Skip to main content
SpringerLink
Log in

SISCOM (Subtraction Ictal SPECT Coregistered to MRI)

  • Chapter
  • First Online:
PET and SPECT in Neurology

Abstract

Brain single photon emission computed tomography (SPECT) is a functional imaging test that can provide a map of cerebral blood flow (CBF) changes during the interictal or ictal period in patients with epilepsy and other neurological disorders. The radiotracer for brain SPECT is rapidly taken up by the brain within 30–60 s after its injection. The radiotracer injection during seizure activity (ictal SPECT) can show a snapshot of CBF changes during seizure. The sensitivity of ictal SPECT is high in temporal lobe epilepsy, but relatively lower in extratemporal epilepsy. SISCOM is a subtraction technique between ictal and interictal SPECT images with coregistration on brain MRI. SISCOM significantly improved the sensitivity of ictal SPECT and can further localize epileptic focus. But according to the time of radiotracer injection, an epileptic focus can be associated with ictal hyperperfusion or hypoperfusion or mixed one. Thus, ictal SPECT and SISCOM should be interpreted carefully with clinical information, features, and duration of seizure, ictal EEG pattern at the injection time. SISCOM is also useful for localizing brain structure generating specific feature of seizures and studying propagation pathways of epileptic seizures and pathomechanism of other neurological disorders and sleep disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 229.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 299.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  • Ahnlide JA, Rosén I, Lindén-Mickelsson Tech P, Källén K (2007) Does SISCOM contribute to favorable seizure outcome after epilepsy surgery? Epilepsia 48(3):579–588

    Article  PubMed  Google Scholar 

  • Cho JW, Seo DW, Joo EY et al (2007) Neural correlates of musicogenic epilepsy: SISCOM and FDG-PET. Epilepsy Res 77(2–3):169–173

    Article  PubMed  Google Scholar 

  • Hong SB, Tae WS, Joo EY (2006a) Cerebral perfusion changes during cataplexy in narcolepsy patients. Neurology 66(11):1747–1749

    Article  PubMed  Google Scholar 

  • Hong SB, Joo EY, Tae WS et al (2006b) Episodic diencephalic hypoperfusion in Kleine-Levin syndrome. Sleep 29(8):1091–1093

    PubMed  Google Scholar 

  • Hong SB, Joo EY, Tae WS et al (2008) Preictal versus ictal injection of radiotracer for SPECT study in partial epilepsy: SISCOM. Seizure 17(4):383–386

    Article  PubMed  Google Scholar 

  • Joo YE, Hong SB, Lee EK et al (2004) Regional cerebral hyperperfusion with ictal dystonic posturing: ictal-interictal SPECT subtraction. Epilepsia 45(6):686–689

    Article  PubMed  Google Scholar 

  • Kaiboriboon K, Bertrand ME, Osman MM, Hogan RE (2005) Quantitative analysis of cerebral blood flow patterns in mesial temporal lobe epilepsy using composite SISCOM. J Nucl Med 46:38–43

    PubMed  Google Scholar 

  • Knowlton RC, Elgavish RA, Bartolucci A, Ojha B, Limdi N, Blount J, Burneo JG, Ver Hoef L, Paige L, Faught E, Kankirawatana P, Riley K, Kuzniecky R (2008) Functional imaging: II. Prediction of epilepsy surgery outcome. Ann Neurol 64(1):35

    Article  PubMed  Google Scholar 

  • Koh CS, Lee MC, Chung JK, Lee DS, Lee SK, Seo JM, Lee JS, Kim HJ (1998) Diagnosis of ictal hyperperfusion using subtraction image of ictal and interictal brain perfusion SPECT. Kor J Nucl Med 32(1):20–31

    Google Scholar 

  • Lee HW, Hong SB, Tae WS et al (1999) Partial seizures manifesting as apnea only in an adult. Epilepsia 40:1828–1831

    Article  CAS  PubMed  Google Scholar 

  • Lee HW, Hong SB, Tae WS (2000) Opposite ictal perfusion patterns of subtracted SPECT. Hyperperfusion and hypoperfusion. Brain 123:2150–2159

    Article  PubMed  Google Scholar 

  • Lee KH, Meador KJ, Park YD et al (2002) Pathophysiology of altered consciousness during seizures: subtraction SPECT study. Neurology 59:841–846

    Article  CAS  PubMed  Google Scholar 

  • Lee SK, Lee SY, Kim KK, Hong KS, Lee DS, Chung CK (2005) Surgical outcome and prognostic factors of cryptogenic neocortical epilepsy. Ann Neurol 58(4):525–532

    Article  PubMed  Google Scholar 

  • Lee JY, Joo EY, Park HS et al (2011) Repeated ictal SPECT in partial epilepsy patients: SISCOM analysis. Epilepsia 52(12):2249–2256

    Article  PubMed  Google Scholar 

  • O’Brien TJ, So EL, Mullan BP et al (1998a) Subtraction ictal SPECT co-registered to MRI improves clinical usefulness of SPECT in localizing the surgical seizure focus. Neurology 50:445–454

    Article  PubMed  Google Scholar 

  • O’Brien TJ, O’Connor MK, Mullan BP et al (1998b) Subtraction ictal SPET co-registered to MRI in partial epilepsy: description and technical validation of the method with phantom and patient studies. Nucl Med Commun 19:31–45

    Article  PubMed  Google Scholar 

  • O’Brien TJ, So EL, Mullan BP et al (1999) Subtraction SPECT co-registered to MRI improves postictal SPECT localization of seizure foci. Neurology 52:137–146

    Article  PubMed  Google Scholar 

  • O’Brien TJ, So EL, Mullan BP et al (2000) Subtraction peri-ictal SPECT is predictive of extratemporal epilepsy surgery outcome. Neurology 55:1668–1677

    Article  PubMed  Google Scholar 

  • Shin WC, Hong SB, Tae WS et al (2001) Ictal hyperperfusion of cerebellum and basal ganglia in temporal lobe epilepsy: SPECT subtraction with MRI coregistration. J Nucl Med 42:853–858

    CAS  PubMed  Google Scholar 

  • Shin WC, Hong SB, Tae WS et al (2002) Ictal hyperperfusion patterns according to the progression of temporal lobe seizures. Neurology 58:373–380

    Article  PubMed  Google Scholar 

  • Spanaki MV, Spencer SS, Corsi M et al (1999) Sensitivity and specificity of quantitative difference SPECT analysis in seizure localization. J Nucl Med 40:730–736

    CAS  PubMed  Google Scholar 

  • Tan KM, Britton JW, Buchhalter JR, Worrell GA, Lagerlund TD, Shin C, Cascino GD, Meyer FB, So EL (2008) Influence of subtraction ictal SPECT on surgical management in focal epilepsy of indeterminate localization: a prospective study. Epilepsy Res 82(2–3):190–193

    Article  PubMed  Google Scholar 

  • Valenti MP, Froelich S, Armspach JP et al (2002) Contribution of SISCOM imaging in the presurgical evaluation of temporal lobe epilepsy related to dysembryoplastic neuroepithelial tumors. J Nucl Med 43:991–998

    PubMed  Google Scholar 

  • Van Paesschen W, Dupont P, Van Heerden B et al (2000) Self-injection ictal SPECT during partial seizures. Neurology 54:1994–1997

    Article  PubMed  Google Scholar 

  • von Oertzen TJ, Mormann F, Urbach H, Reichmann K, Koenig R, Clusmann H, Biersack HJ, Elger CE (2011) Prospective use of subtraction ictal SPECT coregistered to MRI (SISCOM) in presurgical evaluation of epilepsy. Epilepsia 52(12):2239–2248

    Article  Google Scholar 

  • Zubal IG, Spencer SS, Imam K et al (1995) Difference images calculated from ictal and interictal technetium-99 m-HMPAO SPECT scans of epilepsy. J Nucl Med 36:684–689

    CAS  PubMed  Google Scholar 

  • Zubal IG, Spanaki MV, MacMullan J et al (1999) Influence of technetium-99 m-hexamethylpropylene amine oxime injection time on single-photon emission tomography perfusion changes in epilepsy. Eur J Nucl Med 26:12–17

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, Epilepsy and Sleep Center, Samsung Medical Center, Sungkyungkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea

    Seung Bong Hong MD, PhD

  2. Neuroimaging Laboratory, Clinical Research Institute, Neuroscience Research Institute, Kangwon National University Hospital, Chuncheon, Kangwon-do, Republic of Korea

    Woo Suk Tae PhD

Authors
  1. Seung Bong Hong MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Woo Suk Tae PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Seung Bong Hong MD, PhD .

Editor information

Editors and Affiliations

  1. Dept. of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Rudi A.J.O. Dierckx

  2. Faculty of Electrical Engineering and Information Technology, University of Applied Sciences Offenburg, Offenburg, Germany

    Andreas Otte

  3. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Erik F.J. de Vries

  4. Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Aren van Waarde

  5. Neurology, University Medical Center Groningen, Groningen, The Netherlands

    Klaus L. Leenders

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Hong, S.B., Tae, W.S. (2014). SISCOM (Subtraction Ictal SPECT Coregistered to MRI). In: Dierckx, R., Otte, A., de Vries, E., van Waarde, A., Leenders, K. (eds) PET and SPECT in Neurology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54307-4_39

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-54307-4_39

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-54306-7

  • Online ISBN: 978-3-642-54307-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation