Quantitative assessment of rest and acetazolamide CBF using quantitative SPECT reconstruction and sequential administration of (123)I-iodoamphetamine: comparison among data acquired at three institutions.

Miho Yamauchi,Hiroshi Matsuda,Masaaki Takahashi,Michiyasu Suzuki,Koji Iihara,Kenji Fukuda,Jun Hatazawa,Etsuko Imabayashi,Hideyuki Iwanaga,Hidehiro Iida,Eku Shimosegawa,Jyoji Nakagawara

doi:10.1007/s12149-014-0879-9

Abstract

PurposeA recently developed technique which reconstructs quantitative images from original projection data acquired using existing single-photon emission computed tomography (SPECT) devices enabled quantitative assessment of cerebral blood flow (CBF) at rest and after acetazolamide challenge. This study was intended to generate a normal database and to investigate its inter-institutional consistency.Methods The three institutions carried out a series of SPECT scanning on 32 healthy volunteers, following a recently proposed method that involved dual administration of 123I-iodoamphetamine during a single SPECT scan. Intra-institute and inter-institutional variations of regional CBF values were evaluated both at rest and after acetazolamide challenge. Functional images were pooled for both rest and acetazolamide CBF, and inter-institutional difference was evaluated among these images using two independent software programs.ResultsQuantitative assessment of CBF images at rest and after acetazolamide was successfully achieved with the given protocol in all institutions. Intra-institutional variation of CBF values at rest and after acetazolamide was consistent with previously reported values. Quantitative CBF values showed no significant difference among institutions in all regions, except for a posterior cerebral artery region after acetazolamide challenge in one institution which employed SPECT device with lowest spatial resolution. Pooled CBF images at rest and after acetazolamide generated using two software programs showed no institutional differences after equalization of the spatial resolution.Conclusions SPECT can provide reproducible images from projection data acquired using different SPECT devices. A common database acquired at different institutions may be shared among institutions, if images are reconstructed using a quantitative reconstruction program, and acquired by following a standardized protocol.

Highlights

Single-photon emission computed tomography (SPECT) can provide valuable diagnostic information in clinical patients with various cerebral diseases including cerebral vascular diseases, cognitive disorders, and others
Quantitative cerebral blood flow (CBF) values showed no significant difference among institutions in all regions, except for a posterior cerebral artery region after acetazolamide challenge in one institution which employed single-photon emission computed tomography (SPECT) device with lowest spatial resolution
Yoneda et al [15] demonstrated that quantitative CBF and CVR obtained from the same patients repeatedly acquired using different SPECT systems equipped at different institutions were reproducible, both in the quantitative regional values and in relative distributions. These findings suggested that SPECT images can be reproducible among different SPECT systems installed at different institutions, provided that the clinical protocols are well standardized for CBF quantitation

Summary

Introduction

Single-photon emission computed tomography (SPECT) can provide valuable diagnostic information in clinical patients with various cerebral diseases including cerebral vascular diseases, cognitive disorders, and others. Minoshima et al [1] developed a program, called the threedimensional stereotactic surface projection (3D-SSP), and it was first applied to identify unique patterns suggestive of Alzheimer’s disease for 18F-fluorodeoxy glucose positron emission tomography (PET) images [2, 3]. Z values were referred to identify regions which are different as compared to the normal database by means of the statistical analysis procedures. This software has been extended to SPECT images obtained with 123I-labeled cerebral perfusion tracer (123I-iodoamphetamine, 123I-IMP) to detect suggestive defect of cerebral blood flow (CBF) (magnitude and the extent of the defect) in probable Alzheimer disease patients [4]. The package was applied to cerebral perfusion studies with 99mTc-ethylcysteinate dimer (99mTc-ECD) acquired at 4 institutions using different SPECT cameras, demonstrating the significant discrimination of Alzheimer disease patients from the control group images

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