ArticleEpilepsia open2024
Ex-SPECTing success: Predictors of successful SPECT radiotracer injection during presurgical video-EEG admissions.
Article in Epilepsia open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 3 citations in OpenAlex.
- Prediction of Seizure Outcome Using Combinations of Four Noninvasive Presurgical Modalities in Magnetic Resonance Imaging-negative Focal Intractable Epilepsy.Neurologia medico-chirurgica · 2025Article
- Ex-SPECTing success: Predictors of successful SPECT radiotracer injection during presurgical video-EEG admissions.Epilepsia open · 2024Article
- Determinants of successful ictal SPECT injection in phase 1 epilepsy presurgical evaluation: Findings from the pediatric epilepsy research consortium surgery database project.Epilepsia open · 2024Article
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Authors and funding
12 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo determine predictors of successful ictal single photon emission computed tomography (SPECT) injections during Epilepsy Monitoring Unit (EMU) admissions for patients undergoing presurgical evaluation for drug-resistant focal epilepsy.
methodsIn this retrospective study, consecutive EMU admissions were analyzed at a single center between 2019 and 2021. All seizures that occurred during the admission were reviewed. "Injectable seizures" occurred during hours when the radiotracer was available. EMU-level data were analyzed to identify factors predictive of an EMU admission with a successful SPECT injection (successful admission). Seizure-level data were analyzed to identify factors predictive of an injectable seizure receiving a SPECT injection during the ictal phase (successful injection). A multivariate generalized linear model was used to identify predictive variables.
results125 EMU admissions involving 103 patients (median 37 years, IQR 27.0-45.5) were analyzed. 38.8% of seizures that were eligible for SPECT (n = 134) were successfully injected; this represented 17.4% of all seizures (n = 298) that occurred during admission. Unsuccessful admissions were most commonly due to a lack of seizures during EMU-SPECT (19.3%) or no injectable seizures (62.3%). Successful EMU-SPECT was associated with baseline seizure frequency >1 per week (95% CI 2.1-3.0, P < 0.001) and focal PET hypometabolism (95% CI 2.0-3.7, P < 0.001). On multivariate analysis, the only factor associated with successful injection was patients being able to indicate they were having a seizure to staff (95% CI 1.0-4.4, P = 0.038). SIGNIFICANCE: Completing a successful ictal SPECT study remains challenging. A baseline seizure frequency of >1 per week, a PET hypometabolic focus, and a patient's ability to indicate seizure onset were identified as predictors of success. These findings may assist EMUs in optimizing their SPECT protocols, patient selection, and resource allocation.
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