Reproducibility Between Brain Uptake Ratio Using Anatomic Standardization and Patlak-Plot Methods.
The Patlak-plot and conventional methods of determining brain uptake ratio (BUR) have some problems with reproducibility. We formulated a method of determining BUR using anatomic standardization (BUR-AS) in a statistical parametric mapping algorithm to improve reproducibility. The objective of this study was to demonstrate the inter- and intraoperator reproducibility of mean cerebral blood flow as determined using BUR-AS in comparison to the conventional-BUR (BUR-C) and Patlak-plot methods.


METHODS
The images of 30 patients who underwent brain perfusion SPECT were retrospectively used in this study. The images were reconstructed using ordered-subset expectation maximization and processed using an automatic quantitative analysis for cerebral blood flow of ECD tool. The mean SPECT count was calculated from axial basal ganglia slices of the normal side (slices 31-40) drawn using a 3-dimensional stereotactic region-of-interest template after anatomic standardization. The mean cerebral blood flow was calculated from the mean SPECT count. Reproducibility was evaluated using coefficient of variation and Bland-Altman plotting.


RESULTS
For both inter- and intraoperator reproducibility, the BUR-AS method had the lowest coefficient of variation and smallest error range about the Bland-Altman plot. Mean CBF obtained using the BUR-AS method had the highest reproducibility.


CONCLUSIONS
Compared with the Patlak-plot and BUR-C methods, the BUR-AS method provides greater inter- and intraoperator reproducibility of cerebral blood flow measurement.
Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Ishikawa, Japan.
Takayuki
T
Shibutani
Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Ishikawa, Japan onoguchi@staff.kanazawa-u.ac.jp.
Masahisa
M
Onoguchi
Department of Radiological Technology, Faculty of Health Sciences, Butsuryo College of Osaka, Osaka, Japan.
Atsushi
A
Noguchi
Department of Radiological Technology, Kishiwada City Hospital, Osaka, Japan; and.
Tomoki
T
Yamada
Department of Radiological Technology, Kishiwada City Hospital, Osaka, Japan; and.
Hiroko
H
Tsuchihashi
Department of Radiological Technology, Kishiwada City Hospital, Osaka, Japan; and.
Tadashi
T
Nakajima
Department of Biotracer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan.
Seigo
S
Kinuya
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001692:Biological Transport; D001921:Brain / Q000033:anatomy & histology* / Q000098:blood supply / Q000000981:diagnostic imaging / Q000378:metabolism*; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012015:Reference Standards; D015203:Reproducibility of Results; D012189:Retrospective Studies; D015899:Tomography, Emission-Computed, Single-Photon
Patlak plot method; brain perfusion SPECT; brain uptake ratio; cerebral blood flow (CBF); reproducibility