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ORIGINAL RESEARCH article

Front. Neurol.

Sec. Applied Neuroimaging

Volume 16 - 2025 | doi: 10.3389/fneur.2025.1633993

This article is part of the Research TopicMedical Image Reconstruction and Big Data Analysis for Neurological DisordersView all articles

Comparison of SPECT/CT, AEEG and 3D-pCASL in people with epilepsy

Provisionally accepted
Rong  ChenRong Chen1Qing  ZhangQing Zhang2*Yajun  LiYajun Li3Jingyun  ChenJingyun Chen1Xu  WangXu Wang2Yanzi  JinYanzi Jin2Fang  LiFang Li1Qiuyan  ChenQiuyan Chen3Mengyun  LiMengyun Li3
  • 1Cardiovascular and Cerebrovascular Disease Hospital Branch, General Hospital of Ningxia Medical University, Yinchuan, China
  • 2General Hospital of Ningxia Medical University, Yinchuan, China
  • 3Ningxia Medical University, Yinchuan, China

The final, formatted version of the article will be published soon.

To analyze the clinical value of single-photon emission computed tomography(SPECT)/computed tomography(CT), ambulatory electroencephalogram (AEEG) and three-dimensional pseudo-continuous arterial spin labeling(3D-pCASL) in people with epilepsy(PWE).The study included 98 PWE who were treated in The General Hospital of Ningxia Medical University from December 2021 to September 2023. The positive detection rates and characteristics of SPECT/CT, AEEG and 3D-pCASL were compared. Additionally, the agreement between SPECT/CT, 3D-pCASL and AEEG-positive results was analyzed.The positive detection rates for SPECT/CT, AEEG, and 3D-pCASL examinations were 77.55% (76/98), 62.24% (61/98), and 54.08% (53/98) respectively. SPECT/CT exhibited higher positive detection rates than AEEG (aOR= 1.165, 95%CI: 1.036-1.311, P= 0.011) and 3D-pCASL(aOR= 1.265, 95%CI: 1.119-1.430, P< 0.001), no significant difference was observed between AEEG and 3D-pCASL (aOR= 0.922, 95%CI: 0.810-1.048, P= 0.213). In combined modalities, the positive detection rate of AEEG+SPECT/CT+3D-pCASL(93.88%, 92/98) was higher than AEEG+3D-pCASL (79.59%, 78/98, P=0.003), but showed no statistically significant difference compared to AEEG+SPECT/CT (88.78%, 87/98, P= 0.204). The proportions of PWE with no lesions, focal lesions, unilateral multifocal lesions and bilateral lesions across the three modalities results revealed statistically significant differences (P< 0.05). Among 61 PWE with interictal epileptiform discharges(IEDs) detected by AEEG, the agreement rate between SPECT/CT and AEEG was 63.93%(39/61), while that of 3D-pCASL was 39.34%(24/61), the difference is statistically significant (P= 0.007). In PWE with AEEG-detected temporal lobe (43 cases) and frontal lobe (31 cases) IEDs, SPECT/CT exhibited higher agreement rate with AEEG compared to 3D-pCASL(P< 0.05).SPECT/CT demonstrated a high positive detection rate and showed strong agreement with AEEG-positive results in PWE. The combined use of SPECT/CT, AEEG and 3D-pCASL significantly increased the positive detection rate. These findings highlight the advantages of SPECT/CT and combined modalities.

Keywords: PWE, SPECT/CT, aEEG, 3D-pcASL, Positive detection rate

Received: 28 May 2025; Accepted: 08 Aug 2025.

Copyright: © 2025 Chen, Zhang, Li, Chen, Wang, Jin, Li, Chen and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Qing Zhang, General Hospital of Ningxia Medical University, Yinchuan, China

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