Direct comparison of FP-CIT SPECT and F-DOPA PET in patients with Parkinson’s disease and healthy controls

Eshuis, Silvia; Jager, Pieter L.; Maguire, R. Paul; Jonkman, S.; Dierckx, Rudi; Leenders, Klaus L.

doi:10.1007/s00259-008-0989-5

Cited by 96 publications

(59 citation statements)

References 45 publications

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“…This difference in mean age could theoretically enhance the difference in 18 F-FDOPA uptake between patients and controls. However, 18 F-FDOPA uptake shows no or only a minimal decrease during aging (15,(28)(29)(30); therefore, it is unlikely that the small difference in the ages of the PD patients and the healthy controls in the present study would have affected the results.…”

Section: Discussionmentioning

confidence: 67%

Simple Ratio Analysis of ¹⁸F-Fluorodopa Uptake in Striatal Subregions Separates Patients with Early Parkinson Disease from Healthy Controls

Jokinen¹,

Helenius²,

Rauhala³

et al. 2009

J Nucl Med

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6-18 F-fluoro-L-dopa ( 18 F-FDOPA) is widely used to investigate dopaminergic hypofunction, for instance, in Parkinson disease (PD). Conventionally, a 90-min scan with either a graphical or a metabolite-purified plasma input approach has been used for quantification. In the clinical setting, to increase compliance, especially in patients with more advanced disease, and to increase the efficacy of tracer and scanner time use, a shorter acquisition and a simple quantitative analysis are desirable. Taking into account the asymmetry of clinical symptoms and the uneven distribution of striatal dopaminergic hypofunction may also improve the use of 18 F-FDOPA PET in early disease detection. Therefore, we compared subregional striatal 18 F-FDOPA PET data from a large group of nonmedicated patients with early PD and a set of healthy elderly volunteers to find out whether a simple ratio approach would reliably separate PD patients from healthy controls. Methods: A total of 89 nonmedicated patients with early PD and 21 healthy volunteers were studied with 18 F-FDOPA PET, and both a region-to-reference (striatal-to-occipital) ratio (SOR) calculated from 75 to 90 min after injection and a graphical analysis of data calculated from 15 to 90 min after 18 F-FDOPA injection (yielding the influx constant [K i ref ]) were used. Results: Both SOR and K i ref values in the PD patients were lowest, relative to those in the healthy controls, in the posterior putamen contralateral to the side with predominant clinical symptoms. The contralateral posterior putamen showed the largest areas under the receiver operating characteristic (ROC) curve-0.994 for SOR and 0.998 for K i ref -indicating excellent separation of the PD and control groups. The caudate nucleus and the ventral striatum were less impressive in this respect. Conclusion: A single 15-min scan 75 min after tracer injection seems to be sufficient for separating patients with PD from healthy controls in a clinical research environment. This method represents a powerful and economical alternative for research on the disease mechanism and differential diagnosis.

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Section: Discussionmentioning

confidence: 67%

Simple Ratio Analysis of ¹⁸F-Fluorodopa Uptake in Striatal Subregions Separates Patients with Early Parkinson Disease from Healthy Controls

Jokinen¹,

Helenius²,

Rauhala³

et al. 2009

J Nucl Med

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“…Eshuis et al [13] reported a significant age-dependent decline in the SOR of FP-CIT of 3.9% per decade in healthy controls. A study using beta-CIT SPECT showed a reduction in striatal binding of 6.6% per decade [14]; another SPECT study using Tc-99m TRODAT demonstrated a decline of 6.2% per decade [15].…”

Section: Discussionmentioning

confidence: 98%

Clinical Significance of F-18 FP-CIT Dual Time Point PET Imaging in Idiopathic Parkinson’s Disease

Yoo

Seo

et al. 2011

Nucl Med Mol Imaging

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Purpose The purpose of this study was to investigate the diagnostic value of dual time point F-18 FP-CIT PET imaging in idiopathic Parkinson's disease (PD). Materials and Methods Twenty-four patients with PD (mean age 69.6) and 18 healthy people (mean age 70.26) underwent two sequential PET/CT scans (dual time point imaging) at 90 and 210 min after F-18 FP-CIT injection. Tracer activity of region of interest was measured in the caudate, putamen and a reference region in the brain from both time points. The outcome parameter was the striatooccipital ratio (SOR). Normal SOR values were obtained in the control group. The percent change in tracer activity between 90-and 210-min images was calculated. The SOR values and the percent change in tracer activity were compared between the patients and healthy control group. ResultsThe SOR values for the caudate, anterior and posterior putamen at both 90-and 210-min images were significantly reduced in the patients with PD. The lowest P value was obtained for the anterior and posterior putamen (p<0.001) at both time points. There were significant differences of the percent change in tracer activity for the anterior and posterior putamen in the two groups (p=0.01). Conclusions F-18 FP-CIT PET scans at 90 and 210 min after injection are both able to diagnose PD. Therefore, the 90-min image by itself is sufficient for diagnosing PD.

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“…Briefly, an initial template was generated by summing the SPAM images [15] of striatum, brain, and head, with multiplying different weighting factors (9.0, 0.5, and 0.5, respectively). Afterward, the initial template was smoothed with a 12-mm Gaussian kernel to adjust resolution.…”

Section: Spam-based Automatic Voi and Quantificationmentioning

confidence: 99%

“…A VOI can be drawn manually with aid of magnetic resonance imaging (MRI) or semiautomatically using standard VOI [10][11][12]. Another method for VOI delineation is normalization of image to a standard brain template [13][14][15]. However, these methods are still laborious for routine clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Validation of Simple Quantification Methods for 18F-FP-CIT PET Using Automatic Delineation of Volumes of Interest Based on Statistical Probabilistic Anatomical Mapping and Isocontour Margin Setting

Kim

Paeng

et al. 2012

Nucl Med Mol Imaging

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Purpose 18 F-FP-CIT positron emission tomography (PET) is an effective imaging for dopamine transporters. In usual clinical practice, 18 F-FP-CIT PET is analyzed visually or quantified using manual delineation of a volume of interest (VOI) for the striatum. In this study, we suggested and validated two simple quantitative methods based on automatic VOI delineation using statistical probabilistic anatomical mapping (SPAM) and isocontour margin setting. Methods Seventy-five 18 F-FP-CIT PET images acquired in routine clinical practice were used for this study. A studyspecific image template was made and the subject images were normalized to the template. Afterwards, uptakes in the striatal regions and cerebellum were quantified using probabilistic VOI based on SPAM. A quantitative parameter, Q SPAM , was calculated to simulate binding potential. Additionally, the functional volume of each striatal region and its uptake were measured in automatically delineated VOI using isocontour margin setting. Uptake-volume product (Q UVP ) was calculated for each striatal region. Q SPAM and Q UVP were compared with visual grading and the influence of cerebral atrophy on the measurements was tested. Results Image analyses were successful in all the cases. Both the Q SPAM and Q UVP were significantly different according to visual grading (P<0.001). The agreements of Q UVP or Q SPAM with visual grading were slight to fair for the caudate nucleus (κ00.421 and 0.291, respectively) and good to perfect to the putamen (κ00.663 and 0.607, respectively). Also, Q SPAM and Q UVP had a significant correlation with each other (P<0.001). Cerebral atrophy made a significant difference in Q SPAM and Q UVP of the caudate nuclei regions with decreased 18 F-FP-CIT uptake. Conclusion Simple quantitative measurements of Q SPAM and Q UVP showed acceptable agreement with visual grading. Although Q SPAM in some group may be influenced by cerebral atrophy, these simple methods are expected to be effective in the quantitative analysis of 18 F-FP-CIT PET in usual clinical practice.

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Direct comparison of FP-CIT SPECT and F-DOPA PET in patients with Parkinson’s disease and healthy controls

Cited by 96 publications

References 45 publications

Simple Ratio Analysis of ¹⁸F-Fluorodopa Uptake in Striatal Subregions Separates Patients with Early Parkinson Disease from Healthy Controls

Simple Ratio Analysis of ¹⁸F-Fluorodopa Uptake in Striatal Subregions Separates Patients with Early Parkinson Disease from Healthy Controls

Clinical Significance of F-18 FP-CIT Dual Time Point PET Imaging in Idiopathic Parkinson’s Disease

Validation of Simple Quantification Methods for 18F-FP-CIT PET Using Automatic Delineation of Volumes of Interest Based on Statistical Probabilistic Anatomical Mapping and Isocontour Margin Setting

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Direct comparison of FP-CIT SPECT and F-DOPA PET in patients with Parkinson’s disease and healthy controls

Cited by 96 publications

References 45 publications

Simple Ratio Analysis of 18F-Fluorodopa Uptake in Striatal Subregions Separates Patients with Early Parkinson Disease from Healthy Controls

Simple Ratio Analysis of 18F-Fluorodopa Uptake in Striatal Subregions Separates Patients with Early Parkinson Disease from Healthy Controls

Clinical Significance of F-18 FP-CIT Dual Time Point PET Imaging in Idiopathic Parkinson’s Disease

Validation of Simple Quantification Methods for 18F-FP-CIT PET Using Automatic Delineation of Volumes of Interest Based on Statistical Probabilistic Anatomical Mapping and Isocontour Margin Setting

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Simple Ratio Analysis of ¹⁸F-Fluorodopa Uptake in Striatal Subregions Separates Patients with Early Parkinson Disease from Healthy Controls

Simple Ratio Analysis of ¹⁸F-Fluorodopa Uptake in Striatal Subregions Separates Patients with Early Parkinson Disease from Healthy Controls