title: Comparison of region-of-interest analysis and human observers in the diagnosis of Parkinson's disease using [99mTc]TRODAT-1 and SPECT.
abstract: This study determined the relative accuracy of diagnosis of Parkinson's disease (PD) using SPECT imaging data, comparing a semi-quantitative region-of-interest (ROI) approach and human observers. A set of patients with PD and normal healthy control subjects were studied using the dopamine transporter tracer [(99m)Tc]TRODAT-1 and SPECT. The sample comprised 81 patients (mean age +/- SD, 63.4 +/- 10.4 years; age range, 39.0-84.2 years) and 94 healthy controls (mean age +/- SD, 61.8 +/- 11.0 years; age range, 40.9-83.3 years). A standardized template containing six ROIs was transposed onto subregions of the brain, and the ratio of striatal to background ROI values was used as a semi-quantitative outcome measure. All images were used in a human observer study, with four experienced investigators. The data from the observer and ROI studies were analysed using a receiver operating characteristic (ROC) analysis, where the area under the ROC curve (AUC) indicated the diagnostic accuracy. ROI analysis and human observers gave similar diagnostic performance (mean observer AUC = 0.89, best ROI AUC = 0.90). This suggested that the human observers are visually acquiring similar information from the images that are contained in the semi-quantitative striatal uptake.
authors.affiliation: Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107, USA. paul.acon@jefferson.edu
authors.forename: Paul D
authors.initials: PD
authors.lastname: Acton
authors.forename: Andrew
authors.initials: A
authors.lastname: Newberg
authors.forename: Karl
authors.initials: K
authors.lastname: Plössl
authors.forename: P David
authors.initials: PD
authors.lastname: Mozley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002523:Edible Grain / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D015609:Organotechnetium Compounds / Q000494:pharmacology*; D010300:Parkinson Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D012372:ROC Curve; D011859:Radiography; D019275:Radiopharmaceuticals / Q000494:pharmacology*; D015203:Reproducibility of Results; D013667:Technetium / Q000494:pharmacology*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014326:Tropanes / Q000494:pharmacology*
chemical_list: D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D014326:Tropanes; C104196:technetium Tc 99m TRODAT-1; D013667:Technetium