Triple-technique (MR imaging, single-photon emission CT, and CT) coregistration for image-guided surgical evaluation of patients with intractable epilepsy

Ictal and interictal single-photon emission CT (SPECT) play an increasingly important role in the surgical evaluation of patients with epilepsy. We pr esent a method of coregistration of MR, SPECT, and CT images to correlate s tructural data (MR imaging), blood how changes (SPECT), and location of sub dural electrodes (CT) for patients undergoing image-guided surgical treatme nt of epilepsy. MR-SPECT root mean square (rms) mismatch distances were 2.1 to 2.5 mm, and MR-CT rms mismatch distances were 1.0 to 4.5 mm, Coregistra tion assisted in image-guided placement of subdural electrodes and in surgi cal resection of the suspected epileptogenic focus.