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Annals of Nuclear Medicine

, Volume 32, Issue 5, pp 363–371 | Cite as

Quantitative evaluation of the tracer distribution in dopamine transporter SPECT for objective interpretation

  • Yu Iwabuchi
  • Tadaki Nakahara
  • Masashi Kameyama
  • Yoshitake Yamada
  • Masahiro Hashimoto
  • Yuji Ogata
  • Yohji Matsusaka
  • Mari Katagiri
  • Kazunari Itoh
  • Takashi Osada
  • Daisuke Ito
  • Hajime Tabuchi
  • Masahiro Jinzaki
Original Article
  • 217 Downloads

Abstract

Purpose

Quantification of the tracer distribution would add objectivity to the visual assessments of dopamine transporter (DAT) single photon emission computed tomography (SPECT) data. Our study aimed to evaluate the diagnostic utility of fractal dimension (FD) as a quantitative indicator of tracer distribution and compared with the conventional quantitative value: specific binding ratio (SBR). We also evaluated the utility of the combined index SBR/FD (SBR divided by FD).

Materials and methods

We conducted both clinical and phantom studies. In the clinical study, 150 patients including 110 patients with Parkinsonian syndrome (PS) and 40 without PS were enrolled. In the phantom study, we used a striatal phantom with the striatum chamber divided into two spaces, representing the caudate nucleus and putamen. The SBR, FD, and SBR/FD were calculated and compared between datasets for evaluating the diagnostic utility. Mann–Whitney test and receiver-operating characteristics (ROC) analysis were used for analysis.

Results

ROC analysis revealed that the FD value had high diagnostic performance [the areas under the curve (AUC) = 0.943] and the combined use of SBR and FD (SBR/FD) delivered better results than the SBR alone (AUC, 0.964 vs 0.899; p < 0.001). The sensitivity, specificity, and accuracy, respectively, were 79.1, 85.0, and 80.7% with SBR, 84.5, 97.5, and 88.0% with FD, and 92.7, 87.5, and 91.3% with SBR/FD.

Conclusion

Our results confirmed that the FD value is a useful diagnostic index, which reflects the tracer distribution in DAT SPECT images. The combined use of SBR and FD was more useful than either used alone.

Keywords

123I-Ioflupane 123I-FP-CIT DAT Fractal analysis Fractal dimension 

Abbreviations

PD

Parkinson’s disease

PET

Positron emission tomography

SPECT

Single photon emission computed tomography

DAT

Dopamine transporter

PS

Parkinsonian syndrome

DLB

Dementia with Lewy body

SBR

Specific binding ratio

VOI

Volume of interest

FD

Fractal dimension

3D-FA

Three-dimensional-fractal analysis

NPS

Non Parkinsonian syndrome

RI

Radioisotope

OSEM

Ordered-subset expectation maximization

ICC

Intra-class correlation coefficient

ROC

Receiver-operating characteristics

AUC

Area under the ROC curve

LOA

Limit of agreement

SSRI

Selective serotonin reuptake inhibitor

Notes

Acknowledgements

The authors thank the staff of the Division of Nuclear Medicine at the Department of Diagnostic Radiology, for their valuable support. We also thank Editage for English language editing.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.

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Copyright information

© The Japanese Society of Nuclear Medicine 2018

Authors and Affiliations

  • Yu Iwabuchi
    • 1
  • Tadaki Nakahara
    • 1
  • Masashi Kameyama
    • 1
    • 2
  • Yoshitake Yamada
    • 1
  • Masahiro Hashimoto
    • 1
  • Yuji Ogata
    • 1
  • Yohji Matsusaka
    • 1
  • Mari Katagiri
    • 1
  • Kazunari Itoh
    • 1
  • Takashi Osada
    • 3
  • Daisuke Ito
    • 3
  • Hajime Tabuchi
    • 4
  • Masahiro Jinzaki
    • 1
  1. 1.Department of Diagnostic RadiologyKeio University School of MedicineTokyoJapan
  2. 2.Department of Diagnostic RadiologyTokyo Metropolitan Geriatric Hospital and Institute of GerontologyTokyoJapan
  3. 3.Department of NeurologyKeio University School of MedicineTokyoJapan
  4. 4.Department of NeuropsychiatryKeio University School of MedicineTokyoJapan

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