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Methods: A descriptive observational study over 18 months included 60 patients, each undergoing history, video EEG, MRI, and 99mTc-ECD SPECT. SPECT hypoperfusion/hyperperfusion findings were analyzed visually and semiquantitatively and compared for concordance with clinical lateralization and EEG/MRI results. Results: All cases showed medial temporal lobe hypoperfusion; concordance with EEG and MRI was limited. Conclusion: 99mTc-ECD SPECT is valuable for lateralization/localization of epileptogenic zones and complements conventional non-diagnostic imaging.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/crucial-insights-from-interictal-99mtcecd-brain-perfusion-spect-in-enhancing-pediatric-epilepsy-diagnosis-and-management/445189/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/crucial-insights-from-interictal-99mtcecd-brain-perfusion-spect-in-enhancing-pediatric-epilepsy-diagnosis-and-management/445189.png","ImageObject",300,407,{"name":92,"@type":93},"acoobca","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-04","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What clinical problem does the study address?","Question",{"text":113,"@type":114},"The study targets drug-resistant epilepsy in children, where conventional MRI and EEG may be inconclusive and improved localization is needed for management decisions.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was 99mTc-ECD SPECT used in the study?",{"text":118,"@type":114},"All participants underwent interictal 99mTc-ECD brain perfusion SPECT, and images were assessed visually and semiquantitatively for hypoperfusion and hyperperfusion patterns.",{"name":120,"@type":111,"acceptedAnswer":121},"What were the key findings regarding perfusion patterns?",{"text":122,"@type":114},"Medial temporal lobe hypoperfusion was present in all patients, and additional frontal hyperperfusion foci were observed in a subset, with perfusion abnormalities sometimes involving one or both hemispheres.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},445189,1790742176,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},3985747870733,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Article published online: 2025-11-12  \nOriginal Article 325  \nCrucial Insights from Interictal 99mTc–ECD Brain Perfusion SPECT in Enhancing Pediatric Epilepsy Diagnosis and Management  \nGupta Sarath Chandra Sanisetty 1 Manishi L. Narayan 1 Prateek Kumar Panda2 Indar Kumar Sharawat 1 Ramya S.1  \n1 Department of Nuclear Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, Uttarakhand, India  \n2 Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Rishikesh, Uttarakhand, India  \nWorld J Nuclear Med 2025;24:325–334.  \nAddress for correspondence Manishi L. Narayan, MBBS, DRM, DNB, Department of Nuclear Medicine, All India Institute of Medical Sciences (A.I.I. M.S), Rishikesh 249203, Uttarakhand, India  \n([e-mail: manishi. Ln@gmail.com](e-mail: manishi. Ln@gmail.com)).  \nAbstract  \nKeywords  \n► seizure onset zone  \n► temporal lobe epilepsy  \n► 99mTc-ECD brain perfusion SPECT  \n► drug-resistant epilepsy  \n► interictal-ictal SPECT  \nObjective Epilepsy, a prevalent neurological disorder in children, manifests through recurrent seizures due to abnormal neuronal activity. Drug-resistant epilepsy (DRE) is asignificant clinical challenge, often necessitating advanced diagnostic approaches to optimize treatment strategies. Single photon emission computed tomography (SPECT) imaging, particularly using the radiopharmaceutical 99mTc-ethyl cysteinate dimer (99mTc-ECD), offers potential in localizing epileptogenic zones, especially when conventional magnetic resonance imaging (MRI) and electroencephalography (EEG)findings are inconclusive. This study was performed to evaluate patterns of brain perfusion using 99mTc-ECD SPECT in children aged \u003C 18 years diagnosed with DRE, and to correlate these findings with clinical evaluations, MRI, and video EEG reports. Materials and Methods A descriptive observational study was conducted over 18 months on 60 children with DRE. Each participant underwent a detailed clinical history, video EEG, MRI, and a 99mTc-ECD brain perfusion SPECT scan. The SPECT images were analyzed visually and semiquantitatively for hypoperfusion and hyperperfusion patterns. Data were cross-referenced with clinical lateralization, MRI findings, and EEG results to assess concordance.  \nResults A total of 60 children with DRE and mean age of 11.02 þ 3.8 years (1–\u003C 18 years) including 16 (26.7%) female and 44 (73.3%) male patients were prospectively analyzed. Forty of 60 (66.7%) patients had normal MRI brain study and 23/60 (38.3%) patients had normal EEG records. Medial temporal lobe hypoperfusion was seen in all patients, while 16/60 (26.67%) patients had additional foci of hyperperfusion in left frontal lobe and 14/60 (23.3%) patients in right frontal lobe. Thirty-six of 60 (60%) patients had involvement of one hemisphere, 24/60 (40%) showed perfusion abnormalities in both hemispheres. Moderate to severe hypoperfusion was seen in left temporal lobe in 39/60 (65%) patients whereas 30/60 (50%) patients showed moderate to severe hypoperfusion in right temporal lobe. SPECT findings were concordant with  \narticle published online November 12, 2025  \nDOI [https://doi.org/](https://doi.org/)[ ](https://doi.org/)10.1055/s-0045-1812326 . ISSN 1450-1147.  \n© 2025 . The Author(s) .  \nThis is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited.([https://creativecommons.org/licenses/by/4.0/](https://creativecommons.org/licenses/by/4.0/))  \nThieme Medical and Scientific Publishers Pvt. Ltd. , A-12, 2nd Floor, Sector 2, Noida-201301 UP, India  \n326 99mTc-ECD SPECT in Enhancing Pediatric Epilepsy Diagnosis Gupta et al.  \nEEG in 16/60 (26.67%) of cases and concordant MRI, EEG, and 99mTc-ECD was seen in 5/60 (8.3%) cases.  \nConclusion 99mTc-ECD brain perfusion SPECT is a valuable diagnostic tool in the comprehensive evaluation of pediatric DRE. It enhances ","cbCaitSWnvJyo4zk","https://ap.wps.com/l/cbCaitSWnvJyo4zk","pdf",3065417,"English","# Objective\n# Materials and Methods\n# Results\n# Conclusion\n# Introduction","[{\"question\":\"What clinical problem does the study address?\",\"answer\":\"The study targets drug-resistant epilepsy in children, where conventional MRI and EEG may be inconclusive and improved localization is needed for management decisions.\"},{\"question\":\"How was 99mTc-ECD SPECT used in the study?\",\"answer\":\"All participants underwent interictal 99mTc-ECD brain perfusion SPECT, and images were assessed visually and semiquantitatively for hypoperfusion and hyperperfusion patterns.\"},{\"question\":\"What were the key findings regarding perfusion patterns?\",\"answer\":\"Medial temporal lobe hypoperfusion was present in all patients, and additional frontal hyperperfusion foci were observed in a subset, with perfusion abnormalities sometimes involving one or both hemispheres.\"}]","Crucial Insights from Interictal 99mTc–ECD Brain Perfusion SPECT in Enhancing Pediatric Epilepsy Diagnosis and Management | PDF",1790710582,25]