Abstract
Purpose. We aimed at improving the existing methods for the fully automatic quantification of striatal uptake of [99mTc]-TRODAT with SPECT imaging. Procedures. A normal [99mTc]-TRODAT template was first formed based on 28 healthy controls. Images from PD patients (n = 365) and nPD subjects (28 healthy controls and 33 essential tremor patients) were spatially normalized to the normal template. We performed an inverse transform on the predefined striatal and reference volumes of interest (VOIs) and applied the transformed VOIs to the original image data to calculate the striatal-to-reference ratio (SRR). The diagnostic performance of the SRR was determined through receiver operating characteristic (ROC) analysis. Results. The SRR measured with our new and automatic method demonstrated excellent diagnostic performance with 92% sensitivity, 90% specificity, 92% accuracy, and an area under the curve (AUC) of 0.94. For the evaluation of the mean SRR and the clinical duration, a quadratic function fit the data with R 2 = 0.84. Conclusions. We developed and validated a fully automatic method for the quantification of the SRR in a large study sample. This method has an excellent diagnostic performance and exhibits a strong correlation between the mean SRR and the clinical duration in PD patients.
Highlights
Parkinson’s disease (PD) is a neurodegenerative disease that results from the loss of dopaminergic neurons in the substantia nigra
With the proposed data processing scheme, a fully automated striatal-to-reference ratio (SRR) quantification method was implemented in MATLAB based on SPM8
Even for the most challenging group within three years of clinical duration, we still obtained a 90% specificity and approximately 90% accuracy and sensitivity. These findings indicate that the SRR quantified with [99mTc]-TRODAT single-photon emission computed tomography (SPECT) images using our method has good diagnostic value even when a patient is in the early stages of the disease
Summary
Parkinson’s disease (PD) is a neurodegenerative disease that results from the loss of dopaminergic neurons in the substantia nigra It has become a serious health issue that affects 1– 1.5% of the elderly population worldwide [1, 2]. Single-photon emission computed tomography (SPECT) has been commonly used in the diagnosis and management of PD patients. In brain scans of PD, common SPECT tracers include 123I-β-CIT [10, 11], 123I-FPCIT [12, 13], 123I-Ioflupane (DATSCAN) [6, 14, 15], and [99mTc]-TRODAT [16,17,18] for DAT imaging and 123I-S(-)IBZM [19, 20] for D2 receptors
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