title: IBZM tool: a fully automated expert system for the evaluation of IBZM SPECT studies.
abstract: OBJECTIVE
  Visual reading of [(123)I]IBZM SPECT scans depends on the experience of the interpreter. Therefore, semi-quantification of striatal IBZM uptake is commonly considered mandatory. However, semi-quantification is time consuming and prone to error, particularly if the volumes of interest (VOIs) are positioned manually. Therefore, the present paper proposes a new software tool ("IBZM tool") for fully automated and standardised processing, evaluation and documentation of [(123)I]IBZM SPECT scans.
  
  
  METHODS
  The IBZM tool is an easy-to-use SPM toolbox. It includes automated procedures for realignment and summation of multiple frames (motion correction), stereotactic normalisation, scaling, VOI analysis of striatum-to-reference ratio R, classification of R and standardised display. In order to evaluate the tool, which was developed at the University of Hamburg, the tool was transferred to the University of Hannover. There it was applied to 27 well-documented subjects: eight patients with multi-system atrophy (MSA), 12 patients with Parkinson's disease (PD) and seven controls. The IBZM tool was compared with manual VOI analysis.
  
  
  RESULTS
  The sensitivity and specificity of the IBZM tool for the differentiation of the MSA subjects from the controls were 100% and 86%, respectively. The IBZM tool provided improved statistical power compared with manual VOI analysis.
  
  
  CONCLUSIONS
  The IBZM tool is an expert system for the detection of reduced striatal D(2) availability on [(123)I]IBZM SPECT scans. The standardised documentation supports visual and semi-quantitative evaluation, and it is useful for presenting the findings to the referring physician. The IBZM tool has the potential for widespread use, since it appears to be fairly independent of the performance characteristics of the particular SPECT system used. The tool is available free of charge.
authors.affiliation: Department of Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. buchert@uke.uni-hamburg.de
authors.forename: Ralph
authors.initials: R
authors.lastname: Buchert
authors.forename: Georg
authors.initials: G
authors.lastname: Berding
authors.forename: Florian
authors.initials: F
authors.lastname: Wilke
authors.forename: Brigitte
authors.initials: B
authors.lastname: Martin
authors.forename: Daniel
authors.initials: D
authors.lastname: von Borczyskowski
authors.forename: Janos
authors.initials: J
authors.lastname: Mester
authors.forename: Winfried
authors.initials: W
authors.lastname: Brenner
authors.forename: Malte
authors.initials: M
authors.lastname: Clausen
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D005103:Expert Systems; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000000981:diagnostic imaging; D010300:Parkinson Disease / Q000000981:diagnostic imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D012984:Software; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods* / Q000706:statistics & numerical data
chemical_list: D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D019275:Radiopharmaceuticals; C426805:idobenzamide