Abstract
Purpose
Quantitative estimates of dopamine transporter availability, determined with [123I]FP-CIT SPECT, depend on the SPECT equipment, including both hardware and (reconstruction) software, which limits their use in multicentre research and clinical routine. This study tested a dedicated reconstruction algorithm for its ability to reduce camera-specific intersubject variability in [123I]FP-CIT SPECT. The secondary aim was to evaluate binding in whole brain (excluding striatum) as a reference for quantitative analysis.
Methods
Of 73 healthy subjects from the European Normal Control Database of [123I]FP-CIT recruited at six centres, 70 aged between 20 and 82 years were included. SPECT images were reconstructed using the QSPECT software package which provides fully automated detection of the outer contour of the head, camera-specific correction for scatter and septal penetration by transmission-dependent convolution subtraction, iterative OSEM reconstruction including attenuation correction, and camera-specific “to kBq/ml” calibration. LINK and HERMES reconstruction were used for head-to-head comparison. The specific striatal [123I]FP-CIT binding ratio (SBR) was computed using the Southampton method with binding in the whole brain, occipital cortex or cerebellum as the reference. The correlation between SBR and age was used as the primary quality measure.
Results
The fraction of SBR variability explained by age was highest (1) with QSPECT, independently of the reference region, and (2) with whole brain as the reference, independently of the reconstruction algorithm.
Conclusion
QSPECT reconstruction appears to be useful for reduction of camera-specific intersubject variability of [123I]FP-CIT SPECT in multisite and single-site multicamera settings. Whole brain excluding striatal binding as the reference provides more stable quantitative estimates than occipital or cerebellar binding.
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Authors’ contributions
All authors made substantial contributions to the conception of the study, analysis of the data, and/or interpretation of the results. R.B. drafted the manuscript, and all other authors revised it critically for important intellectual content. All authors read and approved the final manuscript.
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Conflicts of interest
R.B. received an honorarium from ABX-CRO for independent statistical analysis, interpretation of results, and drafting the manuscript. ABX-CRO collaborates in development and distribution of the QSPECT software package, developed by H.I. J.B. is a consultant at GE Healthcare.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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As the present study was retrospective in nature, formal consent was not required.
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Ralph Buchert and Andreas Kluge contributed equally to this work.
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Buchert, R., Kluge, A., Tossici-Bolt, L. et al. Reduction in camera-specific variability in [123I]FP-CIT SPECT outcome measures by image reconstruction optimized for multisite settings: impact on age-dependence of the specific binding ratio in the ENC-DAT database of healthy controls. Eur J Nucl Med Mol Imaging 43, 1323–1336 (2016). https://doi.org/10.1007/s00259-016-3309-5
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DOI: https://doi.org/10.1007/s00259-016-3309-5