Diagnostic performance of [18F]FDG-PET and ictal [99mTc]-HMPAO SPECT in occipital lobe epilepsy

Epilepsia. 2001 Dec;42(12):1531-40. doi: 10.1046/j.1528-1157.2001.21901.x.


Purpose: We investigated whether interictal F-18 fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) or ictal [99mTc]-HMPAO single-photon emission computed tomography (SPECT) was useful to find epileptogenic zones in occipital lobe epilepsy (OLE).

Methods: We reviewed visually and quantified patterns of hypometabolism in interictal [18F]FDG-PET and those of hyperperfusion in ictal SPECT in 17 OLE patients (27 plus minus 6.8 years old; M/F, 10/7; injection time, 30 plus minus 17 s). OLE was diagnosed based on invasive electroencephalography, surgery, and postsurgical outcome (Engel class I in all at an average of 26 months after surgery).

Results: Epileptogenic zones were correctly localized in nine (60%) of 15 patients by interictal [18F]FDG-PET, and asymmetric indices corroborated visual diagnosis. Epileptogenic hemispheres were correctly lateralized in 14 (93%) of 15 patients on [18F]FDG-PET. Epileptogenic hemispheres were correctly lateralized in 13 (76%) of 17 patients using ictal SPECT, but localization was possible in only five (29%) patients. Interictal [18F]FDG-PET was helpful in two of the patients who showed no abnormality on magnetic resonance imaging (MRI) and no possible localization with ictal SPECT.

Conclusions: In OLE, ictal SPECT was helpful in lateralization, but less helpful in localization. Interictal [18F]FDG-PET was helpful in localization or lateralization of epileptogenic zones, even in patients with ambiguous MRI or ictal SPECT findings.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cerebral Cortex / blood supply
  • Cerebral Cortex / diagnostic imaging
  • Cerebral Cortex / metabolism
  • Diagnosis, Differential
  • Electroencephalography / statistics & numerical data
  • Epilepsies, Partial / diagnosis
  • Epilepsies, Partial / diagnostic imaging*
  • Epilepsies, Partial / metabolism
  • Female
  • Fluorodeoxyglucose F18
  • Functional Laterality / physiology
  • Humans
  • Magnetic Resonance Imaging / statistics & numerical data
  • Male
  • Occipital Lobe / diagnostic imaging*
  • Occipital Lobe / metabolism
  • Occipital Lobe / physiopathology
  • Regional Blood Flow
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Technetium Tc 99m Exametazime
  • Tomography, Emission-Computed / statistics & numerical data*
  • Tomography, Emission-Computed, Single-Photon / statistics & numerical data*


  • Fluorodeoxyglucose F18
  • Technetium Tc 99m Exametazime