IBZM tool: a fully automated expert system for the evaluation of IBZM SPECT studies.
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.
Buchert
Ralph
R
Department of Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. buchert@uke.uni-hamburg.de
Berding
Georg
G
Wilke
Florian
F
Martin
Brigitte
B
von Borczyskowski
Daniel
D
Mester
Janos
J
Brenner
Winfried
W
Clausen
Malte
M
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
D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D019275:Radiopharmaceuticals; C426805:idobenzamide