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SISCOM technique with a variable Z score improves detectability of focal cortical dysplasia: a comparative study with MRI

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Abstract

Objective

Focal cortical dysplasia (FCD) is one of the causes of epilepsy, but its diagnosis by MRI remains difficult. The purpose of this study was to evaluate the use of subtraction ictal SPECT coregistered to MRI (SISCOM) and MRI to detect the epileptogenic focus in patients with FCD.

Methods

MRI and SISCOM findings of 20 patients with pathologically proven FCD were retrospectively reviewed. MRI was visually assessed for detecting FCD. SISCOM was evaluated by a new method selecting a higher standard deviation (Z score) area as the epileptogenic focus. We scored the detectability in both SISCOM and MRI while referring to the pathology.

Results

Sixteen patients agreed with pathology on SISCOM and 14 patients on MRI. Although MRI could not point out foci in two cases of FCD type I, SISCOM could do so in both of them. A combined diagnosis of SISCOM and MRI agreed with the pathology in 18 patients.

Conclusions

Narrowing the target by elevating the Z score on SISCOM seems to be an appropriate method to detect the foci without the need for expertise of radiologists. We recommend this combined method of SISCOM and MRI for presurgical evaluation in patients with FCD.

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Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cyo, Kodaira, Tokyo, 187-8511, Japan

    Yukio Kimura, Noriko Sato, Kimiteru Ito, Kouhei Kamiya & Yasuhiro Nakata

  2. Department of Pathology and Laboratory Medicine, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan

    Yuko Saito

  3. Department of Child Neurology, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan

    Kenji Sugai & Masayuki Sasaki

  4. Department of Nuclear Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan

    Hiroshi Matsuda

  5. Department of Radiology, Jichi Medical University, Shimotsuke, Tochigi, Japan

    Hideharu Sugimoto

Authors
  1. Yukio Kimura
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  2. Noriko Sato
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  3. Kimiteru Ito
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  4. Kouhei Kamiya
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  5. Yasuhiro Nakata
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  6. Yuko Saito
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  7. Hiroshi Matsuda
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  8. Kenji Sugai
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  9. Masayuki Sasaki
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  10. Hideharu Sugimoto
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Corresponding author

Correspondence to Noriko Sato.

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Kimura, Y., Sato, N., Ito, K. et al. SISCOM technique with a variable Z score improves detectability of focal cortical dysplasia: a comparative study with MRI. Ann Nucl Med 26, 397–404 (2012). https://doi.org/10.1007/s12149-012-0585-4

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  • DOI: https://doi.org/10.1007/s12149-012-0585-4

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