The Role of CT-Based Attenuation Correction and Collimator Blurring Correction in Striatal Spect Quantification

Warwick, James; Rubow, Sietske; Toit, Monique du; Beetge, E; Carey, Paul D.; Dupont, Patrick

doi:10.1155/2011/195037

Cited by 10 publications

(8 citation statements)

References 20 publications

(30 reference statements)

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“…However, Chang AC resulted in larger SBRs than CT-based AC even with LAC as low as µ = 0.10 cm −1 (LAC for CT-based AC fixed at µ = 0.148 cm −1 ). Warwick and co-workers also found larger SBRs in dopamine transporter SPECT with Chang AC than with CT-based AC, at least in the patient scans included in their study [35] . Rajeevan et al evaluated non-uniform AC based on transmission imaging for I-123-β-CIT and concluded that both non-uniform and uniform AC provide a small improvement of semi-quantitative analysis compared to no AC [36] .…”

Section: Discussionmentioning

confidence: 72%

CT-Based Attenuation Correction in I-123-Ioflupane SPECT

et al. 2014

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PurposeAttenuation correction (AC) based on low-dose computed tomography (CT) could be more accurate in brain single-photon emission computed tomography (SPECT) than the widely used Chang method, and, therefore, has the potential to improve both semi-quantitative analysis and visual image interpretation. The present study evaluated CT-based AC for dopamine transporter SPECT with I-123-ioflupane.Materials and methodsSixty-two consecutive patients in whom I-123-ioflupane SPECT including low-dose CT had been performed were recruited retrospectively at 3 centres. For each patient, 3 different SPECT images were reconstructed: without AC, with Chang AC and with CT-based AC. Distribution volume ratio (DVR) images were obtained by scaling voxel intensities using the whole brain without striata as reference. For assessing the impact of AC on semi-quantitative analysis, specific-to-background ratios (SBR) in caudate and putamen were obtained by fully automated SPM8-based region of interest (ROI) analysis and tested for their diagnostic power using receiver-operator-characteristic (ROC) analysis. For assessing the impact of AC on visual image reading, screenshots of stereotactically normalized DVR images presented in randomized order were interpreted independently by two raters at each centre.ResultsCT-based AC resulted in intermediate SBRs about half way between no AC and Chang. Maximum area under the ROC curve was achieved by the putamen SBR, with negligible impact of AC (0.924, 0.935 and 0.938 for no, CT-based and Chang AC). Diagnostic accuracy of visual interpretation also did not depend on AC.ConclusionsThe impact of CT-based versus Chang AC on the interpretation of I-123-ioflupane SPECT is negligible. Therefore, CT-based AC cannot be recommended for routine use in clinical patient care, not least because of the additional radiation exposure.

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Section: Discussionmentioning

confidence: 72%

CT-Based Attenuation Correction in I-123-Ioflupane SPECT

et al. 2014

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“…The mean CT effective dose was 0.36 mSv and the increase in radiation dose was very low at 3.2%. In addition to attenuation correction and added anatomical information for DAT-SPECT [ 28 – 30 ], our study demonstrated that CT can be used to guide ROI delineation for semiquantifying striatal DAT availability. It may also justify the extra radiation dose from CT.…”

Section: Discussionmentioning

confidence: 99%

The Feasibility of Using CT-Guided ROI for Semiquantifying Striatal Dopamine Transporter Availability in a Hybrid SPECT/CT System

Hsu

Chang

Lin

et al. 2014

The Scientific World Journal

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A hybrid SPECT/CT system provides accurate coregistration of functional and morphological images. CT-guided region of interest (ROI) for semiquantifying striatal dopamine transporter (DAT) availability may be a feasible method. We therefore assessed the intra- and interobserver reproducibility of manual SPECT and CT-guided ROI methods and compared their semiquantitative data with data from MRI-guided ROIs. We enrolled twenty-eight patients who underwent Tc-99m TRODAT-1 brain SPECT/CT and brain MRI. ROIs of the striatal, caudate, putamen, and occipital cortex were manually delineated on the SPECT, CT, and MRI. ROIs from CT and MRI were transferred to the coregistered SPECT for semiquantification. The striatal, caudate, and putamen nondisplaceable binding potential (BPND) were calculated. Using CT-guided ROIs had higher intra- and interobserver concordance correlation coefficients, closer Bland-Altman biases to zero, and narrower limits of agreement than using manual SPECT ROIs. The correlation coefficients of striatal, caudate, and putamen BPND were good between manual SPECT and MRI-guided ROI methods and even better between CT-guided and MRI-guided ROI methods. Conclusively, CT-guided ROI delineation for semiquantifying striatal DAT availability in a hybrid SPECT/CT system is highly reproducible, and the semiquantitative data correlate well with data from MRI-guided ROIs.

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“…10 However, Warwick et al studied phantoms and 14 patients and showed that AC improved the quantitation of striatal SPECT images of the phantom, and AC also optimized patients' brain SPECT reconstruction. 11 Another parameter in interpreting 123 I-FP-CIT SPECT is the asymmetric index (AI) value to evaluate the asymmetry of radioligand uptake. 12 The aim of this study was to evaluate the influence of AC and SC on the quantitative analysis of 123 I-FP-CIT SPECT brain imaging in both phantom and clinical studies.…”

Section: Resourcesmentioning

confidence: 99%

The Influence of Attenuation and Scatter Corrections on Quantitative Analysis of <sup>123</sup>I-FP-CIT SPECT Brain Imaging

Kanzaki

Higuchi

et al. 2019

kmj

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Objective: [ 123 I] N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-[ 123 I]iodophenyl) nortropane (123 I-FP-CIT) or dopamine transporter (DAT) SPECT scan quantitatively depicts striatum dopamine transporter density. The specific binding ratio (SBR) is important for Parkinson's disease (PD) diagnosis. Correction techniques may improve 123 I-FP-CIT image quality, but they are currently not standardized. We aim to determine attenuation correction (AC) and scatter correction (SC) influence on 123 I-FP-CIT quantitative analysis. Methods: We preformed SPECT imaging on a striatal phantom representing striatum-to-background ratios ranging from 10:1 to 1:1. We used the Chang method for AC and triple energy window for SC. Commercially available software semi-automatically calculated SBR. We performed correlation analysis between SBR and the actual concentration ratio in four groups: no correction (NC), SC, AC, and combined correction (CC), paying particular attention to SBR values below the clinical cutoff (4.5). We applied the same imaging conditions, reconstruction, and corrections on 49 human 123 I-FP-CIT SPECT studies. Asymmetric index values (AI) were also analyzed. Receiver operating characteristic (ROC) analysis provided AI diagnostic cutoff values in PD patients. PD patient population whose AI values were above these cutoff value were subject to a correlation study to confirm the association between their clinical symptoms and 123 I-FP-CIT SPECT. Results: Phantom study. AC or CC increased SBR 123 I-FP-CIT SPECT, making them very close to the standard ratios (AC: y＝1.19x-0.7; R 2 ＝0.98; CC: y＝1.4x-1.2; R 2 ＝0.98), while NC and SC underestimated SBR at lower values (1 to 4). Clinical study. There was no difference in SBR between NC and SC, while AC and CC produced significantly higher SBR than NC (p＜0.0001). Only SC affected AI values (p＜0.05). The association between clinical symptoms and 123 I-FP-CIT imaging results were maintained only when either NC (n＝12, p＜0.05) or CC (n＝14, p＜0.05) was applied. Conclusions: AC increased SBR more than other corrections, while SC increased AI value more than other corrections. The association between clinical symptom and SPECT findings were maintained when either NC or CC was applied. These correction methods should be carefully selected for 123 I-FP-CIT SPECT brain imaging.

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The Role of CT-Based Attenuation Correction and Collimator Blurring Correction in Striatal Spect Quantification

Cited by 10 publications

References 20 publications

CT-Based Attenuation Correction in I-123-Ioflupane SPECT

CT-Based Attenuation Correction in I-123-Ioflupane SPECT

The Feasibility of Using CT-Guided ROI for Semiquantifying Striatal Dopamine Transporter Availability in a Hybrid SPECT/CT System

The Influence of Attenuation and Scatter Corrections on Quantitative Analysis of <sup>123</sup>I-FP-CIT SPECT Brain Imaging

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