Evaluating the development of a SPECT protocol in a Canadian epilepsy unit.

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  • Author(s): Burneo JG;Burneo JG; Vezina W; Romsa J; Smith BJ; McLachlan RS
  • Source:
    The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques [Can J Neurol Sci] 2007 May; Vol. 34 (2), pp. 225-9.
  • Publication Type:
    Evaluation Study; Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: published by Cambridge University Press for the Canadian Neurological Sciences Federation Country of Publication: England NLM ID: 0415227 Publication Model: Print Cited Medium: Print ISSN: 0317-1671 (Print) Linking ISSN: 03171671 NLM ISO Abbreviation: Can J Neurol Sci Subsets: MEDLINE
    • Publication Information:
      Publication: <1999>- : Cambridge : published by Cambridge University Press for the Canadian Neurological Sciences Federation
      Original Publication: Calgary : Canadian Journal of Neurological Sciences
    • Subject Terms:
      Brain/*diagnostic imaging ; Brain Mapping/*methods ; Epilepsy/*diagnostic imaging ; Seizures/*diagnostic imaging ; Tomography, Emission-Computed, Single-Photon/*methods; Brain Mapping/instrumentation ; Canada ; Humans ; Nursing Staff, Hospital ; Radiopharmaceuticals ; Staff Development ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon/nursing
    • Abstract:
      Background: Functional neuroimaging can address some challenges of seizure localization, and sometimes preclude the need for EEG recording using intracranial electrodes. Ictal Single Photon Emission Computed Tomography (SPECT) has developed into an important tool in the presurgical evaluation of patients with medically-intractable localization-related epilepsy. The purpose of the study was to determine whether the development of a programme using trained nurses to perform ictal injections enabled a more efficient delivery of radiopharmaceuticals and therefore a greater sensitivity and specificity of outcome.
      Methods: In our epilepsy unit, nursing staff inject 99mTc-HMPAO at bedside, during or at seizure onset. Brain SPECT is performed later on a gamma camera.
      Results: Since the implementation of the new protocol (February 2005), 57 scans have been performed: 22 ictal and 35 interictal. Latency of ictal injection was found to be 5-40 seconds (mean 19.7 sec, standard deviation (SD) 10.4). Only 20% of reconstituted radiopharmaceutical vials were not used. Contamination rate was nil. Sixty three percent of SPECT studies were concordant with standard presurgical evaluation.
      Conclusion: The latency of injections and the percentage of unused vials indicated an efficient and effective protocol compared to the literature. Our results show that ictal SPECT can be a safe, noninvasive procedure performed on a routine basis in the epilepsy unit when appropriately trained support staff are incorporated into a structured multidisciplinary programme.
    • Accession Number:
      0 (Radiopharmaceuticals)
      3B744AG22N (Technetium Tc 99m Exametazime)
    • Publication Date:
      Date Created: 20070630 Date Completed: 20070809 Latest Revision: 20191210
    • Publication Date:
      20221213
    • Accession Number:
      10.1017/s0317167100006090
    • Accession Number:
      17598603