Multicenter Semiquantitative Evaluation of (123)I-FP-CIT Brain SPECT.
OBJECTIVE
The aims of this study were: (1) to cross-compare data from semiquantitative, software-assisted, and phantom-corrected evaluations of (123)I-ioflupane [(123)I]N-ω-fluoropropyl-2β-carbomethoxy-3β-{4-iodophenyl}nortropane FP-CIT brain single-photon emission computed tomography (SPECT) acquired in three centers; (2) to assess the accuracy of semiquantitative evaluation; and (3) to identify the threshold with the best accuracy, sensitivity, and specificity in patients with suspected Parkinsonian Syndrome.


METHODS
Two-hundred-twenty patients, acquired in three centers, were included. All of them underwent (123)I-FP-CIT brain SPECT. All examinations were analyzed with the freely available software, BasGan, and semiquantitative data were used to predict disease. Analysis was based on the values from the most deteriorated putamen and caudate, normalized for age, and corrected by anthropomorphic phantom data. Receiver operating characteristic (ROC) analysis was performed and areas under the curve (AUC) were estimated.


RESULTS
Analysis showed high AUCs (.880, .866, .920, and .882 for each center and multicenter setting). Best thresholds were 1.53 and 1.56 for putamen and caudate, respectively. Thresholds of putamen data showed sensitivity and specificity of 86% and 89%, respectively, in the multicenter setting. Neither sensibility nor specificity showed significant differences among centers.


CONCLUSIONS
A unique, accurate threshold for all centers, with high sensitivity and specificity was identified. Semiquantitative assessment of (123)I-FP-CIT brain SPECT among different centers resulted reliable, accurate, and potentially useful in clinical trials.
Nuclear Medicine Unit, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy.|Medical Science Department, University A. Avogadro, Novara, Italy.
Andrea
A
Skanjeti
Nuclear Medicine Unit, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy.
Giancarlo
G
Castellano
Nuclear Medicine Unit, Umberto I Hospital, Turin, Italy.
Baldassarre O
BO
Elia
Nuclear Medicine Unit, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy.
Michela
M
Zotta
Nuclear Medicine Unit, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy.
Francesca
F
Dazzara
Nuclear Medicine Unit, San Giovanni Battista Hospital, University of Turin, Turin, Italy.
Matteo
M
Manfredi
Nuclear Medicine Unit, San Giovanni Battista Hospital, University of Turin, Turin, Italy.
Antonello
A
Galati
Nuclear Medicine Unit, San Giovanni Battista Hospital, University of Turin, Turin, Italy.
Serena
S
Grimaldi
Nuclear Medicine Unit, San Giovanni Battista Hospital, University of Turin, Turin, Italy.
Michele
M
Balma
Nuclear Medicine Unit, Umberto I Hospital, Turin, Italy.
Riccardo E
RE
Pellerito
Nuclear Medicine Unit, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy.
Valerio
V
Podio
D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020734:Parkinsonian Disorders / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon
D019275:Radiopharmaceuticals
123I-FP-CIT-SPECT; Movement disorder; Parkinson's disease; multicenter study; semiquantitative evaluation