Beom Su Kim MD, Presenter: Nothing to Disclose

Beom Su Kim MD, Abstract Co-Author: Nothing to Disclose

Tae Jin Yun MD, Abstract Co-Author: Nothing to Disclose

Jin Chul Paeng, Abstract Co-Author: Nothing to Disclose

Seung Hong Choi MD, PhD, Abstract Co-Author: Nothing to Disclose

Ji-hoon Kim MD, Abstract Co-Author: Nothing to Disclose

Chul-Ho Sohn MD, Abstract Co-Author: Nothing to Disclose

Roh-Eul Yoo MD, Abstract Co-Author: Nothing to Disclose

Jung Hyo Rhim MD, PhD, Abstract Co-Author: Nothing to Disclose

The capability of arterial spin labeling (ASL) MR to depict the seizure focus in patients with clinical seizure activity has not yet been elucidated. We aimed to assess the relative capability of ASL to depict the seizure focus compared with electroencephalogram (EEG) in patients with clinical seizure activity. 

This retrospective study was approved by the institutional review board, and informed consent requirement was waived. Consecutive postictal ASL images from 36 patients with clinical seizure activity were analyzed. All patients underwent both EEG and MR imaging using ASL technique after clinical seizure activity. Eight of the patients also underwent 99mTc-HMPAO single-photon emission computed tomography after clinical seizure activity. The area under the receiver operating characteristic curve was used to evaluate diagnostic accuracy of ASL relative to that of EEG. Diagnostic performance of ASL images to depict the location of seizure focus was evaluated using EEG as the gold standard.  

The area under the receiver operating characteristic curve of ASL to depict the seizure focus was 0.903 (95% confidence interval: 0.756 – 0.976, p < 0.0001). In terms of diagnostic performance of ASL to depict the seizure focus, there was a sensitivity of 87% (26/30), a specificity of 33% (2/6), a positive predictive value of 87% (26/30), and a negative predictive value of 33% (2/6). Of 8 patients who underwent single-photon emission computed tomography images after clinical seizure activity, all patients showed perfusion abnormality. Among the patients, concordance was revealed in all 7 patients in terms of seizure location.

ASL can depict the seizure focus with excellent performance in patients with clinical seizure activity and has the potential to serve as a non-invasive imaging tool for detection of seizure focus in the patients.

ASL can depict the seizure focus with excellent performance in patients with clinical seizure activity. ASL has the potential to serve as a non-invasive imaging tool for detection of seizure focus in the patients.

Kim, B, Kim, B, Yun, T, Paeng, J, Choi, S, Kim, J, Sohn, C, Yoo, R, Rhim, J, Evaluation of the Capability of Arterial Spin Labeling to Depict the Seizure Focus in Patients with Clinical Seizure Activity.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009370.html