Simultaneous Registration of Ictal SPECT, Interictal SPECT and MR Images for Epilepsy Studies: Method and Simulations

F. Nar, E. Mumcuoğlu, Y. Yardımcı, and U. Koçak (Turkey)


Image registration, ictal SPECT, SISCOM, Epilepsy


Subtraction of ictal and interictal single-photon emission computed tomography (SPECT) images is known to be successful in localizing the seizure focus in presurgical evaluation of patients with partial epilepsy. The subtracted images are also aligned with a patient's high resolution magnetic resonance image (MRI) and fused to identify the anatomical regions involved in the seizure. Computer-aided methods for producing subtraction ictal SPECT coregistered to MRI (SISCOM) have been developed. There are two registrations involved in SISCOM: between the ictal-interictal SPECT images and between the ictal image and MRI. Registration error of the first one has been shown to be more crucial. This article introduces a new method of registering all three images (ictal, interictal SPECT images and MRI) simultaneously in order to improve the registration accuracy of ictal-interictal SPECT images. Accuracy of this method is analyzed by Monte-Carlo simulation studies.

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