To the best of our knowledge
no multicenter studies have been published using standardized
semi-quantitative evaluation of [123I]FP-CIT scan (DAT-SPECT). The aims of this
study were: 1) to cross-compare semi-quantitative software-assisted
evaluations of DAT-SPECTs performed in three centers with different equipments;
2) to assess the accuracy of semi-quantitative evaluations of DAT-SPECT and 3)
to identify the threshold with the best accuracy, sensitivity and specificity
in a patient population with suspected parkinsonian syndrome.Materials and Methods: Two
hundred twenty patients (mean age at the time of SPECT acquisition, 67.4 ± 9.5yy) acquired
in three centers (Ospedale San Luigi Gonzaga; Ospedale San Giovanni Battista
Molinette; Ospedale Mauriziano Umberto I) were included. All of them underwent
DAT-SPECT from January 2006 to July 2010. All exams were analyzed with the
freely available software BASGAN and semi-quantitative data were used to
predict disease. In particular, analyses were based on the values from the most
deteriorated putamen and caudate, normalized for age and corrected for equipment.
ROC analysis was performed and area under the curve (AUC) was estimated. Results: Analysis showed high AUCs (0.898,
0.864, 0.900 and 0.891 for each center and for the multicenter setting,
respectively) confirming the very good accuracies reached. The best cut-off
were 0.72 and 0.82 for putamen and caudate respectively. These thresholds
allowed sensitivities and specificities in each center and in the multicenter
setting of 76% and 96%, 91% and 82%, 93% and 90%, 86% and 89% respectively. No
significant differences were observed between sensibility and specificity in
each center. Conclusion: A unique
threshold useful for all centers with high and similar sensitivities and
specificities is possible after correction for age and equipments. The high
accuracy reached in this multicenter trial by the semi-quantitative analysis
seems similar to accuracies from qualitative analysis in other multicenter
studies.
References
[1]
A. M. Vlaar, M. J. van Kroonenburgh, A. G. Kessels and W. E. Weber, “Meta-Analysis of the Literature on Diag- nostic Accuracy of SPECT in Parkinsonian Syndromes,” BMC Neurology, Vol. 7, 2007, p. 27.
http://dx.doi.org/10.1186/1471-2377-7-27
[2]
H. T. Benamer, J. Patterson, D. J. Wyper, D. M. Hadley, G. J. Macphee and D. G. Grosset, “Correlation of Parkinson’s Disease Severity and Duration with 123I-FP-CIT SPECT Striatal Uptake,” Movement Disorders, Vol. 15, No. 4, 2000, pp. 692-698.
http://dx.doi.org/10.1002/1531-8257(200007)15:4<692::AID-MDS1014>3.0.CO;2-V
[3]
V. L. Marshall, C. B. Reininger, M. Marquardt, J. Patterson, D. M. Hadley, W. H. Oertel, H. T. Benamer, P. Kemp, D. Burn, E. Tolosa, J. Kulisevsky, L. Cunha, D. Costa, J. Booij, K. Tatsch, K. R. Chaudhuri, G. Ulm, O. Pogarell, H. Hoffken, A. Gerstner and D. G. Grosset, “Parkinson’s Disease Is Overdiagnosed Clinically at Baseline in Diagnostically Uncertain Cases: A 3-Year European Multicenter Study with Repeat [123I]FP-CIT SPECT,” Movement Disorders, Vol. 24, No. 4, 2009, pp. 500-508.
http://dx.doi.org/10.1002/mds.22108?
[4]
A. R. Kupsch, N. Bajaj, F. Weiland, A. Tartaglione, S. Klutmann, M. Buitendyk, P. Sherwin, A. Tate and I. D. Grachev, “Impact of DaTscan SPECT Imaging on Clinical Management, Diagnosis, Confidence of Diagnosis, Quality of Life, Health Resource Use and Safety in Patients with Clinically Uncertain Parkinsonian Syndromes: A Prospective 1-Year Follow-Up of an Open-Label Controlled Study,” Journal of Neurology, Neurosurgery, and Psychiatry, Vol. 83, No. 6, 2012, pp. 620-628.
http://dx.doi.org/10.1136/jnnp-2011-301695
[5]
M. C. Tondeur, A. S. Hambye, S. Dethy and H. R. Ham, “Interobserver Reproducibility of the Interpretation of I-123 FP-CIT Single-Photon Emission Computed Tomo- graphy,” Nuclear Medicine Communications, Vol. 31, No. 8, 2010, pp. 717-725.
http://dx.doi.org/10.1097/MNM.0b013e32833b7ea4
[6]
I. McKeith, J. O’Brien, Z. Walker, K. Tatsch, J. Booij, J. Darcourt, A. Padovani, R. Giubbini, U. Bonuccelli, D. Volterrani, C. Holmes, P. Kemp, N. Tabet, I. Meyer and C. Reininger, “DLB Study Group. Sensitivity and Specificity of Dopamine Transporter Imaging with 123I-FP-CIT SPECT in Dementia with Lewy Bodies: A Phase III, Multicenter Study,” Lancet Neurology, Vol. 6, No. 4, 2007, pp. 305-313.
http://dx.doi.org/10.1016/S1474-4422(07)70057-1
[7]
E. Tolosa, T. V. Borght and E. Moreno, “DaTSCAN Cli- nically Uncertain Parkinsonian Syndromes Study Group. Accuracy of DaTSCAN (123I-Ioflupane) SPECT in Di- agnosis of Patients with Clinically Uncertain Parkinsonism: 2-Year Follow-Up of an Open-Label Study,” Move- ment Disorders, Vol. 22, No. 16, 2007, pp. 2346-2351.
http://dx.doi.org/10.1002/mds.21710
[8]
K. Badiavas, E. Molyvda, I. Iakovou, M. Tsolaki, K. Psarrakos and N. Karatzas, “SPECT Imaging Evaluation in Movement Disorders: Far beyond Visual Assessment,” European Journal of Nuclear Medicine and Molecular Imaging, Vol. 38, No. 1, 2011, pp. 764-773.
http://dx.doi.org/10.1007/s00259-010-1664-1
[9]
A. Skanjeti, T. Angusti, M. Margheron, M. Iudicello and V. Podio, “FP-CIT SPECT Evaluation: Time to Go beyond visual assessment!” European Journal of Nuclear Medicine and Molecular Imaging, Vol. 39, No. 4, 2012, pp. 727-728.
http://dx.doi.org/10.1007/s00259-011-2042-3
[10]
H. Bergmann, E. Busemann-Sokole and P. W. Horton, “Quality Assurance and Harmonisation of Nuclear Medicine Investigations in Europe,” European Journal of Nu- clear Medicine, Vol. 22, No. 5, 1995, pp. 477-480.
http://dx.doi.org/10.1007/BF00839063
[11]
W. Koch, P. E. Radau, W. Münzing and K. Tatsch, “Cross-Camera Comparison of SPECT Measurements of a 3-D Anthropomorphic Basal Ganglia Phantom,” European Journal of Nuclear Medicine and Molecular Imaging, Vol. 33, No. 4, 2006, pp. 495-502.
http://dx.doi.org/10.1007/s00259-005-0036-8
[12]
A. Varrone, J. C. Dickson, L. Tossici-Bolt, T. Sera, S. Ase- nbaum, J. Booij, O. L. Kapucu, A. Kluge, G. M. Knudsen, P. M. Koulibaly, F. Nobili, M. Pagani, O. Sabri, T. Vander Borght, K. Van Laere and K. Tatsch, “European Multicenter Database of Healthy Controls for [123I]FP-CIT SPECT (ENC-DAT): Age-Related Effects, Gender Differences and Evaluation of Different Methods of Analysis,” European Journal of Nuclear Medicine and Molecular Imaging, Vol. 40, No. 2, 2013, pp. 213-227.
http://dx.doi.org/10.1007/s00259-012-2276-8
[13]
P. Calvini, G. Rodriguez, F. Inguglia, A. Mignone, U. P. Guerra and F. Nobili, “The Basal Ganglia Matching Tools Package for Striatal Uptake Semi-Quantification: De- scription and Validation,” European Journal of Nuclear Medicine and Molecular Imaging, Vol. 34, No. 8, 2007, pp. 1240-1253.
http://dx.doi.org/10.1007/s00259-006-0357-2
[14]
J. Booij and P. Kemp, “Dopamine Transporter Imaging with [(123)I]FP-CIT SPECT: Potential Effects of Drugs,” European Journal of Nuclear Medicine and Molecular Imaging, Vol. 35, No. 2, 2008, pp. 424-438.
http://dx.doi.org/10.1007/s00259-007-0621-0
[15]
R. J. Morton, M. J. Guy, R. Clauss, P. J. Hinton, C. A. Marshall and E. A. Clarke, “Comparison of Different Methods of DatSCAN Quantification,” Nuclear Medicine Communications, Vol. 26, No. 12, 2005, pp. 1139-1146.
http://dx.doi.org/10.1097/00006231-200512000-00015
[16]
P. T. Meyer, B. Sattler, T. Lincke, A. Seese and O. Sabri, “Investigating Dopaminergic Neurotransmission with 123I-FP-CIT SPECT: Comparability of Modern SPECT Systems,” Journal of Nuclear Medicine, Vol. 44, No. 5, 2003, pp. 839-845.
[17]
D. J. Brooks, “Neuroimaging in Parkinson’s Disease,” NeuroRx, Vol. 1, No. 2, 2004, pp. 243-254.
http://dx.doi.org/10.1602/neurorx.1.2.243
[18]
J. M. Fearnley and A. J. Lees, “Ageing and Parkinson’s Disease: Substantia Nigra Regional Selectivity,” Brain, Vol. 114, Pt. 5, 1991, pp. 2283-2301.
http://dx.doi.org/10.1093/brain/114.5.2283
