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A new quantitative index in the diagnosis of Parkinson syndrome by dopamine transporter single-photon emission computed tomography

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Abstract

Objective

Dopamine transporter single-photon emission computed tomography (DAT SPECT) has been widely used to diagnose Parkinson syndrome. Using the standardized uptake value (SUV) of DAT SPECT, we propose “functional dopamine transporter volume (f-DTV)” as a new quantitative index to evaluate the three-dimensional volume of functional dopamine transporters and assess its diagnostic ability in differentiating dopaminergic neurodegenerative diseases (dNDD) from non-dNDD.

Methods

Seventy-nine patients were enrolled (42 dNDD, 37 non-dNDD; 38 men; age 24–88 years). We analyzed seven quantitative indices. The specific binding ratio (SBR) was calculated using a program specialized for DAT SPECT (SBR_Bolt). The SUVmax, SUVpeak, and SUVmean were calculated using a quantification program for bone SPECT. SBR_SUV was calculated by dividing striatal SUVmean by the average of background SUVmean. The cutoff value of the active dopamine transporter level was examined using three methods (threshold of 40% of SUVmax, SUV 2, and SUV 3) to calculate the active dopamine transporter volume (ADV). The f-DTV was calculated by multiplying ADV and SUVmean. We assessed the correlations between SBR_Bolt and SBR_SUV, and compared the mean value of each index between the dNDD and non-dNDD groups. The abilities of SBR_Bolt, SBR_SUV, SUVmax, SUVpeak, SUVmean, ADV, and f-DTV in differentiating dNDD from non-dNDD were determined by the area under the receiver operating curve (AUC) generated by the receiver operating characteristics analysis.

Results

The SBR_Bolt and SBR_SUV highly correlated with each other (r = 0.71). The cutoff value of the active dopamine transporter level was determined as SUV 3. All seven quantitative indices showed lower values in the dNDD group than in the non-dNDD group, and the difference between the two groups was statistically significant (p < 0.05). Sensitivity, specificity, and AUC of f-DTV were slightly lower than those of SBR_Bolt (71%, 79%, and 0.81, respectively, for f-DTV, and 81%, 84%, 0.88, respectively, for SBR_Bolt). The difference in AUC between f-DTV and SBR_Bolt was not statistically significant.

Conclusions

This study demonstrates the utility of f-DTV as a novel quantitative index for evaluating the three-dimensional volume of functional dopamine transporters, and that f-DTV has almost the same diagnostic ability to differentiate dNDD from non-dNDD using DAT SPECT.

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Authors and Affiliations

  1. Department of Radiology, Tokushima University Hospital, Kuramoto-cho 3-18-15, Tokushima, 770-8503, Japan

    Ryota Bando, Noritake Matsuda, Shota Azane & Yamato Kunikane

  2. Department of Medical Imaging/Nuclear Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan

    Hideki Otsuka

  3. Advance Radiation Research, Education and Management Center, Tokushima University, Tokushima, Japan

    Tamaki Otani

  4. Department of Radiology and Radiation Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan

    Yoichi Otomi & Masafumi Harada

  5. Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan

    Wataru Sako & Yuishin Izumi

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  1. Ryota Bando
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  2. Hideki Otsuka
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  3. Tamaki Otani
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Correspondence to Hideki Otsuka.

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Bando, R., Otsuka, H., Otani, T. et al. A new quantitative index in the diagnosis of Parkinson syndrome by dopamine transporter single-photon emission computed tomography. Ann Nucl Med 35, 504–513 (2021). https://doi.org/10.1007/s12149-021-01592-w

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  • DOI: https://doi.org/10.1007/s12149-021-01592-w

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