ACQUISITION AND ANALYSIS TOOLS FOR SPECT IN EPILEPSY

最近的研究表明，单正电子发射计算机断层扫描（SPECT）是一种有用的无创方法，用于癫痫手术候选人的癫痫发作病灶定位。尽管如此，由于难以确保最佳的初始注射和缺乏足够的软件进行必要的图像分析，相对较少的中心常规应用该技术。这个项目的总体目标是开发软件工具，以促进在手术前定位中使用垂直SPECT。第一阶段将侧重于实施一种针对患者的预警系统的可行性，该系统能够通过头皮脑电图可靠地预测或早期检测癫痫发作，通过开发可训练的癫痫发作检测软件，根据先前的癫痫发作来检测或预测特定患者的癫痫发作。此外，我们还将研究受SPECT局部定位约束的脑电图偶极子模型，该模型可用于检查脑电图中脑电图的血流变化与癫痫发作放电的一致性，并可用于评估快速扩散的癫痫发作中多个病灶之间的动态脑电图关系。第二阶段将专注于优化癫痫预警系统和实施现场测试的实时软件，以及系统地评估由SPECT约束的临界偶极子模型的临床价值。拟议的商业应用：一个成功的结果将大大提高SPECT的临床应用，以定位大脑中癫痫发作开始的特定区域，从而最大限度地减少手术前诊断研究中颅内电极的使用。这将显著减少与这些研究相关的费用和患者压力。

Recent studies have demonstrated that ictal SPECT (Single Positron Emission Computed Tomography) is a useful noninvasive method for localizing seizure foci in candidates for epilepsy surgery. Despite this, relatively few centers apply this technique routinely, due to the difficulty of ensuring optimal ictal injection and the lack of adequate software for the necessary image analysis. The overall goal of: t:his project is to develop software tools to facilitate the use of ictal SPECT for presurgical localization. Phase I will focus on the feasibility of implementing a patient-specific warning system capable of reliable prediction or early detection of seizure onset from scalp EEG, by developing trainable seizure detection software to detect or predict seizures in a given patient based on previous seizures. Ictal EEG dipole model in with localization constrained by SPECT foci will also be investigated, which may be a useful tool for checking concordance between ictal blood flow changes and the seizure discharge, and for assessing dynamic EEG relationships between multiple foci in rapidly spreading seizures. Phase II will focus on optimizing the seizure warning system and implementing realtime software for field testing, in addition to systematically evaluating the clinical value of ictal dipole modeling constrained by SPECT. PROPOSED COMMERCIAL APPLICATION: A successful outcome will substantially improve the clinical application of SPECT to locate the specific zone in the brain where seizures start and thus minimize the use of intracranial electrodes in presurgical diagnostic studies. This will significantly reduce the costs and patient stress associated with these studies.