Fully Automated Quantification of the Striatal Uptake Ratio of [<sup>99m</sup>Tc]-TRODAT with SPECT Imaging: Evaluation of the Diagnostic Performance in Parkinson’s Disease and the Temporal Regression of Striatal Tracer Uptake

Fang, Yiqun; Chiu, Shao Chieh; Lu, Chin Song; Yen, Tzu Chen; Weng, Yueh-Hsuan

doi:10.1155/2015/461625

Cited by 7 publications

(10 citation statements)

References 43 publications

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“…Conversely, others have found normal striatal dopaminergic integrity in ET patients with resting tremor (102). That being said, some authors reported signs of slight striatal dopaminergic degradation in classical ET (97)(98)(99)106). Of note, ET patients may show reductions of tracer uptake primarily in the caudate nucleus, contrasting the typical pattern of pronounced posterior putamenal reductions observed in PD (99,106).…”

Section: Dopaminergic Imagingmentioning

confidence: 98%

Imaging the Pathophysiology of Essential Tremor—A Systematic Review

Holtbernd

Shah

2021

Front. Neurol.

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Background: The pathophysiology underlying essential tremor (ET) still is poorly understood. Recent research suggests a pivotal role of the cerebellum in tremor genesis, and an ongoing controversy remains as to whether ET constitutes a neurodegenerative disorder. In addition, mounting evidence indicates that alterations in the gamma-aminobutyric acid neurotransmitter system are involved in ET pathophysiology. Here, we systematically review structural, functional, and metabolic neuroimaging studies and discuss current concepts of ET pathophysiology from an imaging perspective.Methods: We conducted a PubMed and Scopus search from 1966 up to December 2020, entering essential tremor in combination with any of the following search terms and their corresponding abbreviations: positron emission tomography (PET), single-photon emission computed tomography (SPECT), magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), and gamma-aminobutyric acid (GABA).Results: Altered functional connectivity in the cerebellum and cerebello-thalamico-cortical circuitry is a prevalent finding in functional imaging studies. Reports from structural imaging studies are less consistent, and there is no clear evidence for cerebellar neurodegeneration. However, diffusion tensor imaging robustly points toward microstructural cerebellar changes. Radiotracer imaging suggests that the dopaminergic axis is largely preserved in ET. Similarly, measurements of nigral iron content and neuromelanin are unremarkable in most studies; this is in contrast to Parkinson's disease (PD). PET and MRS studies provide limited evidence for cerebellar and thalamic GABAergic dysfunction.Conclusions: There is robust evidence indicating that the cerebellum plays a key role within a multiple oscillator tremor network which underlies tremor genesis. However, whether cerebellar dysfunction relies on a neurodegenerative process remains unclear. Dopaminergic and iron imaging do not suggest a substantial overlap of ET with PD pathophysiology. There is limited evidence for alterations of the GABAergic neurotransmitter system in ET. The clinical, demographical, and genetic heterogeneity of ET translates into neuroimaging and likely explains the various inconsistencies reported.

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Section: Dopaminergic Imagingmentioning

confidence: 98%

Imaging the Pathophysiology of Essential Tremor—A Systematic Review

Holtbernd

Shah

2021

Front. Neurol.

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“…These results were similar to those found by Pagano et al [ 13 ] with 61.6 ± 9.7 for PD and by Tzen et al [ 15 ] with 70 ± 7.5 for VP. We believe that these differences in age and gender between the Parkinsonism did not influence the differences obtained in the SPECT-TRODAT results because most studies with PET-CT and SPECT have not shown statistically significant differences between changes in DAT uptake concerning sex [ 13 , 14 , 28 – 32 ]. Moreover, DAT/SPECT uptake rates in healthy patients are stable between 30 and 70 years of age, allowing someone around 70 years of age to have SPECT-TRODAT results similar to another 30-year old [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Brain SPECT with 99mTc-TRODAT-1 in the Differential Diagnosis of Parkinsonism

Fabiani

Camargo

Filho³

et al. 2022

Parkinson's Disease

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Introduction. Brain SPECT with 99mTc-TRODAT-1 (SPECT-TRODAT) may be a useful tool in the differential diagnosis of Parkinsonism. Objective. To compare results of SPECT-TRODAT with clinical findings in patients with Parkinsonism. Methods. We evaluated 153 outpatients. SPECT-TRODAT results were visually analyzed into normal, abnormal, symmetric, and asymmetric, and according to the degree of impairment into mild, moderate, marked, and severe (1–4). Results. A direct relationship was found between motor scores severity (MDS-UPDRS-III) and SPECT-TRODAT-reduced binding in general, in the group of patients with synucleinopathies (rho = 0.258, p = 0.005 ), especially in patients with Parkinson’s disease (rho = 0.204, p = 0.049 ). Changes in SPECT-TRODAT had high correspondence with symmetry in all Parkinsonism. When comparing groups to the correspondence predominantly bilateral or unilateral impairment in SPECT, there was a difference between patients with SNP ( p = 0.041 ) and between this group and patients with secondary Parkinsonism (SP) ( p < 0.0001 ). It was handy in differentiating drug-induced Parkinsonism from synucleinopathies. In the group of drug-induced Parkinsonism, younger people were the ones who showed the most significant reductions in radiotracer uptake. In this group, nonmotor signs resulted in examinations with more significant reductions in radiotracer uptake. When the scans without alterations and those that did not correspond to the symmetry were considered negative, SPECT-TRODAT’s accuracy and specificity to differentiate PD from other forms of Parkinsonism were low. There was an inverse correlation between the severity of the SPECT-TRODAT result and the absence of nonmotor signs in patients with drug-induced Parkinsonism. Conclusion. The authors concluded that the SPECT with 99mTc-TRODAT-1 was mainly useful in differentiating between synucleinopathies and secondary Parkinsonism.

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“…Therefore, the use of an appropriate drug template can effectively increase the reliability and accuracy of semiquantitative data. Fang et al improved the reliability and accuracy of an automatic semiquantitative analysis [ 23 ]. They proposed a novel method that using inverse transformation of ROIs to calculate the striatal-to-reference ratio (SRR) and proved that their method has a better diagnostic performance than SPM-based method.…”

Section: Discussionmentioning

confidence: 99%

Effects of 99mTc-TRODAT-1 drug template on image quantitative analysis

Yang

Chou

et al. 2018

PLoS ONE

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99mTc-TRODAT-1 is a type of drug that can bind to dopamine transporters in living organisms and is often used in SPCT imaging for observation of changes in the activity uptake of dopamine in the striatum. Therefore, it is currently widely used in studies on clinical diagnosis of Parkinson’s disease (PD) and movement-related disorders. In conventional 99mTc-TRODAT-1 SPECT image evaluation, visual inspection or manual selection of ROI for semiquantitative analysis is mainly used to observe and evaluate the degree of striatal defects. However, these methods are dependent on the subjective opinions of observers, which lead to human errors, have shortcomings such as long duration, increased effort, and have low reproducibility. To solve this problem, this study aimed to establish an automatic semiquantitative analytical method for 99mTc-TRODAT-1. This method combines three drug templates (one built-in SPECT template in SPM software and two self-generated MRI-based and HMPAO-based TRODAT-1 templates) for the semiquantitative analysis of the striatal phantom and clinical images. At the same time, the results of automatic analysis of the three templates were compared with results from a conventional manual analysis for examining the feasibility of automatic analysis and the effects of drug templates on automatic semiquantitative analysis results. After comparison, it was found that the MRI-based TRODAT-1 template generated from MRI images is the most suitable template for 99mTc-TRODAT-1 automatic semiquantitative analysis.

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Fully Automated Quantification of the Striatal Uptake Ratio of [^99mTc]-TRODAT with SPECT Imaging: Evaluation of the Diagnostic Performance in Parkinson’s Disease and the Temporal Regression of Striatal Tracer Uptake

Cited by 7 publications

References 43 publications

Imaging the Pathophysiology of Essential Tremor—A Systematic Review

Imaging the Pathophysiology of Essential Tremor—A Systematic Review

Evaluation of Brain SPECT with 99mTc-TRODAT-1 in the Differential Diagnosis of Parkinsonism

Effects of 99mTc-TRODAT-1 drug template on image quantitative analysis

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Fully Automated Quantification of the Striatal Uptake Ratio of [99mTc]-TRODAT with SPECT Imaging: Evaluation of the Diagnostic Performance in Parkinson’s Disease and the Temporal Regression of Striatal Tracer Uptake

Cited by 7 publications

References 43 publications

Imaging the Pathophysiology of Essential Tremor—A Systematic Review

Imaging the Pathophysiology of Essential Tremor—A Systematic Review

Evaluation of Brain SPECT with 99mTc-TRODAT-1 in the Differential Diagnosis of Parkinsonism

Effects of 99mTc-TRODAT-1 drug template on image quantitative analysis

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Fully Automated Quantification of the Striatal Uptake Ratio of [^99mTc]-TRODAT with SPECT Imaging: Evaluation of the Diagnostic Performance in Parkinson’s Disease and the Temporal Regression of Striatal Tracer Uptake