/CT, 3D-pCASL and AEEG-positive results was analyzed.
Results:
The positive detection rates for SPECT/CT, AEEG, and 3D-pCASL examinations were 77.55% (76/98), 62.24% (61/98), and 54.08% (53/98) respectively. SPECT/CT exhibited higher positive detection rates than AEEG (aOR = 1.165, 95%CI: 1.036-1.311, p = 0.011) and 3D-pCASL (aOR = 1.265, 95%CI: 1.119-1.430, p < 0.001), no significant difference was observed between AEEG and 3D-pCASL (aOR = 0.922, 95%CI: 0.810-1.048, p = 0.213). In combined modalities, the positive detection rate of AEEG+SPECT/CT + 3D-pCASL (93.88%, 92/98) was higher than AEEG+3D-pCASL (79.59%, 78/98, p = 0.003), but showed no statistically significant difference compared to AEEG+SPECT/CT (88.78%, 87/98, p = 0.204). The proportions of PWE with no lesions, focal lesions, unilateral multifocal lesions and bilateral lesions across the three modalities results revealed statistically significant differences (p < 0.05). Among 61 PWE with interictal epileptiform discharges (IEDs) detected by AEEG, the agreement rate between SPECT/CT and AEEG was 63.93% (39/61), while that of 3D-pCASL was 39.34%(24/61), the difference is statistically significant (p = 0.007). In PWE with AEEG-detected temporal lobe (43 cases) and frontal lobe (31 cases) IEDs, SPECT/CT exhibited higher agreement rate with AEEG compared to 3D-pCASL (p < 0.05).
Conclusion:
SPECT/CT demonstrated a high positive detection rate and showed strong agreement with AEEG-positive results in PWE. The combined use of SPECT/CT, AEEG and 3D-pCASL significantly increased the positive detection rate. These findings highlight the advantages of SPECT/CT and combined modalities.
