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Research ArticleBasic Science Investigations

Validation of an Automatic Dose Injection System for Ictal SPECT in Epilepsy

Xavier Setoain, Javier Pavía, Eulalia Serés, Ramiro Garcia, Maria Mar Carreño, Antonio Donaire, Sebastià Rubí, Nuria Bargalló, Jordi Rumià, Teresa Boget, Luís Pintor, David Fuster and Francesca Pons
Journal of Nuclear Medicine February 2012, 53 (2) 324-329; DOI: https://doi.org/10.2967/jnumed.111.093211
Xavier Setoain
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Javier Pavía
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Eulalia Serés
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Ramiro Garcia
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Maria Mar Carreño
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Antonio Donaire
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Sebastià Rubí
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Nuria Bargalló
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Jordi Rumià
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Teresa Boget
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Luís Pintor
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David Fuster
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Francesca Pons
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  • FIGURE 1.
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    FIGURE 1.

    AIS (Asena GH-Alaris) pump containing radioactive dose, fixed inside lead-shielded box (A). Pump is connected to patient's forearm via pressure extension line filled with heparin and normal saline. Pump is also connected to pump-control module, which activates pump to inject precise volume of tracer to allow for radioactive decay. At electroencephalogram technicians’ workstation (B), technician supervises V-EEG of patient and is ready to push remote-control module buttons when seizure is detected.

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    FIGURE 2.

    Continuous line shows theoretic error in dose administration (in %) using MI at different times (over 4-h period at 30-min intervals) after tracer preparation. Dashed line shows error confidence interval using AI.

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    FIGURE 3.

    TI in seconds for each patient: 29 patients injected using MI (TMI = TSI + Tmanual) (A) and 27 patients injected using AI (TAI = TSI +Tpump) (B).

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    FIGURE 4.

    Percentages of successful seizure focus localization with ictal SPECT, using MI or AIS.

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    TABLE 1

    Clinical Data

    ParameterAIMI
    Patients (n = 56)2729
    Mean age ± SD33 ± 1336 ±14
    Mesial temporal seizures (n = 17)710
    Neocortical seizures (n = 39)2019
    MRI
     Normal64
     Mesial temporal sclerosis711
     Focal MDC*107
     Malacia34
     Atrophy01
     Tumor12
    Seizure focus
     Temporal1114
     Frontal810
     Parietal13
     Occipital10
     Temporoparietal52
     Hemispheric10
    • ↵* Focal MDC = malformation of cortical development (17 patients), that includes focal cortical dysplasia (15 patients) and focal subependymal heterotopias (2 patients).

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    TABLE 2

    Features of Injection and Seizure of Ictal SPECT

    ParameterAIMIP
    Mean duration of seizures ± SD68 ±4992 ± 710.14
    Aura54
    Postictal injections73
    TSI (s)18 ± 1219 ± 220.85
    Tpump and Tmanual (s)15 ± 122 ± 90.0001*
    TI (s)33 ± 1241 ± 210.035*
    • ↵* Statistically significant at the P < 0.05 level.

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Journal of Nuclear Medicine: 53 (2)
Journal of Nuclear Medicine
Vol. 53, Issue 2
February 1, 2012
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Validation of an Automatic Dose Injection System for Ictal SPECT in Epilepsy
Xavier Setoain, Javier Pavía, Eulalia Serés, Ramiro Garcia, Maria Mar Carreño, Antonio Donaire, Sebastià Rubí, Nuria Bargalló, Jordi Rumià, Teresa Boget, Luís Pintor, David Fuster, Francesca Pons
Journal of Nuclear Medicine Feb 2012, 53 (2) 324-329; DOI: 10.2967/jnumed.111.093211

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Validation of an Automatic Dose Injection System for Ictal SPECT in Epilepsy
Xavier Setoain, Javier Pavía, Eulalia Serés, Ramiro Garcia, Maria Mar Carreño, Antonio Donaire, Sebastià Rubí, Nuria Bargalló, Jordi Rumià, Teresa Boget, Luís Pintor, David Fuster, Francesca Pons
Journal of Nuclear Medicine Feb 2012, 53 (2) 324-329; DOI: 10.2967/jnumed.111.093211
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