Determination of thresholds for detection of cerebellar blood flow deficits in brain SPECT images.
Two observer studies were performed to determine the threshold (i.e., ratio of the counts in a lesion area to the counts in the corresponding contralateral region) at which two experienced observers diagnosed blood flow deficits in the cerebellum in 99mTc-HMPAO SPECT scans to be clinically significant, and investigate the effect of the intensity mapping scale on the detectability of lesions.


METHODS
Lesions representing blood flow deficits varying from no decrease to a 12.5% decrease were simulated in 300 patient images. The first study, a receiver-operator characteristics (ROC) experiment, used two observers to compare the detectability of lesions with three intensity mapping scales: two pseudocolor scales, and a linear gray scale. A second "threshold-criterion" study was done to estimate the threshold at which observers determine deficits to be clinically significant.


RESULTS
In the ROC study, the observers were more accurate in detecting lesions displayed in pseudocolor than in gray scale. In the threshold-criterion study, the threshold at which observers assessed clinically significant deficits was found to range between 0.900 and 0.950 (corresponding to a 5%-10% decrease in counts), depending on the observer, and the intensity mapping scale. For both observers, the detection threshold was higher (i.e., closer to 1.0) with the pseudocolor scale than with the gray scale.


CONCLUSIONS
The definition of a threshold value for use in quantitative techniques is dependent on both the observer and the intensity mapping scale. Observers were more accurate with the pseudocolor scales.
Stapleton
S J
SJ
Department of Medical Biophysics, University of Toronto, Sunnybrook Health Science Centre, Canada.
Caldwell
C B
CB
Leonhardt
C L
CL
Ehrlich
L E
LE
Black
S E
SE
Yaffe
M J
MJ
D002531:Cerebellum / Q000098:blood supply* / Q000000981:diagnostic imaging*; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging*; D003198:Computer Simulation; D006801:Humans; D007091:Image Processing, Computer-Assisted; D012372:ROC Curve; D015899:Tomography, Emission-Computed, Single-Photon