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Comparison of the Performances of 18F-FP-CIT Brain PET/MR and Simultaneous PET/CT: a Preliminary Study

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Abstract

Purpose

18F-FP-CIT [18F-fluorinated N-3-fluoropropyl-2-beta-carboxymethoxy-3-beta-(4-iodophenyl) nortropane] has been well established and used for the differential diagnosis of atypical parkinsonian disorders. Recently, combined positron emission tomography (PET)/magnetic resonance (MR) was proposed as a viable alternative to PET/computed tomography (CT). The aim of this study was to compare the performances of conventional 18F-FP-CIT brain PET/CT and simultaneous PET/MR by visual inspection and quantitative analysis.

Methods

Fifteen consecutive patients clinically suspected of having Parkinson’s disease were recruited for the study.18F-FP-CIT PET was performed during PET/CT and PET/MR. PET/CT image acquisition was started 90 min after intravenous injection of 18F-FP-CIT and then PET/MR images were acquired. Dopamine transporter (DAT) density in bilateral striatal subregions was assessed visually. Quantitative analyses were performed on bilateral striatal volumes of interest (VOIs) using average standardized uptake values (SUVmeans). Intraclass correlation coefficients (ICCs) and their 95 % confidence intervals (CIs) were assessed to compare PET/CT and PET/MR data. Bland–Altman plots were drawn to perform method-comparisons.

Results

All subjects showed a preferential decrease in DAT binding in the posterior putamen (PP), with relative sparing of the ventral putamen (VP). Bilateral striatal subregional binding ratio (BR) determined PET/CT and PET/MR demonstrated close interequipment correspondence (BRright caudate - ICC, 0.944; 95 % CI, 0.835–0.981, BRleft caudate - ICC, 0.917; 95 % CI, 0.753–0.972, BRright putamen - ICC, 0.976; 95 % CI, 0.929–0.992 and BRleft putamen - ICC, 0.970; 95 % CI, 0.911–0.990, respectively), and Bland–Altman plots showed interequipment agreement between the two modalities.

Conclusions

It is known that MR provides more information about anatomical changes associated with brain diseases and to enable the anatomical allocations of subregions than CT, though this was not observed in the present study. Although the subregional BR of simultaneous PET/MR was comparable to that of PET/CT in Parkinson’s disease, our isocontouring method could make bias. A future automated method using standard template study or manual segmentation of putamen/caudate based on MR or CT is needed.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Yeungnam University Hospital, Namgu Daemyung 5-dong 317-1, 705-717, Daegu, South Korea

    SangDon Kwon, KyungAh Chun, EunJung Kong & IhnHo Cho

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  1. SangDon Kwon
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  2. KyungAh Chun
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Correspondence to KyungAh Chun.

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Conflict of Interest

SangDon Kwon, Eunjung Kong, KyungAh Chun and IhnHo Cho declare that they have no conflict of interest.

Ethical Statement

All procedures performed in the study involving human participant were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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This manuscript has not been published before or is not under consideration for publication anywhere else and has been approved by all co-authors.

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Kwon, S., Chun, K., Kong, E. et al. Comparison of the Performances of 18F-FP-CIT Brain PET/MR and Simultaneous PET/CT: a Preliminary Study. Nucl Med Mol Imaging 50, 219–227 (2016). https://doi.org/10.1007/s13139-016-0419-8

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