Ratio‐Images Calculated From Interictal Positron Emission Tomography and Single‐Photon Emission Computed Tomography for Quantification of the Uncoupling of Brain Metabolism and Perfusion in Epilepsy

Image processing techniques were applied to interictal positron emission tomography (PET) and single-photon emission computed tomography (SPECT) brain images to aid in the localization of epileptogenic foci by calculating a functional image that represents the degree of coupling between perfusion an...

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Bibliographic Details
Published in:Epilepsia (Copenhagen) 2000-12, Vol.41 (12), p.1560-1566
Main Authors: ZUBAL, I. George, AVERY, Robert A, STOKKING, Rik, STUDHOLME, Colin, CORSI, Maria, DEY, Holley, SEIBYL, John P, SPENCER, Susan S
Format: Article
Language:English
Subjects:
Adolescent
Adult
Biological and medical sciences
Brain - blood supply
Brain - diagnostic imaging
Brain - metabolism
Brain Mapping
Data Interpretation, Statistical
Epilepsy - diagnosis
Epilepsy - diagnostic imaging
Epilepsy - metabolism
Epilepsy, Temporal Lobe - diagnosis
Epilepsy, Temporal Lobe - diagnostic imaging
Epilepsy, Temporal Lobe - metabolism
Female
Fluorodeoxyglucose F18
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Magnetic Resonance Imaging - statistics & numerical data
Male
Medical sciences
Middle Aged
Nervous system (semeiology, syndromes)
Neurology
Regional Blood Flow
Technetium Tc 99m Exametazime
Tomography, Emission-Computed - statistics & numerical data
Tomography, Emission-Computed, Single-Photon - statistics & numerical data
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Description
Summary:Image processing techniques were applied to interictal positron emission tomography (PET) and single-photon emission computed tomography (SPECT) brain images to aid in the localization of epileptogenic foci by calculating a functional image that represents the degree of coupling between perfusion and metabolism. Uncoupling of these two functions has been demonstrated to be a characteristic of epileptogenic tissue in temporal lobe epilepsy and has the potential to serve as a diagnostic measure for localization in other areas as well. Interictal PET ((18)F-FDG) and interictal SPECT ((99m)Tc-HMPAO) scans were acquired from 11 epilepsy patients. The metabolism and perfusion images were three-dimensionally spatially registered, and a functional ratio-image was computed. These functional maps are overlaid onto a three-dimensional rendering of the same patient's magnetic resonance imaging anatomy. In all patients, an average uniform perfusion-to-metabolism ratio showed approximately constant values throughout most of the whole brain. However, the epileptogenic area (confirmed on surgery) demonstrated an area of elevated perfusion/metabolism in the grey matter. Although hypometabolism in the PET image was observed in most of these patients, the calculation of a functional ratio-image demonstrated localized foci that in some cases could not be observed on the PET image alone. The ratio-image also yields a quantitative measure of the uncoupling phenomenon.
ISSN:0013-9580
1528-1167
DOI:10.1111/j.1499-1654.2000.001560.x