Global scaling for semi-quantitative analysis in FP-CIT SPECT

TY - JOUR

T1 - Global scaling for semi-quantitative analysis in FP-CIT SPECT

AU - Kupitz, D

AU - Apostolova, I

AU - Lange, C

AU - Ulrich, G

AU - Amthauer, H

AU - Brenner, W

AU - Buchert, R

PY - 2014

Y1 - 2014

N2 - UNLABELLED: Semi-quantitative characterization of dopamine transporter availability from single photon emission computed tomography (SPECT) with 123I-ioflupane (FP-CIT) is based on uptake ratios relative to a reference region. The aim of this study was to evaluate the whole brain as reference region for semi-quantitative analysis of FP-CIT SPECT. The rationale was that this might reduce statistical noise associated with the estimation of non-displaceable FP-CIT uptake.PATIENTS, METHODS: 150 FP-CIT SPECTs were categorized as neurodegenerative or non-neurodegenerative by an expert. Semi-quantitative analysis of specific binding ratios (SBR) was performed with a custom-made tool based on the Statistical Parametric Mapping software package using predefined regions of interest (ROIs) in the anatomical space of the Montreal Neurological Institute. The following reference regions were compared: predefined ROIs for frontal and occipital lobe and whole brain (without striata, thalamus and brainstem). Tracer uptake in the reference region was characterized by the mean, median or 75th percentile of its voxel intensities. The area (AUC) under the receiver operating characteristic curve was used as performance measure.RESULTS: The highest AUC of 0.973 was achieved by the SBR of the putamen with the 75th percentile in the whole brain as reference. The lowest AUC for the putamen SBR of 0.937 was obtained with the mean in the frontal lobe as reference.CONCLUSION: We recommend the 75th percentile in the whole brain as reference for semi-quantitative analysis in FP-CIT SPECT. This combination provided the best agreement of the semi-quantitative analysis with visual evaluation of the SPECT images by an expert and, therefore, is appropriate to support less experienced physicians.

AB - UNLABELLED: Semi-quantitative characterization of dopamine transporter availability from single photon emission computed tomography (SPECT) with 123I-ioflupane (FP-CIT) is based on uptake ratios relative to a reference region. The aim of this study was to evaluate the whole brain as reference region for semi-quantitative analysis of FP-CIT SPECT. The rationale was that this might reduce statistical noise associated with the estimation of non-displaceable FP-CIT uptake.PATIENTS, METHODS: 150 FP-CIT SPECTs were categorized as neurodegenerative or non-neurodegenerative by an expert. Semi-quantitative analysis of specific binding ratios (SBR) was performed with a custom-made tool based on the Statistical Parametric Mapping software package using predefined regions of interest (ROIs) in the anatomical space of the Montreal Neurological Institute. The following reference regions were compared: predefined ROIs for frontal and occipital lobe and whole brain (without striata, thalamus and brainstem). Tracer uptake in the reference region was characterized by the mean, median or 75th percentile of its voxel intensities. The area (AUC) under the receiver operating characteristic curve was used as performance measure.RESULTS: The highest AUC of 0.973 was achieved by the SBR of the putamen with the 75th percentile in the whole brain as reference. The lowest AUC for the putamen SBR of 0.937 was obtained with the mean in the frontal lobe as reference.CONCLUSION: We recommend the 75th percentile in the whole brain as reference for semi-quantitative analysis in FP-CIT SPECT. This combination provided the best agreement of the semi-quantitative analysis with visual evaluation of the SPECT images by an expert and, therefore, is appropriate to support less experienced physicians.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Algorithms

KW - Brain

KW - Computer Simulation

KW - Diagnosis, Differential

KW - Dopamine Plasma Membrane Transport Proteins

KW - Humans

KW - Image Interpretation, Computer-Assisted

KW - Middle Aged

KW - Models, Biological

KW - Molecular Imaging

KW - Neurodegenerative Diseases

KW - Radiopharmaceuticals

KW - Reproducibility of Results

KW - Sensitivity and Specificity

KW - Tissue Distribution

KW - Tomography, Emission-Computed, Single-Photon

KW - Tropanes

KW - Journal Article

U2 - 10.3413/Nukmed-0659-14-04

DO - 10.3413/Nukmed-0659-14-04

M3 - SCORING: Journal article

C2 - 25209576

VL - 53

SP - 234

EP - 241

JO - NUKLEARMED-NUCL MED

JF - NUKLEARMED-NUCL MED

SN - 0029-5566

IS - 6

ER -