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  • Title: Quantitative evaluation of 99mTc-hexamethylpropylenamineoxime brain SPECT in childhood-onset epilepsy.
    Author: Janicek MJ, O'Tuama LA, Treves ST.
    Journal: J Nucl Biol Med (1991); 1992; 36(4):319-23. PubMed ID: 1296771.
    Abstract:
    In 10 patients with childhood-onset epilepsy, quantitative evaluation (QE) of interictal regional cerebral blood flow (rCBF) using technetium-99m-hexamethylpropylenamine oxime (99mTc HMPAO) single-photon emission computed tomography (SPECT) was correlated with seizure foci localized by electroencephalography (EEG). Eighty regions of interest (5 x 5 pixels) were placed at five different neocortical areas in both cerebral hemispheres, in coronal and transaxial planes. Mean counts/pixel were calculated for each region and multiple right-left comparisons were done. Quantitative evaluation of 99mTc-HMPAO increased detection of rCBF abnormalities by 26%. Abnormal EEG patterns correlated with abnormal rCBF in 75% of cases (Phi = 0.788, p < 0.001), and with visually detected abnormalities in 50% (Phi = 0.493, p < 0.001). Discordance between EEG and SPECT was most frequent in patients with non-localizing EEG (n = 3). In childhood-onset epilepsy, quantitative evaluation of brain perfusion scans provides: (a) objective estimates of interictal rCBF; (b) more precise detection of epileptogenic foci, when used to complement EEG.
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