title: Validation of a method for accurate and highly reproducible quantification of brain dopamine transporter SPECT studies.
abstract: In nuclear medicine brain imaging, it is important to delineate regions of interest (ROIs) so that the outcome is both accurate and reproducible. The purpose of this study was to validate a new time-saving algorithm (DATquan) for accurate and reproducible quantification of the striatal dopamine transporter (DAT) with appropriate radioligands and SPECT and without the need for structural brain scanning.
  
  
  METHODS
  In a reconstructed DAT SPECT image, DATquan automatically calculated the ratio at steady state of specifically bound radioligand to nondisplaceable radioligand in tissue (BP(ND)) within striatal ROIs that were delineated by use of a semiautomatic template-based alignment approach. DATquan was tested with (123)I-N-(3-iodoprop-2E-enyl)-2-β-carbomethoxy-3β-(4-methylphenyl) SPECT images from 15 patients. In each image, ROIs were first manually delineated, and then corresponding BP(ND) values were derived by an experienced physician. Afterward, 2 independent novice operators used DATquan to analyze the same 15 images. The resulting DATquan-derived BP(ND) data were compared with the data retrieved by manual delineation to assess the accuracy and reproducibility of DATquan. Also, the operational aspects of DATquan were assessed on the basis of measurements of the mean running time of the algorithm as well as on the basis of quantification of the overlap of the DATquan-delineated ROIs obtained by the 2 operators.
  
  
  RESULTS
  The mean algorithm running time was 3 min, and the operators' striatal ROIs had a mean overlap of more than 82%. DATquan-derived BP(ND) values obtained by the 2 operators showed high agreement (the mean difference was 0.00 [SD, 0.05] in the striatum, 0.02 [SD, 0.26] in the putamen, and 0.03 [SD, 0.43] in the caudate nucleus). The interoperator variability was 2.2% (SD, 1.3%) in the striatum, 11.7% (SD, 9.9%) in the putamen, and 12.9% (SD, 4.0%) in the caudate nucleus. DATquan-derived BP(ND) values showed high agreement with the values manually derived by the experienced delineator.
  
  
  CONCLUSIONS
  DATquan is a freely available, accurate, and highly reproducible method for quantification of DAT binding in the brain by SPECT. Once implemented in clinics, DATquan will serve as a useful and time-saving tool.
authors.affiliation: Neurobiology Research Unit, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Jensen
authors.forename: Morten
authors.initials: M
authors.lastname: Ziebell
authors.forename: Glenna
authors.initials: G
authors.lastname: Skouboe
authors.forename: Usman
authors.initials: U
authors.lastname: Khalid
authors.forename: Robin
authors.initials: R
authors.lastname: de Nijs
authors.forename: Gerda
authors.initials: G
authors.lastname: Thomsen
authors.forename: Gitte M
authors.initials: GM
authors.lastname: Knudsen
authors.forename: Claus
authors.initials: C
authors.lastname: Svarer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism*; D003198:Computer Simulation; D050483:Dopamine Plasma Membrane Transport Proteins / Q000378:metabolism*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008875:Middle Aged; D008959:Models, Neurological; D009662:Nortropanes / Q000493:pharmacokinetics*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D050483:Dopamine Plasma Membrane Transport Proteins; C113010:N-(3-iodoprop-2-enyl)-2-beta-carbomethoxy-3-(4-methylphenyl)nortropane; D009662:Nortropanes