Validation of an automated morphological MRI-based (123)I-FP-CIT SPECT evaluation method.
Dopamine transporter imaging with (123)I-FP-CIT single photon emission computed tomography (SPECT) is helpful for the differential diagnosis between Parkinsonian syndrome (PS) and essential tremor (ET). Although visual assessment and time-consuming manual evaluation techniques are readily available, a fully objective and automated dopamine transporter quantification technique is always preferable, at least in research and follow-up investigations. Our aim was to develop a novel automated magnetic resonance imaging (MRI)-based evaluation technique of dopamine transporter SPECT images and to compare its diagnostic accuracy with those of the gold-standard visual grading and manual dopamine transporter binding quantification methods.



(123)I-FP-CIT SPECT and MRI sessions were conducted in 33 patients with PS (15 men; mean age: 60.3 ± 9.7 years) and 15 patients with ET (8 men; mean age: 54.7 ± 16.3 years). Striatal dopamine transporter binding was visually classified by 2 independent experts as normal or abnormal grade I, II and III. Caudal and putaminal specific uptake ratios were calculated by both automated MRI-based and manual evaluation techniques.



We found almost perfect agreement (κ = 0.829) between the visual scores by the 2 observers. The automated method showed strong correlation with the visual and manual evaluation techniques and its diagnostic accuracy (sensitivity = 97.0%; specificity = 93.3%) was also comparable to these methods. The automatically determined uptake parameters showed negative correlation with the clinical severity of parkinsonism. Based on ordinal regression modelling, the automated MRI-based method could reliably determine the visual grading scores.



The novel MRI-based evaluation of (123)I-FP-CIT SPECT images is useful for the differentiation of PS from ET.
MTA-PTE Clinical Neuroscience MR Research Group, H-7623 Pecs, Hungary; Pecs Diagnostic Centre, H-7623 Pecs, Hungary.
Gabor
G
Perlaki
Department of Nuclear Medicine, University of Pecs, H-7624 Pecs, Hungary.
Sarolta
S
Szekeres
MTA-PTE Clinical Neuroscience MR Research Group, H-7623 Pecs, Hungary; Pecs Diagnostic Centre, H-7623 Pecs, Hungary.
Gergely
G
Orsi
Mediso Medical Imaging Systems, H-1022 Budapest, Hungary.
Laszlo
L
Papp
Department of Nuclear Medicine, University of Pecs, H-7624 Pecs, Hungary.
Balazs
B
Suha
Pecs Diagnostic Centre, H-7623 Pecs, Hungary; MTA-PTE Neurobiology of Stress Research Group, H-7624 Pecs, Hungary.
Szilvia Anett
SA
Nagy
MTA-PTE Clinical Neuroscience MR Research Group, H-7623 Pecs, Hungary; Pecs Diagnostic Centre, H-7623 Pecs, Hungary; Department of Neurosurgery, University of Pecs, H-7623 Pecs, Hungary.
Tamas
T
Doczi
MTA-PTE Clinical Neuroscience MR Research Group, H-7623 Pecs, Hungary; Department of Neurology, University of Pecs, H-7623 Pecs, Hungary.
Jozsef
J
Janszky
Department of Nuclear Medicine, University of Pecs, H-7624 Pecs, Hungary.
Katalin
K
Zambo
MTA-PTE Clinical Neuroscience MR Research Group, H-7623 Pecs, Hungary; Department of Neurology, University of Pecs, H-7623 Pecs, Hungary. Electronic address: kovacs.norbert@pte.hu.
Norbert
N
Kovacs
D000328:Adult; D000368:Aged; D001330:Electronic Data Processing / Q000379:methods*; D020329:Essential Tremor / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020734:Parkinsonian Disorders / Q000000981:diagnostic imaging*; D012372:ROC Curve; D018709:Statistics, Nonparametric; D015899:Tomography, Emission-Computed, Single-Photon; D014326:Tropanes; D055815:Young Adult
D014326:Tropanes; C087552:2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane
(123)I-FP-CIT SPECT; DATSCAN; Dopamine transporter quantification; MRI; Parkinson’s disease