I-123 DaTscan SPECT Brain Imaging in Parkinsonian Syndromes: Utility of the Putamen-to-Caudate Ratio
I-123 DaTscan SPECT Brain Imaging in Parkinsonian Syndromes: Utility of the Putamen-to-Caudate Ratio
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DOI：
10.1111/jon.12530
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发表时间：
2018-11-01
影响因子：
2.4
通讯作者：
Lewis, David
中科院分区：
文献类型：
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作者：
Matesan, Manuela;Gaddikeri, Santhosh;Lewis, David
背景和目的多巴胺转运蛋白成像（DaTscan）的基于计算机的分析可以帮助图像解释。在这项研究中，我们研究了分布的壳核尾状核比率（PCR），通过使用临床上可用的半定量方法。方法回顾性分析32例经临床随访诊断为帕金森病（PD）（n = 22）或帕金森综合征（PPS）（n = 10）的患者的病历资料。静脉注射3-5 mCi [I-123]-碘氟烷后4小时进行单光子发射断层扫描（SPECT）成像。使用DaTQUANT软件进行半定量评价。PCR的实用性与截断值为0.7和0.8的黑质纹状体变性的诊断进行了评估。分别评估基于临床评估和尾动脉背景比（CBR）的PD和PPS组。两个半球的最小PCR为0.74 +/-0.09（平均值+/- SD，范围：0.58 - 0.89），其中65.63%的患者（21/32）具有PCR > 0.7。轻度黑质纹状体变性的平均PCR为0.77 +/-0.08（范围：0.62 - 0.89），晚期黑质纹状体变性的平均PCR为0.73 +/-0.09（范围：0.58 - 0.89）。PD组的平均PCR为.73 +/- .09（范围：.58-.89），PPS组为.75 +/- .10（范围：.61-.88）。结论：虽然PCR在本质上是一种有用的疾病指征，但在我们的分析中使用临床可用的自动半定量方法之一获得的该比值具有较大的变异性，可能不是解释[I-123]碘氟烷研究的可靠数字标记。这可能是由于在SPECT图像上难以分离尾状核与壳核，以及壳核和尾状核中碘氟烷摄取的不均匀降低。
BACKGROUND AND PURPOSE Computer-based analysis of Dopamine transporter imaging (DaTscan) can aid in image interpretation. In this study, we examined the distribution of putamen-to-caudate ratios (PCRs) obtained by using a clinically available semiquantification method. METHODS RESULTS Medical records of 32 patients (M:16) with a diagnosis of Parkinson's disease (PD) (n = 22) or Parkinson's plus syndromes (PPS) (n = 10) based on clinical follow-up, were retrospectively reviewed. Single photon emission tomography (SPECT) imaging was performed 4 hours after intravenous injection of 3-5 mCi [I-123]-ioflupane. Semiquantitative evaluation using DaTQUANT software was performed. Utility of PCR with a cutoff of .7 and .8 in the diagnosis of nigrostriatal degeneration was assessed. PD and PPS groups based on clinical assessment and caudate-to-background ratio (CBR) were assessed separately. Minimum PCR for both hemispheres was .74 +/- .09 (Mean +/- SD, range: .58-.89), with 65.63% patients (21/32) having PCR > .7. Mean PCR in mild nigrostriatal degeneration was .77 +/- .08 (range: .62-.89) and in advanced nigrostriatal degeneration was .73 +/- .09 (range: .58-.89). Mean PCR in PD group was .73 +/- .09 (range: .58-.89) and in PPS group was .75 +/- .10 (range: .61-.88). CONCLUSIONS Although PCR can intrinsically be a useful indication of disease, this ratio obtained in our analysis by using one of the clinically available automatic semiquantitative methods has large variability and might not be a reliable numeric marker in interpretation of [I-123]ioflupane studies. This may be due to difficulty in separating caudate from putamen on SPECT images, as well as the nonuniform decreased Ioflupane uptake in both putamen and caudate.