Abstract

SPECT imaging with 123I-FP-CIT is used for diagnosis of neurodegenerative disorders like Parkinson’s disease. Attenuation correction (AC) can be useful for quantitative analysis of 123I-FP-CIT SPECT. Ideally, AC would be performed based on attenuation maps (-maps) derived from perfectly registered CT scans. Such -maps, however, are most times not available and possible errors in image registration can induce quantitative inaccuracies in AC corrected SPECT images. Earlier, we showed that a convolutional neural network (CNN) based approach allows to estimate SPECT-aligned -maps for full brain perfusion imaging using only emission data. Here we investigate the feasibility of similar CNN methods for axially focused 123I-FP-CIT scans. We tested our approach on a high-resolution multi-pinhole prototype clinical SPECT system in a Monte Carlo simulation study. Three CNNs that estimate -maps in a voxel-wise, patch-wise and image-wise manner were investigated. As the added value of AC on clinical 123I-FP-CIT scans is still debatable, the impact of AC was also reported to check in which cases CNN based AC could be beneficial. AC using the ground truth -maps (GT-AC) and CNN estimated -maps (CNN-AC) were compared with the case when no AC was done (No-AC). Results show that the effect of using GT-AC versus CNN-AC or No-AC on striatal shape and symmetry is minimal. Specific binding ratios (SBRs) from localized regions show a deviation from GT-AC 2.5% for all three CNN-ACs while No-AC systematically underestimates SBRs by 13.1%. A strong correlation ( 0.99) was obtained between GT-AC based SBRs and SBRs from CNN-ACs and No-AC. Absolute quantification (in kBq ml−1) shows a deviation from GT-AC within 2.2% for all three CNN-ACs and of 71.7% for No-AC. To conclude, all three CNNs show comparable performance in accurate -map estimation and 123I-FP-CIT quantification. CNN-estimated -map can be a promising substitute for CT-based -map.

Highlights

  • SPECT with 123I-FP-CIT can be used for visualization of the dopamine transporter (DaT) distribution in the brain

  • A strong correlation was observed between the GT-attenuation correction (AC) obtained specific binding ratio (SBR) and the values obtained with CNN-AC (r 0.99)

  • We found that the patch-voxel CNN which was used in full brain perfusion imaging (Chen et al 2021) gave slightly noisier m-maps here when applied on 123I-FP-CIT scans, probably due to the lower activity levels of the latter

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Summary

Introduction

SPECT with 123I-FP-CIT can be used for visualization of the dopamine transporter (DaT) distribution in the brain. Attenuation correction (AC) would be performed based on an attenuation map (m-map) derived from a perfectly registered CT scan This m-map provides the tissue attenuation coefficient at each voxel in the patient. Besides the CT based approach, manually drawing an ellipse around the head contour and assuming uniform attenuation within the ellipse is widely used for attenuation map approximation in brain SPECT studies (Tavares et al 2013, Rahmim et al 2017). This ellipse method, suffers from observer subjectivity and insufficient estimation of the head contour and internal head anatomy

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