Application of statistical parametric mapping to SPET in the assessment of intractable childhood XXXX .

@entity1 @entity1315 @entity302 @entity12945 @entity4940
@entity12945 ( @entity12945 ) quantification and analysis has been successfully applied to functional imaging studies of @entity302 in adults. The present study evaluated whether localisation of the epileptogenic zone (determined by @entity12945 ) improves upon visually examined single-photon emission tomography (SPET) imaging in presurgical assessment of @entity1 with @entity1315 ( @entity1315 ) and @entity4940 ( @entity4940 ). The @entity1 sample consisted of 24 @entity1 (15 males) aged 2.1-17.8 years (9.8+/-4.3 years; mean+/-SD) with intractable @entity1315 or @entity4940 . SPET imaging was acquired routinely in presurgical evaluation. All @entity1 images were transformed into the standard stereotactic space of the adult @entity12945 SPET template prior to @entity12945 statistical analysis. Individual @entity1 images were contrasted with an adult control group of 22 healthy adult females. Resultant statistical parametric maps were rendered over the @entity12945 canonical magnetic resonance imaging (MRI). Two corresponding sets of ictal and interictal @entity12945 and SPET images were then generated for each @entity1 . Experienced clinicians independently reviewed the image sets, blinded to clinical details. Concordance of the reports between @entity12945 and SPET images, syndrome classification and MRI abnormality was studied. A fair level of inter-rater reliability (kappa=0.73) was evident for @entity12945 localisation. @entity12945 was concordant with SPET in 71% of all @entity1 , the majority of the discordance being from the @entity4940 group. @entity12945 and SPET localisation were concordant with @entity302 in 80% of the @entity1315 cases. Concordant localisation to syndrome was worse for both @entity12945 (33%) and SPET (44%) in the @entity4940 group. Data from a small sample of @entity1 with varied focal structural pathologies suggested that @entity12945 performed poorly relative to SPET in these cases. Concordance of @entity12945 and SPET with syndrome was lower in @entity1 younger than 6 years than in those aged 6 years and above. @entity12945 is effective in localising the potential epileptogenic zone but does not provide additional benefit beyond SPET in presurgical assessment of @entity1 with intractable @entity302 . The impact of different pathologies on the efficacy of @entity12945 warrants further study.
