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SISCOM (Subtraction Ictal SPECT with Coregistration to MRI)

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PET and SPECT in Neurology

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Abstract

Brain single-photon emission computed tomography (SPECT) is a functional nuclear imaging technique that can provide a regional 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 regional CBF (rCBF) changes during seizure. The sensitivity of ictal SPECT is high in temporal lobe epilepsy but relatively lower in extratemporal epilepsy. SISCOM is an imaging technique to subtract ictal and interictal SPECT images and to coregister them on brain MRI. SISCOM significantly improves the sensitivity of ictal SPECT and can further localize epileptic focus. But the successful localization of epileptic focus can be affected by the time of radiotracer injection, seizure duration, and propagation pattern of ictal EEG. Ictal hypoperfusion as well as ictal hyperperfusion is an important finding. Thus, ictal SPECT and SISCOM should be carefully interpreted by simultaneous review with seizure semiology, clinical information, features, injection time, duration of seizure, and ictal EEG pattern at the injection times. 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.

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Authors and Affiliations

  1. Department of Neurology, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University, Seoul, Republic of Korea

    Hwareung Lee, Jung Sik Kim & Seung Bong Hong

  2. Severnace Hospital, Yonsei University, Seoul, South Korea

    Hwareung Lee

  3. The David S. Olton Behavioral Biology Program, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD, USA

    Ji Hyun Kim

Authors
  1. Hwareung Lee
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  2. Jung Sik Kim
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  3. Ji Hyun Kim
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  4. Seung Bong Hong
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Corresponding author

Correspondence to Seung Bong Hong .

Editor information

Editors and Affiliations

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

    Rudi A. J. O. Dierckx

  2. Faculty of Electrical Engineering, Medical Engineering and Computer Science, Offenburg University, 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

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Lee, H., Kim, J.S., Kim, J.H., Hong, S.B. (2021). SISCOM (Subtraction Ictal SPECT with Coregistration to MRI). In: Dierckx, R.A.J.O., Otte, A., de Vries, E.F.J., van Waarde, A., Leenders, K.L. (eds) PET and SPECT in Neurology. Springer, Cham. https://doi.org/10.1007/978-3-030-53168-3_38

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  • DOI: https://doi.org/10.1007/978-3-030-53168-3_38

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-53167-6

  • Online ISBN: 978-3-030-53168-3

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