Automated quantification with BRASS reduces equivocal reporting of DaTSCAN (123I-FP-CIT) SPECT studies

Pencharz, Deborah; Hanlon, Paul; Chakravartty, Riddhika; Quigley, Ann‐Marie; Wagner, Thomas

doi:10.5603/nmr.2014.0019

Cited by 13 publications

(15 citation statements)

References 9 publications

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“…Between-groups (PD vs CG) differences were evaluated by univariate General Linear Model, considering age and gender as nuisance variables. Statistical threshold was set at p<0.05 18, 22 .Statistical Parametric Mapping (SPM8 Wellcome Department of Imaging Neuroscience; http://www.fil.ion.ucl.ac.uk/spm/); 123 I-FP-CIT template from 30 healthy controls 36 was used for normalization process. Individual 123 I-FP-CIT data were realigned, spatially normalized to 123 I-FP-CIT template in Montreal Neurological Institute space and smoothed (3D Gaussian filter with 8 mm Full Width at Half Maximum).…”

Section: Methodsmentioning

confidence: 99%

“…Between-groups (PD vs CG) differences were evaluated by univariate General Linear Model, considering age and gender as nuisance variables. Statistical threshold was set at p<0.05 18, 22 .…”

Section: Methodsmentioning

confidence: 99%

“…A region-of-interest (ROI) approach is based on a semi-quantitative analysis of the striatal region compared to a reference (occipital) region, after normalizing all images to a standardized 123 I-FP-CIT template derived from healthy subjects (BRASS software, Brain Registration & Analysis Software Suite, Hermes Medical Solutions, Stockholm, Sweden) 18 . Furthermore, a whole-brain approach based on Statistical Parametric Mapping for SPECT 123 I-FP-CIT imaging has been proposed 19-21 , with the possibility to perform voxelwise studies on different groups of subjects with different statistical paradigms, and with the possibility to explore extrastriatal regions 22-25 .…”

Section: Introductionmentioning

confidence: 99%

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Source-Based Morphometry Multivariate Approach to Analyze [123I]FP-CIT SPECT Imaging

et al. 2017

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Background 123I-FP-CIT (DaTSCAN®) SPECT imaging is widely used to study neurodegenerative parkinsonism, with the evaluation of presynaptic dopamine transporter (DAT) in striatal regions. Beyond DAT, 123I-FP-CIT may be also considered for other monoaminergic systems, in particular serotonin transporter (SERT). Independent Component Analysis (ICA) implemented in Source-Based Morphometry (SBM), a multivariate approach, represents an alternative method to explore monoaminergic neurotransmission, studying the relationship among voxels, and grouping them into “metabolic” neural networks. Methods One-hundred forty-three subjects (84 with Parkinson’s disease (PD) and 59 control individuals (CG)) underwent DATSCAN® imaging. The 123I-FP-CIT binding was evaluated by the multivariate SBM approach, as well as by region-of-interest (ROI) (caudate/putamen) (BRASS software) and whole-brain voxelwise univariate (Statistical Parametric Mapping, SPM) approaches. Results As compared to univariate approaches (BRASS and SPM), which only demonstrated striatal 123I-FP-CIT binding reduction in the PD group, SBM identified six sources of non-artifactual origin, including basal ganglia and cortical regions as well as brainstem. Among them, three sources (basal ganglia and cortical regions) presented loading scores (as index of 123I-FP-CIT binding) significantly different between PD and CG. Notably, even though not significantly different between PD and CG, the remaining three non-artifactual sources were characterized by a predominant frontal, brainstem and occipito-temporal involvement. Discussion The concept of source blind separation by the application of ICA (as implemented in SBM) represents a feasible approach to be considered in 123I-FP-CIT (DaTSCAN®) SPECT imaging. Taking advantage of this multivariate analysis, specific patterns of variance can be identified (involving either striatal or extrastriatal regions) that could be useful in differentiating neurodegenerative parkinsonisms.

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Section: Methodsmentioning

confidence: 99%

“…Between-groups (PD vs CG) differences were evaluated by univariate General Linear Model, considering age and gender as nuisance variables. Statistical threshold was set at p<0.05 18, 22 .…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Source-Based Morphometry Multivariate Approach to Analyze [123I]FP-CIT SPECT Imaging

et al. 2017

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“…However, both techniques are operator dependent and may introduce small degrees of variability in reporting of results. More recently automated quantification with proprietary computer software has been applied, and this offers the possibility of reducing the rate of equivocal reporting of 123 I FP-CIT SPECT scans [16].…”

Section: Interpretation Of 123 I Fp-cit Spect Scan Datamentioning

confidence: 99%

Overview of Dopamine Transporter Imaging in Parkinson’s Disease, Dementia with Lewy Bodies and Other Dementias

Malek

Grosset

2015

Curr Geri Rep

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123 I FP-CIT is a radiotracer that is used in conjunction with single photon emission computed tomography (SPECT) scanning to detect dopaminergic neuron presynaptic terminal degeneration, in the striatum (caudate nucleus and putamen) of patients with Parkinson's disease (PD) and dementia with Lewy bodies (DLB), showing a reduced uptake of this ligand by the dopamine transporters (DaT). This is a licensed diagnostic test in Europe (as DaTSCAN) and in the USA (as DaTscan). Recent work on functional imaging in PD and DLB largely uses the FP-CIT SPECT approach, and this is the focus of our paper, whilst noting that other ligands (e.g. beta-CIT) and imaging techniques such as positron emission tomography (PET) have been used in similar settings.

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“…The introduction of sophisticated fully automated commercial 123 I-FP-CIT software packages [2][3][4][5][6], combined with greater awareness in the nuclear medicine community of "balanced loss" of dopaminergic function, particularly in DLB, has increased interest in quantification for FP-CIT imaging [7]. Balanced loss can be challenging for the non-expert to identify visually as images are scaled to maximum uptake rather than to a predefined absolute uptake level; low striatal binding ratio (SBR) values for striata with otherwise normal appearance are therefore useful for identifying global loss of uptake.…”

Section: Introduction 123mentioning

confidence: 99%

123I-FP-CIT striatal binding ratios do not decrease significantly with age in older adults

et al. 2019

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Objective I-123-2β-Carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl)nortropane (FP-CIT) imaging is an established biomarker used in the diagnosis of Lewy body disease. Images are often reported with the aid of striatal binding ratios (SBRs), comparing uptake to a normal database via Z scores. It is well-known that SBRs are age-dependent. However, previous studies cover wide age ranges between 20 and 80 years, rather than focusing on older adults. Typically a linear relationship is reported, but some authors have suggested that SBRs do not decline as rapidly in old age. Commercial software packages usually adjust the SBR Z score to attempt to compensate for agerelated decline, but the model used varies. Ensuring age-correction is appropriate for older adults is important, given that the majority of patients referred for FP-CIT scans are aged over 60 years. We examined the relationship of SBR with age in older adults and the effect of age correction using research scans from 123 adults over 60 years of age. Methods Twenty-nine healthy older adults and twenty-three with MCI due to Alzheimer's disease were included as controls, i.e. individuals with no evidence of Lewy body disease. Their ages ranged from 60-92 years (mean 76; SD 7.9)). SBRs and Z scores were calculated using BRASS (Hermes Medical) and DaTQUANT (GE Healthcare). SBRs were plotted against age and linear mixed effects models applied. We tested the effect of removing age-correction in BRASS using an independent dataset of 71 older adults with dementia or mild cognitive impairment. Results The slopes of the linear fits between SBR and age per year were-0.007 (p=0.30) with BRASS and-0.004 (p=0.35) with DaTQUANT. The slopes are smaller than reported in the literature and show no statistically significant difference from zero. Switching age correction off in BRASS in the test subjects reduced Z scores by approximately 1 standard deviation at 80 years of age. Conclusion We found no statistically significant age-related decline in SBR in adults over 60 years of age without Lewy body disease. Commercial software packages that apply a fixed rate of age correction may be overcorrecting for age in older adults, which could contribute to misdiagnosis.

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Automated quantification with BRASS reduces equivocal reporting of DaTSCAN (123I-FP-CIT) SPECT studies

Cited by 13 publications

References 9 publications

Source-Based Morphometry Multivariate Approach to Analyze [123I]FP-CIT SPECT Imaging

Source-Based Morphometry Multivariate Approach to Analyze [123I]FP-CIT SPECT Imaging

Overview of Dopamine Transporter Imaging in Parkinson’s Disease, Dementia with Lewy Bodies and Other Dementias

123I-FP-CIT striatal binding ratios do not decrease significantly with age in older adults

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