Journal article
Effect of automatic injectors on the injection latency, safety, and seizure onset zone localization of ictal single photon emission computed tomography studies in adult epilepsy monitoring unit
Epilepsy research, Vol.169, pp.106522-106522
01/01/2021
DOI: 10.1016/j.eplepsyres.2020.106522
PMID: 33296809
Abstract
Background: Ictal Single Photon Emission Computed Tomography (iSPECT) is one of the established tools utilized in the presurgical evaluation of patients with drug-resistant epilepsy (DRE). Timely isotope injection for an iSPECT is critical for optimal yield but poses logistical challenges when done manually. We aim to evaluate the added value of automatic iSPECT injectors (ASIs) in overcoming such challenges.
Methods: We retrospectively reviewed all cases admitted to the University of Pittsburgh Medical Center (UPMC) Epilepsy Monitoring Unit from Jan 1, 2010, through Dec 31, 2016, who underwent an iSPECT. We compared the manually injected iSPECTs with those performed with ASIs.
Results: A total of 123 iSPECTs were reviewed. The manually injected iSPECT group consisted of 35 patients (median age, 35 years; and 19 males). The automatically injected iSPECT group consisted of 88 patients (median age, 36 years; and 46 males). The two groups were comparable in age, gender, epilepsy treatment, focal features on neuropsychological testing (NPT), EEG, and MRI, and temporal origin of seizures (p > 0.05).
Compared to manually injected iSPECTs, automatically injected ISPECTs' median injection latency (IL) was shorter (18.5 vs. 60 s, p < 0.001); the ratio of IL/total duration of seizure was lower (0.395 vs. 0.677, p < 0.001); postictal injections were less frequent (4 (4.5 %) vs. 7 (20 %), p = 0.007); the number of isotope spills was less (zero vs. 3, p = 0.022); and successfully localizing iSPECTs were more prevalent (81.8 % vs. 62.9 %, p = 0.025), even after adjusting for focal features on NPT, EEG, and MRI, the temporal origin of seizures, and seizure duration (OR of 5.539, 95 %CI = 1.653-18.563, p = 0.006).
Conclusions: Utilization of ASIs leads to a significant shortening of iSPECT IL with less postictal injections, provides a safer injection option for the EMU staff, and leads to a significant improvement in the number of successfully localizing iSPECTs.
Details
- Title: Subtitle
- Effect of automatic injectors on the injection latency, safety, and seizure onset zone localization of ictal single photon emission computed tomography studies in adult epilepsy monitoring unit
- Creators
- Ahmed Yassin - Jordan University of Science and TechnologyAbdel-Hameed Al-Mistarehi - Jordan University of Science and TechnologyKhalid El-Salem - Jordan University of Science and TechnologyAlexandra Urban - University of Pittsburgh Medical CenterCheryl Plummer - University of Pittsburgh Medical CenterSeyed Mohammadi - University of Pittsburgh Medical CenterArun R. Antony - University of Pittsburgh Medical CenterGena R. Ghearing - University of IowaJames M. Mountz - University of Pittsburgh Medical CenterAnto I. Bagic - University of Pittsburgh Medical Center
- Resource Type
- Journal article
- Publication Details
- Epilepsy research, Vol.169, pp.106522-106522
- Publisher
- Elsevier
- DOI
- 10.1016/j.eplepsyres.2020.106522
- PMID
- 33296809
- ISSN
- 0920-1211
- eISSN
- 1872-6844
- Number of pages
- 6
- Language
- English
- Date published
- 01/01/2021
- Academic Unit
- Neurology
- Record Identifier
- 9984302212302771
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