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Schiebler T, Apostolova I, Mathies FL, Lange C, Klutmann S, Buchert R. No impact of attenuation and scatter correction on the interpretation of dopamine transporter SPECT in patients with clinically uncertain parkinsonian syndrome. Eur J Nucl Med Mol Imaging 2023; 50:3302-3312. [PMID: 37328621 PMCID: PMC10541531 DOI: 10.1007/s00259-023-06293-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/05/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE The benefit from attenuation and scatter correction (ASC) of dopamine transporter (DAT)-SPECT for the detection of nigrostriatal degeneration in clinical routine is still a matter of debate. The current study evaluated the impact of ASC on visual interpretation and semi-quantitative analysis of DAT-SPECT in a large patient sample. METHODS One thousand seven hundred forty consecutive DAT-SPECT with 123I-FP-CIT from clinical routine were included retrospectively. SPECT images were reconstructed iteratively without and with ASC. Attenuation correction was based on uniform attenuation maps, scatter correction on simulation. All SPECT images were categorized with respect to the presence versus the absence of Parkinson-typical reduction of striatal 123I-FP-CIT uptake by three independent readers. Image reading was performed twice to assess intra-reader variability. The specific 123I-FP-CIT binding ratio (SBR) was used for automatic categorization, separately with and without ASC. RESULTS The mean proportion of cases with discrepant categorization by the same reader between the two reading sessions was practically the same without and with ASC, about 2.2%. The proportion of DAT-SPECT with discrepant categorization without versus with ASC by the same reader was 1.66% ± 0.50% (1.09-1.95%), not exceeding the benchmark of 2.2% from intra-reader variability. This also applied to automatic categorization of the DAT-SPECT images based on the putamen SBR (1.78% discrepant cases between without versus with ASC). CONCLUSION Given the large sample size, the current findings provide strong evidence against a relevant impact of ASC with uniform attenuation and simulation-based scatter correction on the clinical utility of DAT-SPECT to detect nigrostriatal degeneration in patients with clinically uncertain parkinsonian syndrome.
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Affiliation(s)
- Tassilo Schiebler
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr, 52, 20246, Hamburg, Germany
| | - Ivayla Apostolova
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr, 52, 20246, Hamburg, Germany
| | - Franziska Lara Mathies
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr, 52, 20246, Hamburg, Germany
| | - Catharina Lange
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Susanne Klutmann
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr, 52, 20246, Hamburg, Germany
| | - Ralph Buchert
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr, 52, 20246, Hamburg, Germany.
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Muñoz-Delgado L, Labrador-Espinosa MÁ, Macías-García D, Jesús S, Benítez Zamora B, Fernández-Rodríguez P, Adarmes-Gómez AD, Reina Castillo MI, Castro-Labrador S, Silva-Rodríguez J, Carrillo F, García Solís D, Grothe MJ, Mir P. Peripheral Inflammation Is Associated with Dopaminergic Degeneration in Parkinson's Disease. Mov Disord 2023. [PMID: 36912400 DOI: 10.1002/mds.29369] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/27/2023] [Accepted: 02/10/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Peripheral inflammatory immune responses are suggested to play a major role in dopaminergic degeneration in Parkinson's disease (PD). The neutrophil-to-lymphocyte ratio (NLR) is a well-established biomarker of systemic inflammation in PD. Degeneration of the nigrostriatal dopaminergic system can be assessed in vivo using [123 I]FP-CIT single photon emission computed tomography imaging of striatal dopamine transporter (DAT) density. OBJECTIVES To assess the relationship between the peripheral immune profile (NLR, lymphocytes, and neutrophils) and striatal DAT density in patients with PD. METHODS We assessed clinical features, the peripheral immune profile, and striatal [123 I]FP-CIT DAT binding levels of 211 patients with PD (primary-cohort). Covariate-controlled associations between the immune response and striatal DAT levels were assessed using linear regression analyses. For replication purposes, we also studied a separate cohort of 344 de novo patients with PD enrolled in the Parkinson's Progression Markers Initiative (PPMI-cohort). RESULTS A higher NLR was significantly associated with lower DAT levels in the caudate (primary-cohort: β = -0.01, p < 0.001; PPMI-cohort: β = -0.05, p = 0.05) and the putamen (primary-cohort: β = -0.05, p = 0.02; PPMI-cohort: β = -0.06, p = 0.02). Intriguingly, a lower lymphocyte count was significantly associated with lower DAT levels in both the caudate (primary-cohort: β = +0.09, p < 0.05; PPMI-cohort: β = +0.11, p = 0.02) and the putamen (primary-cohort: β = +0.09, p < 0.05, PPMI-cohort: β = +0.14, p = 0.01), but an association with the neutrophil count was not consistently observed (caudate; primary-cohort: β = -0.05, p = 0.02; PPMI-cohort: β = 0, p = 0.94; putamen; primary-cohort: β = -0.04, p = 0.08; PPMI-cohort: β = -0.01, p = 0.73). CONCLUSIONS Our findings across two independent cohorts suggest a relationship between systemic inflammation and dopaminergic degeneration in patients with PD. This relationship was mainly driven by the lymphocyte count. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Laura Muñoz-Delgado
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Miguel Ángel Labrador-Espinosa
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, Seville, Spain
| | - Daniel Macías-García
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Silvia Jesús
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Belén Benítez Zamora
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Paula Fernández-Rodríguez
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.,Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Astrid D Adarmes-Gómez
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - María Isabel Reina Castillo
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Sandra Castro-Labrador
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Jesús Silva-Rodríguez
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Fátima Carrillo
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - David García Solís
- Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Michel J Grothe
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Pablo Mir
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, Seville, Spain
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Ito Y, Fujita N, Hara K, Tada T, Abe S, Katsuno M, Naganawa S, Kato K. Novel approach to semi-quantification of tracer accumulation in dopamine transporter scan. J Appl Clin Med Phys 2022; 23:e13626. [PMID: 35536775 PMCID: PMC9278684 DOI: 10.1002/acm2.13626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 03/23/2023] [Accepted: 04/07/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose Accurate tracer accumulation evaluation is difficult owing to the partial volume effect (PVE). We proposed a novel semi‐quantitative approach for measuring the accumulation amount by examining the approximate image. Using a striatal phantom, we verified the validity of a newly proposed method to accurately evaluate the tracer accumulations in the caudate and putamen separately. Moreover, we compared the proposed method with the conventional methods. Methods The left and right caudate/putamen regions and the whole brain region as background were identified in computed tomography (CT) images obtained by single‐photon emission computed tomography (SPECT)/CT and acquired the positional information of each region. SPECT‐like images were generated by assigning assumed accumulation amounts to each region. The SPECT‐like image, approximated to the actual measured SPECT image, was examined by changing the assumed accumulation amounts assigned to each region. When the generated SPECT‐like image most approximated the actual measured SPECT image, the accumulation amounts assumed were determined as the accumulation amounts in each region. We evaluated the correlation between the count density calculated by the proposed method and the actual count density of the 123I solution filled in the phantom. Conventional methods (CT‐guide method, geometric transfer matrix [GTM] method, region‐based voxel‐wise [RBV] method, and Southampton method) were also evaluated. The significance of differences between the correlation coefficients of various methods (except the Southampton method) was evaluated. Results The correlation coefficients between the actual count density and the SPECT count densities were 0.997, 0.973, 0.951, 0.950, and 0.996 for the proposed method, CT‐guide method, GTM method, RBV method, and Southampton method, respectively. The correlation of the proposed method was significantly higher than those of the other methods. Conclusions The proposed method could calculate accurate accumulation amounts in the caudate and putamen separately, considering the PVE.
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Affiliation(s)
- Yoshinori Ito
- Department of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Higashi-ku, Nagoya, Japan
| | - Naotoshi Fujita
- Department of Radiological Technology, Nagoya University Hospital, Showa-ku, Nagoya, Japan
| | - Kazuhiro Hara
- Department of Neurology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan
| | - Tomohiro Tada
- Department of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Higashi-ku, Nagoya, Japan
| | - Shinji Abe
- Department of Radiological Technology, Nagoya University Hospital, Showa-ku, Nagoya, Japan
| | - Masahisa Katsuno
- Department of Neurology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan
| | - Katsuhiko Kato
- Functional Medical Imaging, Biomedical Imaging Sciences, Division of Advanced Information Health Sciences, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Higashi-ku, Nagoya, Japan
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