51
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Rusz J, Tykalová T, Novotný M, Zogala D, Růžička E, Dušek P. Automated speech analysis in early untreated Parkinson's disease: Relation to gender and dopaminergic transporter imaging. Eur J Neurol 2021; 29:81-90. [PMID: 34498329 DOI: 10.1111/ene.15099] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND The mechanisms underlying speech abnormalities in Parkinson's disease (PD) remain poorly understood, with most of the available evidence based on male patients. This study aimed to estimate the occurrence and characteristics of speech disorder in early, drug-naive PD patients with relation to gender and dopamine transporter imaging. METHODS Speech samples from 60 male and 40 female de novo PD patients as well as 60 male and 40 female age-matched healthy controls were analyzed. Quantitative acoustic vocal assessment of 10 distinct speech dimensions related to phonation, articulation, prosody, and speech timing was performed. All patients were evaluated using [123]I-2b-carbomethoxy-3b-(4-iodophenyl)-N-(3-fluoropropyl) nortropane single-photon emission computed tomography and Montreal Cognitive Assessment. RESULTS The prevalence of speech abnormalities in the de novo PD cohort was 56% for male and 65% for female patients, mainly manifested with monopitch, monoloudness, and articulatory decay. Automated speech analysis enabled discrimination between PD and controls with an area under the curve of 0.86 in men and 0.93 in women. No gender-specific speech dysfunction in de novo PD was found. Regardless of disease status, females generally showed better performance in voice quality, consonant articulation, and pauses production than males, who were better only in loudness variability. The extent of monopitch was correlated to nigro-putaminal dopaminergic loss in men (r = 0.39, p = 0.003) and the severity of imprecise consonants was related to cognitive deficits in women (r = -0.44, p = 0.005). CONCLUSIONS Speech abnormalities represent a frequent and early marker of motor abnormalities in PD. Despite some gender differences, our findings demonstrate that speech difficulties are associated with nigro-putaminal dopaminergic deficits.
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Affiliation(s)
- Jan Rusz
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czechia.,Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
| | - Tereza Tykalová
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czechia
| | - Michal Novotný
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czechia
| | - David Zogala
- First Faculty of Medicine, Institute of Nuclear Medicine, Charles University and General University Hospital, Prague, Czechia
| | - Evžen Růžička
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
| | - Petr Dušek
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
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Faster Region-Based Convolutional Neural Network in the Classification of Different Parkinsonism Patterns of the Striatum on Maximum Intensity Projection Images of [ 18F]FP-CIT Positron Emission Tomography. Diagnostics (Basel) 2021; 11:diagnostics11091557. [PMID: 34573899 PMCID: PMC8467049 DOI: 10.3390/diagnostics11091557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/14/2021] [Accepted: 08/25/2021] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to compare the performance of a deep-learning convolutional neural network (Faster R-CNN) model to detect imaging findings suggestive of idiopathic Parkinson's disease (PD) based on [18F]FP-CIT PET maximum intensity projection (MIP) images versus that of nuclear medicine (NM) physicians. The anteroposterior MIP images of the [18F]FP-CIT PET scan of 527 patients were classified as having PD (139 images) or non-PD (388 images) patterns according to the final diagnosis. Non-PD patterns were classified as overall-normal (ONL, 365 images) and vascular parkinsonism with definite defects or prominently decreased dopamine transporter binding (dVP, 23 images) patterns. Faster R-CNN was trained on 120 PD, 320 ONL, and 16 dVP pattern images and tested on the 19 PD, 45 ONL, and seven dVP patterns images. The performance of the Faster R-CNN and three NM physicians was assessed using receiver operating characteristics curve analysis. The difference in performance was assessed using Cochran's Q test, and the inter-rater reliability was calculated. Faster R-CNN showed high accuracy in differentiating PD from non-PD patterns and also from dVP patterns, with results comparable to those of NM physicians. There were no significant differences in the area under the curve and performance. The inter-rater reliability among Faster R-CNN and NM physicians showed substantial to almost perfect agreement. The deep-learning model accurately differentiated PD from non-PD patterns on MIP images of [18F]FP-CIT PET, and its performance was comparable to that of NM physicians.
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Nuvoli S, Tanda G, Stazza ML, Palumbo B, Frantellizzi V, De Vincentis G, Spanu A, Madeddu G. 123I-Ioflupane SPECT and 18F-FDG PET Combined Use in the Characterization of Movement and Cognitive Associated Disorders in Neurodegenerative Diseases. Curr Alzheimer Res 2021; 18:196-207. [PMID: 34102975 DOI: 10.2174/1567205018666210608112302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/21/2021] [Accepted: 04/21/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Both movement (MD) and cognitive (CD) disorders can occur associated in some neurodegenerative diseases, such as Parkinson's disease (PD) and Alzheimer's disease (AD). OBJECTIVE We further investigated the usefulness of 123I-Ioflupane SPECT and 18F-FDG PET combined use in patients with these disorders in the early stage. METHODS We retrospectively enrolled twenty-five consecutive patients with MD and CD clinical symptoms of recent appearance. All patients had undergone neurologic examination, neuropsychological tests, and magnetic resonance imaging. 123I-Ioflupane SPECT was performed in all cases, followed by 18F-FDG PET two weeks later. In the two procedures, both qualitative (QL) and quantitative (QN) image analyses were determined. RESULTS In patients with both 123I-Ioflupane SPECT and 18F-FDG PET pathologic data, associated dopaminergic and cognitive impairments were confirmed in 56% of cases. Pathologic SPECT with normal PET in 16% of cases could diagnose MD and exclude an associated CD, despite clinical symptoms. On the contrary, normal SPECT with pathologic PET in 28% of cases could exclude basal ganglia damage while confirming CD. QN 123I-Ioflupane SPECT analysis showed better performance than QL since QN correctly characterized two cases of MD with normal QL. Moreover, correct classification of normal metabolism was made only by QN analysis of 18F-FDG PET in four cases, despite suspect areas of hypometabolism at QL. CONCLUSION The combined use of these imaging procedures proved a reliable diagnostic tool to accurately identify and characterize MD and CD in early stage. QN analysis was effective in supporting QL evaluation, and its routine use is suggested, especially with inconclusive QL.
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Affiliation(s)
- Susanna Nuvoli
- Unit of Nuclear Medicine, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Giovanna Tanda
- Unit of Nuclear Medicine, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Maria L Stazza
- Unit of Nuclear Medicine, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Barbara Palumbo
- Section of Nuclear Medicine and Health Physics, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | | | | | - Angela Spanu
- Unit of Nuclear Medicine, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Giuseppe Madeddu
- Unit of Nuclear Medicine, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
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54
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Diagnostic accuracy of glabellar tap sign for Parkinson's disease. J Neural Transm (Vienna) 2021; 128:1655-1661. [PMID: 34328563 PMCID: PMC8536581 DOI: 10.1007/s00702-021-02391-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/22/2021] [Indexed: 11/30/2022]
Abstract
Glabellar tap or reflex (GR) is an old bedside clinical test used in the diagnostics of Parkinson’s disease (PD), but its diagnostic value is unclear. This study examines the diagnostic validity and reliability of GR in PD in relation to brain dopaminergic activity. GR was performed on 161 patients with PD, 47 patients with essential tremor (ET) and 40 healthy controls immediately prior to dopamine transporter (DAT) [123I]FP-CIT SPECT scanning. The binding ratios were investigated with consideration of the GR result (normal/abnormal). In addition, the consistency of the GR was investigated with 89 patients after a mean follow-up of 2.2 years. PD and ET patients had higher GR scores than healthy controls (p < 0.001), but there was no difference in GR between PD and ET patients (p = 0.09). There were no differences in the ratio of abnormal to normal GRs between the PD and ET groups (73% vs. 64% abnormal, respectively, p = 0.13) or in DAT binding between PD patients with abnormal and normal GRs (p > 0.36). Over follow-up, the GR changed from abnormal to normal in 20% of PD patients despite the presence of clinically typical disease. The sensitivity and specificity of GR for differentiating PD from ET were 78.3% and 36.2%, respectively. Although GR has been used by clinicians in the diagnostics of PD, it does not separate PD from ET. It also shows considerable inconsistency over time, and abnormal GR has no relationship with dopamine loss. Its usefulness should be tested for other clinical diagnostic purposes.
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55
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Brumberg J, Kerstens V, Cselényi Z, Svenningsson P, Sundgren M, Fazio P, Varrone A. Simplified quantification of [ 18F]FE-PE2I PET in Parkinson's disease: Discriminative power, test-retest reliability and longitudinal validity during early peak and late pseudo-equilibrium. J Cereb Blood Flow Metab 2021; 41:1291-1300. [PMID: 32955955 PMCID: PMC8138335 DOI: 10.1177/0271678x20958755] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Quantification of dopamine transporter (DAT) availability with [18F]FE-PE2I PET enables the detection of presynaptic dopamine deficiency and provides a potential progression marker for Parkinson`s disease (PD). Simplified quantification is feasible, but the time window of short acquisition protocols may have a substantial impact on the reliability of striatal binding estimates. Dynamic [18F]FE-PE2I PET data of cross-sectional (33 PD patients, 24 controls), test-retest (9 patients), and longitudinal (12 patients) cohorts were used to assess the variability and reliability of specific binding ratios (SBR) measured during early peak and late pseudo-equilibrium. Receiver operating characteristics area under the curve (PD vs. controls) was high for early (0.996) and late (0.991) SBR. Early SBR provided more favourable effect size, absolute variability, and standard error of measurement than late SBR (caudate: 1.29 vs. 1.23; 6.9% vs. 9.8%; 0.09 vs. 0.20; putamen: 1.75 vs. 1.67; 7.7% vs. 14.0%; 0.08 vs. 0.17). The annual percentage change was comparable for both time windows (-7.2%-8.5%), but decline was significant only for early SBR. Whereas early and late [18F]FE-PE2I PET acquisitions have similar discriminative power to separate PD patients and controls, the early peak equilibrium acquisition can be recommended if [18F]FE-PE2I is used to measure longitudinal changes of DAT availability.
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Affiliation(s)
- Joachim Brumberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden.,Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Vera Kerstens
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
| | - Zsolt Cselényi
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden.,AstraZeneca Translational Science Centre at Karolinska Institutet PET CoE, Stockholm, Sweden
| | - Per Svenningsson
- Department of Clinical Neuroscience, Section Neuro, Karolinska Institutet, Stockholm, Sweden.,Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Mathias Sundgren
- Department of Clinical Neuroscience, Section Neuro, Karolinska Institutet, Stockholm, Sweden.,Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Patrik Fazio
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden.,Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Andrea Varrone
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
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Buratachwatanasiri W, Chantadisai M, Onwanna J, Chongpison Y, Rakvongthai Y, Khamwan K. Pharmacokinetic Modeling of 18F-FDOPA PET in the Human Brain for Early Parkinson's Disease. Mol Imaging Radionucl Ther 2021; 30:69-78. [PMID: 34082499 PMCID: PMC8185476 DOI: 10.4274/mirt.galenos.2021.08831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objectives: Early detection is essential for the treatment approaches of Parkinson’s disease (PD). Clinical criteria alone may be insufficient to distinguish early PD from other conditions. This study aimed to investigate the transfer rate constants of 6-18F-fluoro-L-dopa (18F-FDOPA) in positron emission tomography (PET) brain images as a sensitive parameter to detect early PD. Methods: Retrospective 18F-FDOPA PET data of five patients with early PD were collected. PET data were acquired for 90 min after intravenous injection of 306-379 MBq 18F-FDOPA, and reconstructed into a series of 18 five-minute frames. Reoriented PET images were coregistered and normalized with the PET brain template on the statistical parametric mapping. The 18F-FDOPA activity concentrations were measured in the striatum, caudate, and putamen on both sides: Contralateral (as PD) and ipsilateral (as control) to the main motor symptoms. The pharmacokinetic model was generated using the SAAM II simulation software. The transfer rate constants across the blood-brain barrier (forward, K1 and reverse, k2) and decarboxylation rate constants (k3) were estimated in these regions. Results: The activity uptakes in the contralateral striatum (0.0323%±0.0091%) and putamen (0.0169%±0.0054%) were significantly lower than the control (0.0353%±0.0086%, 0.0199%±0.0054%, respectively). The K1 and k3 were significantly lower in the contralateral striatum and putamen (p<0.05). There were no significant differences in any transfer rate constants in the caudate. Conclusion: The transfer rate constants (K1 and k3) of 18F-FDOPA on the contralateral striatum and putamen were significantly lower than the control. These biokinetic data could be potential indicators for quantitative detection of early PD diagnosis.
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Affiliation(s)
- Wirunpatch Buratachwatanasiri
- Medical Physics Program, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand,Chulalongkorn University Biomedical Imaging Group, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Maythinee Chantadisai
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Jaruwan Onwanna
- Chulalongkorn University Biomedical Imaging Group, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand,Biomedical Engineering Program, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
| | - Yuda Chongpison
- Center of Excellence in Biostatistics, Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Yothin Rakvongthai
- Medical Physics Program, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand,Chulalongkorn University Biomedical Imaging Group, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand,Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Kitiwat Khamwan
- Medical Physics Program, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand,Chulalongkorn University Biomedical Imaging Group, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand,Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
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57
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Akdemir ÜÖ, Bora Tokçaer A, Atay LÖ. Dopamine transporter SPECT imaging in Parkinson’s disease and parkinsonian disorders. Turk J Med Sci 2021; 51:400-410. [PMID: 33237660 PMCID: PMC8203173 DOI: 10.3906/sag-2008-253] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 11/24/2020] [Indexed: 12/29/2022] Open
Abstract
The dopamine transporter (DAT) imaging provides an objective tool for the assessment of dopaminergic function of presynaptic terminals which is valuable for the differential diagnosis of parkinsonian disorders related to a striatal dopaminergic deficiency from movement disorders not related a striatal dopaminergic deficiency. DAT imaging with single-photon emission computed tomography (SPECT) can be used to confirm or exclude a diagnosis of dopamine deficient parkinsonism in cases where the diagnosis is unclear. It can also detect the dopaminergic dysfunction in presymptomatic subjects at risk for Parkinson’s disease (PD) since the reduced radiotracer binding to DATs in striatum is already present in the prodromal stage of PD. This review covers the rationale of using DAT SPECT imaging in the diagnosis of PD and other parkinsonian disorders, specifically focusing on the practical aspects of imaging and routine clinical indications.
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Affiliation(s)
- Ümit Özgür Akdemir
- Department of Nuclear Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ayşe Bora Tokçaer
- Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Lütfiye Özlem Atay
- Department of Nuclear Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
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58
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Ordinal classification of the affectation level of 3D-images in Parkinson diseases. Sci Rep 2021; 11:7067. [PMID: 33782476 PMCID: PMC8007580 DOI: 10.1038/s41598-021-86538-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 03/16/2021] [Indexed: 01/12/2023] Open
Abstract
Parkinson’s disease is characterised by a decrease in the density of presynaptic dopamine transporters in the striatum. Frequently, the corresponding diagnosis is performed using a qualitative analysis of the 3D-images obtained after the administration of \documentclass[12pt]{minimal}
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\begin{document}$$^{123}$$\end{document}123I-ioflupane, considering a binary classification problem (absence or existence of Parkinson’s disease). In this work, we propose a new methodology for classifying this kind of images in three classes depending on the level of severity of the disease in the image. To tackle this problem, we use an ordinal classifier given the natural order of the class labels. A novel strategy to perform feature selection is developed because of the large number of voxels in the image, and a method for generating synthetic images is proposed to improve the quality of the classifier. The methodology is tested on 434 studies conducted between September 2015 and January 2019, divided into three groups: 271 without alteration of the presynaptic nigrostriatal pathway, 73 with a slight alteration and 90 with severe alteration. Results confirm that the methodology improves the state-of-the-art algorithms, and that it is able to find informative voxels outside the standard regions of interest used for this problem. The differences are assessed by statistical tests which show that the proposed image ordinal classification could be considered as a decision support system in medicine.
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Dotinga M, van Dijk JD, Vendel BN, Slump CH, Portman AT, van Dalen JA. Clinical value of machine learning-based interpretation of I-123 FP-CIT scans to detect Parkinson's disease: a two-center study. Ann Nucl Med 2021; 35:378-385. [PMID: 33471288 DOI: 10.1007/s12149-021-01576-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/28/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Our aim was to develop and validate a machine learning (ML)-based approach for interpretation of I-123 FP-CIT SPECT scans to discriminate Parkinson's disease (PD) from non-PD and to determine its generalizability and clinical value in two centers. METHODS We retrospectively included 210 consecutive patients who underwent I-123 FP-CIT SPECT imaging and had a clinically confirmed diagnosis. Linear support vector machine (SVM) was used to build a classification model to discriminate PD from non-PD based on I-123-FP-CIT striatal uptake ratios, age and gender of 90 patients. The model was validated on unseen data from the same center where the model was developed (n = 40) and consecutively on data from a different center (n = 80). Prediction performance was assessed and compared to the scan interpretation by expert physicians. RESULTS Testing the derived SVM model on the unseen dataset (n = 40) from the same center resulted in an accuracy of 95.0%, sensitivity of 96.0% and specificity of 93.3%. This was identical to the classification accuracy of nuclear medicine physicians. The model was generalizable towards the other center as prediction performance did not differ thereby obtaining an accuracy of 82.5%, sensitivity of 88.5% and specificity of 71.4% (p = NS). This was comparable to that of nuclear medicine physicians (p = NS). CONCLUSION ML-based interpretation of I-123-FP-CIT scans results in accurate discrimination of PD from non-PD similar to visual assessment in both centers. The derived SVM model is therefore generalizable towards centers using comparable acquisition and image processing methods and implementation as diagnostic aid in clinical practice is encouraged.
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Affiliation(s)
- M Dotinga
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands
- MIRA: Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - J D van Dijk
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands.
| | - B N Vendel
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands
- Department of Nuclear Medicine, Treant Zorggroep, Emmen, The Netherlands
| | - C H Slump
- MIRA: Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - A T Portman
- Department of Neurology, Treant Zorggroep, Emmen, The Netherlands
| | - J A van Dalen
- Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands
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60
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Arnaldi D, Chincarini A, Hu MT, Sonka K, Boeve B, Miyamoto T, Puligheddu M, De Cock VC, Terzaghi M, Plazzi G, Tachibana N, Morbelli S, Rolinski M, Dusek P, Lowe V, Miyamoto M, Figorilli M, de Verbizier D, Bossert I, Antelmi E, Meli R, Barber TR, Trnka J, Miyagawa T, Serra A, Pizza F, Bauckneht M, Bradley KM, Zogala D, McGowan DR, Jordan L, Manni R, Nobili F. Dopaminergic imaging and clinical predictors for phenoconversion of REM sleep behaviour disorder. Brain 2021; 144:278-287. [PMID: 33348363 PMCID: PMC8599912 DOI: 10.1093/brain/awaa365] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/01/2020] [Accepted: 08/13/2020] [Indexed: 11/15/2022] Open
Abstract
This is an international multicentre study aimed at evaluating the combined value of dopaminergic neuroimaging and clinical features in predicting future phenoconversion of idiopathic REM sleep behaviour (iRBD) subjects to overt synucleinopathy. Nine centres sent 123I-FP-CIT-SPECT data of 344 iRBD patients and 256 controls for centralized analysis. 123I-FP-CIT-SPECT images were semiquantified using DaTQUANTTM, obtaining putamen and caudate specific to non-displaceable binding ratios (SBRs). The following clinical variables were also analysed: (i) Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale, motor section score; (ii) Mini-Mental State Examination score; (iii) constipation; and (iv) hyposmia. Kaplan-Meier survival analysis was performed to estimate conversion risk. Hazard ratios for each variable were calculated with Cox regression. A generalized logistic regression model was applied to identify the best combination of risk factors. Bayesian classifier was used to identify the baseline features predicting phenoconversion to parkinsonism or dementia. After quality check of the data, 263 iRBD patients (67.6 ± 7.3 years, 229 males) and 243 control subjects (67.2 ± 10.1 years, 110 males) were analysed. Fifty-two (20%) patients developed a synucleinopathy after average follow-up of 2 years. The best combination of risk factors was putamen dopaminergic dysfunction of the most affected hemisphere on imaging, defined as the lower value between either putamina (P < 0.000001), constipation, (P < 0.000001) and age over 70 years (P = 0.0002). Combined features obtained from the generalized logistic regression achieved a hazard ratio of 5.71 (95% confidence interval 2.85-11.43). Bayesian classifier suggested that patients with higher Mini-Mental State Examination score and lower caudate SBR asymmetry were more likely to develop parkinsonism, while patients with the opposite pattern were more likely to develop dementia. This study shows that iRBD patients older than 70 with constipation and reduced nigro-putaminal dopaminergic function are at high risk of short-term phenoconversion to an overt synucleinopathy, providing an effective stratification approach for future neuroprotective trials. Moreover, we provide cut-off values for the significant predictors of phenoconversion to be used in single subjects.
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Affiliation(s)
- Dario Arnaldi
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Chincarini
- National Institute of Nuclear Physics (INFN), Genoa section, Genoa, Italy
| | - Michele T Hu
- Oxford Parkinson’s Disease Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Karel Sonka
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Bradley Boeve
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Tomoyuki Miyamoto
- Department of Neurology, Dokkyo Medical University Saitama Medical Centre, Saitama, Japan
| | - Monica Puligheddu
- Sleep Disorder Centre, Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - Valérie Cochen De Cock
- Department of Sleep and Neurology, Beau Soleil Clinic, and EuroMov Digital Health in Motion, University of Montpellier, Montpellier, France
| | - Michele Terzaghi
- Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Giuseppe Plazzi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Naoko Tachibana
- Division of Sleep Medicine, Kansai Electric Power Medical Research Institute, Osaka, Japan
| | - Silvia Morbelli
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa, Italy
| | - Michal Rolinski
- Oxford Parkinson’s Disease Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
- Institute of Clinical Neurosciences, University of Bristol, Bristol, UK
| | - Petr Dusek
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Val Lowe
- Department of Nuclear Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Masayuki Miyamoto
- Centre of Sleep Medicine, Dokkyo Medical University Hospital, Tochigi, Japan
| | - Michela Figorilli
- Sleep Disorder Centre, Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | | | - Irene Bossert
- Nuclear Medicine Unit, ICS Maugeri SpA SB IRCCS, Pavia, Italy
| | - Elena Antelmi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Riccardo Meli
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Thomas R Barber
- Oxford Parkinson’s Disease Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Jiří Trnka
- Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Toji Miyagawa
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Alessandra Serra
- Nuclear Medicine Unit, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Fabio Pizza
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Matteo Bauckneht
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa, Italy
| | | | - David Zogala
- Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Daniel R McGowan
- Radiation Physics and Protection Department, Churchill Hospital, Oxford, UK
| | - Lennon Jordan
- Department of Nuclear Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Raffaele Manni
- Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy
| | - Flavio Nobili
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Cuneus/precuneus as a central hub for brain functional connectivity of mild cognitive impairment in idiopathic REM sleep behavior patients. Eur J Nucl Med Mol Imaging 2021; 48:2834-2845. [PMID: 33511424 DOI: 10.1007/s00259-021-05205-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/17/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE To investigate brain functional correlates of mild cognitive impairment (MCI) in idiopathic REM sleep behavior disorder (iRBD). METHODS Thirty-nine consecutive iRBD patients, 17 with (RBD-MCI, 73.6±6.5 years), and 22 without (RBD-NC, 69.6±6.1 years) MCI underwent neuropsychological assessment, 18F-FDG-PET, and 123I-FP-CIT-SPECT as a marker of nigro-striatal dopaminergic function. Forty-two healthy subjects (69.6±8.5 years) were used as control for 18F-FDG-PET analysis. Brain metabolism was compared between the three groups by univariate analysis of variance. Post hoc comparison between RBD-MCI and RBD-NC was performed to investigate the presence of an MCI-related volume of interest (MCI-VOI). Brain functional connectivity was explored by interregional correlation analysis (IRCA), using the whole-brain normalized MCI-VOI uptake as the independent variable. Moreover, the MCI-VOI uptake was correlated with 123I-FP-CIT-SPECT specific-to-non displaceable binding ratios (SBR) and neuropsychological variables. Finally, the MCI-VOI white matter structural connectivity was analyzed by using a MRI-derived human atlas. RESULTS The MCI-VOI was characterized by a relative hypometabolism involving precuneus and cuneus (height threshold p<0.0001). IRCA (height threshold p<0.0001) revealed a brain functional network involving regions in frontal, temporal, parietal, and occipital lobes, thalamus, caudate, and red nuclei in iRBD patients. In controls, the network was smaller and involved temporal, occipital, cingulate cortex, and cerebellum. Moreover, MCI-VOI metabolism was correlated with verbal memory (p=0.01), executive functions (p=0.0001), and nigro-putaminal SBR (p=0.005). Finally, MCI-VOI was involved in a white matter network including cingulate fasciculus and corpus callosum. CONCLUSION Our data suggest that cuneus/precuneus is a hub of a large functional network subserving cognitive function in iRBD.
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Auer B, Zeraatkar N, Goding JC, Könik A, Fromme TJ, Kalluri KS, Furenlid LR, Kuo PH, King MA. Inclusion of quasi-vertex views in a brain-dedicated multi-pinhole SPECT system for improved imaging performance. Phys Med Biol 2021; 66:035007. [PMID: 33065564 PMCID: PMC9899040 DOI: 10.1088/1361-6560/abc22e] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
With brain-dedicated multi-detector systems employing pinhole apertures the usage of detectors facing the top of the patient's head (i.e. quasi-vertex (QV) views) can provide the advantage of additional viewing from close to the brain for improved detector coverage. In this paper, we report the results of simulation and reconstruction studies to investigate the impact of the QV views on the imaging performance of AdaptiSPECT-C, a brain-dedicated stationary SPECT system under development. In this design, both primary and scatter photons from regions located inferior to the brain can contribute to SPECT projections acquired by the QV views, and thus degrade AdaptiSPECT-C imaging performance. In this work, we determined the proportion, origin, and nature (i.e. primary, scatter, and multiple-scatter) of counts emitted from structures within the head and throughout the body contributing to projections from the different AdaptiSPECT-C detector rings, as well as from a true vertex view detector. We simulated phantoms used to assess different aspects of image quality (i.e. uniform activity concentration sphere, and Derenzo), as well as anthropomorphic phantoms with different count levels emulating clinical 123I activity distributions (i.e. DaTscan and perfusion). We determined that attenuation and scatter in the patient's body greatly diminish the probability of the photons emitted outside the volume of interest reaching to detectors and being recorded within the 15% photopeak energy window. In addition, we demonstrated that the inclusion of the residual of such counts in the system acquisition does not degrade visual interpretation or quantitative analysis. The addition of the QV detectors improves volumetric sensitivity, angular sampling, and spatial resolution leading to significant enhancement in image quality, especially in the striato-thalamic and superior regions of the brain. Besides, the use of QV detectors improves the recovery of clinically relevant metrics such as the striatal binding ratio and mean activity in selected cerebral structures. Our findings proving the usefulness of the QV ring for brain imaging with 123I agents can be generalized to other commonly used SPECT imaging agents labelled with isotopes, such as 99mTc and likely 111In.
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Affiliation(s)
- Benjamin Auer
- Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA, 01655
| | - Navid Zeraatkar
- Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA, 01655
| | - Justin C. Goding
- Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA, 01655
| | - Arda Könik
- Department of Imaging, Dana Farber Cancer Institute, Boston, MA, USA, 02215
| | | | - Kesava S. Kalluri
- Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA, 01655
| | - Lars R. Furenlid
- Wyant College of Optical Sciences, University of Arizona, Tucson, AZ, USA, 85721.,Department of Medical Imaging, University of Arizona, Tucson, AZ, USA, 85724
| | - Phillip H. Kuo
- Department of Medical Imaging, University of Arizona, Tucson, AZ, USA, 85724
| | - Michael A. King
- Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA, 01655
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Milenkovic I, Bartova L, Papageorgiou K, Kasper S, Traub-Weidinger T, Winkler D. Case Report: Bupropion Reduces the [ 123I]FP-CIT Binding to Striatal Dopamine Transporter. Front Psychiatry 2021; 12:631357. [PMID: 33692710 PMCID: PMC7937912 DOI: 10.3389/fpsyt.2021.631357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 01/29/2021] [Indexed: 11/13/2022] Open
Abstract
The diagnosis of parkinsonian syndromes in patients with severe depression may be challenging due to overlapping clinical phenomena, especially regarding psychomotor and affective symptoms. [123I]FP-CIT-SPECT is a useful method to detect degenerative parkinsonian disorders. However, some drugs may influence the tracer binding and thus alter the result. We present a case of 56-year-old female inpatient with difficult-to-treat late-onset depression. Since the current major depressive episode (MDE) was accompanied by psychotic features including delusions and hallucinations as well as hypokinesia, stooped posture and hypomimia, underlying degenerative parkinsonism was suspected. The pathologic [123I]FP-CIT-SPECT scan under ongoing antidepressant therapy with bupropion 300 mg/die (serum level of bupropion 43 ng/ml and hydroxybupropion 2,332 ng/ml) showed reduced [123I]FP-CIT binding throughout the striatum. The scan normalized upon a wash-out phase of four half-time periods (serum level of bupropion was 0.4 ng/ml and for hydroxybupropion 80.5 ng/ml). Our report should serve as a cautionary note for use of [123I]FP-CIT in depressed patients, particularly in those treated with drugs interfering with the dopamine transporter. Furthermore, our case argues for a need of consultation of a movement disorder specialist prior to dopamine transporter imaging.
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Affiliation(s)
- Ivan Milenkovic
- Department of Neurology, Medical University of Vienna, Vienna, Austria.,Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Lucie Bartova
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | | | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Tatjana Traub-Weidinger
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Dietmar Winkler
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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Kangasmaa T, Hippeläinen E, Constable C, Turunen S, Sohlberg A. Quantitative Monte Carlo-based brain dopamine transporter SPECT imaging. Ann Nucl Med 2021; 35:17-23. [PMID: 32978713 DOI: 10.1007/s12149-020-01532-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/16/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Brain dopamine transporter imaging with I-123-labeled radioligands is technically demanding due to the small size of the imaging target relative to the spatial resolution of most SPECT systems. In addition, I-123 has high-energy peaks which can penetrate or scatter in the collimator and be detected in the imaging energy window. The aim of this study was to implement Monte Carlo (MC)-based full collimator-detector response (CDR) compensation algorithm for I-123 into a third-party commercial SPECT reconstruction software package and to evaluate its effect on the quantitative accuracy of dopaminergic-image analysis compared to a method where only the geometric component of the CDR is compensated. METHODS In this work, we utilized a full Monte Carlo collimator-detector model and incorporated it into an iterative SPECT reconstruction algorithm. The full Monte Carlo model reconstruction was compared to standard reconstruction using an anthropomorphic striatal phantom filled with different I-123 striatal/cortex uptake ratios and with clinical I-123 Ioflupane DaTScan studies. RESULTS Reconstruction with the full model yielded higher (13-25%) striatal uptake ratios than the conventional reconstruction, but the uptake ratios were still much lower than the true ratios due to partial volume effect. Visually, images reconstructed with the full Monte Carlo model had better contrast and resolution than the conventional images, with both phantom and patient studies. CONCLUSIONS Reconstruction with full Monte Carlo collimator-detector model yields higher quantitative accuracy than conventional reconstruction. Additional work to reduce the partial volume effect related errors would improve the accuracy further.
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Affiliation(s)
- Tuija Kangasmaa
- Department of Clinical Physiology and Nuclear Medicine, Vaasa Central Hospital, Hietalahdenkatu 2-4, 65130, Vaasa, Finland.
| | - Eero Hippeläinen
- Clinical Physiology and Nuclear Medicine, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, 00029, Helsinki, Finland
| | - Chris Constable
- HERMES Medical Solutions, Strandbergsgatan 16, 11251, Stockholm, Sweden
| | - Sampsa Turunen
- Clinical Physiology and Nuclear Medicine, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, 00029, Helsinki, Finland
| | - Antti Sohlberg
- HERMES Medical Solutions, Strandbergsgatan 16, 11251, Stockholm, Sweden
- Laboratory of Clinical Physiology and Nuclear Medicine, Päijät-Häme Central Hospital, Keskussairaalankatu 7, 15850, Lahti, Finland
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Arnaldi D, Famà F, Girtler N, Brugnolo A, Pardini M, Mattioli P, Meli R, Massa F, Orso B, Sormani MP, Donegani MI, Bauckneht M, Morbelli S, Nobili F. Rapid eye movement sleep behavior disorder: A proof-of-concept neuroprotection study for prodromal synucleinopathies. Eur J Neurol 2020; 28:1210-1217. [PMID: 33275819 DOI: 10.1111/ene.14664] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/19/2020] [Accepted: 11/26/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE To explore the feasibility of a neuroprotection trial in prodromal synucleinopathy, using idiopathic rapid eye movement sleep behavior disorder (iRBD) as the target population and 123 I-FP-CIT-SPECT as a biomarker of disease progression. METHODS Consecutive iRBD patients were randomly assigned to a treatment arm receiving selegiline and symptomatic rapid eye movement sleep behavior disorder treatment, or to a control arm receiving symptomatic treatment only. Selegiline was chosen because of a demonstrated neuroprotection effect in animal models. Patients underwent 123 I-FP-CIT-SPECT at baseline and after 30 months on average. The clinical outcome was the emergence of parkinsonism and/or dementia. A repeated-measures general linear model (GLM) was applied using group (control and treatment) as "between" factor, and both time (baseline and follow-up) and regions (123 I-FP-CIT-SPECT putamen and caudate uptake) as the "within" factors, adjusting for age. RESULTS Thirty iRBD patients completed the study (68.2 ± 6.9 years; 29 males; 21% dropout rate), 13 in the treatment arm, and 17 in the control arm. At follow-up (29.8 ± 9.0 months), three patients in the control arm developed dementia and one parkinsonism, whereas two patients in the treatment arm developed parkinsonism. Both putamen and caudate uptake decreased over time in the control arm. In the treatment arm, only the putamen uptake decreased over time, whereas caudate uptake remained stable. GLM analysis demonstrated an effect of treatment on the 123 I-FP-CIT-SPECT uptake change, with a significant interaction between the effect of group, time, and regions (p = 0.004). CONCLUSIONS A 30-months neuroprotection study for prodromal synucleinopathy is feasible, using iRBD as the target population and 123 I-FP-CIT-SPECT as a biomarker of disease progression.
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Affiliation(s)
- Dario Arnaldi
- Clinical Neurology, Department of Neuroscience (DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesco Famà
- Clinical Neurology, Department of Neuroscience (DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Nicola Girtler
- Clinical Neurology, Department of Neuroscience (DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Brugnolo
- Clinical Neurology, Department of Neuroscience (DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Pardini
- Clinical Neurology, Department of Neuroscience (DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Pietro Mattioli
- Clinical Neurology, Department of Neuroscience (DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Riccardo Meli
- Clinical Neurology, Department of Neuroscience (DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Federico Massa
- Clinical Neurology, Department of Neuroscience (DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Beatrice Orso
- Clinical Neurology, Department of Neuroscience (DINOGMI, University of Genoa, Genoa, Italy
| | | | - Maria Isabella Donegani
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Nuclear Medicine, Department of Health Sciences (DISSAL, University of Genoa, Genoa, Italy
| | - Matteo Bauckneht
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Nuclear Medicine, Department of Health Sciences (DISSAL, University of Genoa, Genoa, Italy
| | - Silvia Morbelli
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Nuclear Medicine, Department of Health Sciences (DISSAL, University of Genoa, Genoa, Italy
| | - Flavio Nobili
- Clinical Neurology, Department of Neuroscience (DINOGMI, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Vala C, Mothes C, Chicheri G, Magadur P, Viot G, Deloye JB, Maia S, Bouvet Y, Dupont AC, Arlicot N, Guilloteau D, Emond P, Vercouillie J. Fully automated radiosynthesis of [ 18F]LBT999 on TRACERlab FX FN and AllinOne modules, a PET radiopharmaceutical for imaging the dopamine transporter in human brain. EJNMMI Radiopharm Chem 2020; 5:26. [PMID: 33196944 PMCID: PMC7669936 DOI: 10.1186/s41181-020-00105-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 10/19/2020] [Indexed: 11/30/2022] Open
Abstract
Background Fluorine labelled 8-((E)-4-fluoro-but-2-enyl)-3β-p-tolyl-8-aza-bicyclo[3.2.1]octane-2β-carboxylic acid methyl ester ([18F]LBT999) is a selective radioligand for the in vivo neuroimaging and quantification of the dopamine transporter by Positron Emission Tomography (PET). [18F]LBT999 was produced on a TRACERlab FXFN for the Phase I study but for Phase III and a potent industrial production transfer, production was also implemented on an AllinOne (AIO) system requiring a single use cassette. Both production methods are reported herein. Results Automation of [18F]LBT999 radiosynthesis on FXFN was carried out in 35% yield (decay-corrected) in 65 min (n = 16), with a radiochemical purity higher than 99% and a molar activity of 158 GBq/μmol at the end of synthesis. The transfer to the AIO platform followed by optimizations allowed the production of [18F]LBT999 in 32.7% yield (decay-corrected) within 48 min (n = 5), with a radiochemical purity better than 98% and a molar activity above 154 GBq/μmol on average at the end of synthesis. Quality controls of both methods met the specification for clinical application. Conclusion Both modules allow efficient and reproducible radiosynthesis of [18F]LBT999 with good radiochemical yields and a reasonable synthesis time. The developments made on AIO, such as its ability to meet pharmaceutical criteria and to more easily comply with GMP requirements, make it an optimal approach for the potent industrial production of [18F]LBT999 and future wider use.
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Affiliation(s)
- Christine Vala
- Zionexa, 75017, Paris, France.,Cyclopharma, 63360, Saint-Beauzire, France.,CERRP, 37100, Tours, France
| | - Céline Mothes
- Zionexa, 75017, Paris, France.,Cyclopharma, 63360, Saint-Beauzire, France.,CERRP, 37100, Tours, France
| | - Gabrielle Chicheri
- CERRP, 37100, Tours, France.,UMR 1253, iBrain, Université de Tours, Inserm, 37000, Tours, France
| | - Pauline Magadur
- Cyclopharma, 63360, Saint-Beauzire, France.,CERRP, 37100, Tours, France
| | | | - Jean-Bernard Deloye
- Zionexa, 75017, Paris, France.,Cyclopharma, 63360, Saint-Beauzire, France.,CERRP, 37100, Tours, France
| | - Serge Maia
- CERRP, 37100, Tours, France.,UMR 1253, iBrain, Université de Tours, Inserm, 37000, Tours, France.,INSERM CIC 1415, University Hospital, 37000, Tours, France.,CHRU de Tours, services de Médecine Nucléaire in vitro et in vivo, 37000, Tours, France
| | - Yann Bouvet
- Zionexa, 75017, Paris, France.,Cyclopharma, 63360, Saint-Beauzire, France
| | - Anne-Claire Dupont
- CERRP, 37100, Tours, France.,UMR 1253, iBrain, Université de Tours, Inserm, 37000, Tours, France.,INSERM CIC 1415, University Hospital, 37000, Tours, France.,CHRU de Tours, services de Médecine Nucléaire in vitro et in vivo, 37000, Tours, France
| | - Nicolas Arlicot
- CERRP, 37100, Tours, France.,UMR 1253, iBrain, Université de Tours, Inserm, 37000, Tours, France.,INSERM CIC 1415, University Hospital, 37000, Tours, France.,CHRU de Tours, services de Médecine Nucléaire in vitro et in vivo, 37000, Tours, France
| | - Denis Guilloteau
- CERRP, 37100, Tours, France.,UMR 1253, iBrain, Université de Tours, Inserm, 37000, Tours, France.,INSERM CIC 1415, University Hospital, 37000, Tours, France.,CHRU de Tours, services de Médecine Nucléaire in vitro et in vivo, 37000, Tours, France
| | - Patrick Emond
- CERRP, 37100, Tours, France.,UMR 1253, iBrain, Université de Tours, Inserm, 37000, Tours, France.,CHRU de Tours, services de Médecine Nucléaire in vitro et in vivo, 37000, Tours, France
| | - Johnny Vercouillie
- CERRP, 37100, Tours, France. .,UMR 1253, iBrain, Université de Tours, Inserm, 37000, Tours, France. .,INSERM CIC 1415, University Hospital, 37000, Tours, France.
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Morbelli S, Arnaldi D, Cella E, Raffa S, Donegani MI, Capitanio S, Massa F, Miceli A, Filippi L, Chincarini A, Nobili F. Striatal dopamine transporter SPECT quantification: head-to-head comparison between two three-dimensional automatic tools. EJNMMI Res 2020; 10:137. [PMID: 33159607 PMCID: PMC7648825 DOI: 10.1186/s13550-020-00727-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 10/27/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose Our aim was to compare a widely distributed commercial tool with an older free software (i) one another, (ii) with a clinical motor score, (iii) versus reading by experts. Procedures We analyzed consecutive scans from one-hundred and fifty-one outpatients submitted to brain DAT SPECT for a suspected parkinsonism. Images were post-processed using a commercial (Datquant®) and a free (BasGanV2) software. Reading by expert was the gold standard. A subset of patients with pathological or borderline scan was evaluated with the clinical Unified Parkinson’s Disease Rating Scale, motor part (MDS-UPDRS-III). Results SBR, putamen-to-caudate (P/C) ratio, and both P and C asymmetries were highly correlated between the two software with Pearson’s ‘r’ correlation coefficients ranging from .706 to .887. Correlation coefficients with the MDS-UPDRS III score were higher with caudate than with putamen SBR values with both software, and in general higher with BasGanV2 than with Datquant®. Datquant® correspondence with expert reading was 84.1% (94.0% by additionally considering the P/C ratio as a further index). BasGanV2 correspondence with expert reading was 80.8% (86.1% by additionally considering the P/C ratio). Conclusions Both Datquant® and BasGanV2 work reasonably well and similarly one another in semi-quantification of DAT SPECT. Both tools have their own strength and pitfalls that must be known in detail by users in order to obtain the best help in visual reading and reporting of DAT SPECT.
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Affiliation(s)
- Silvia Morbelli
- Department of Health Science (DISSAL), University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Dario Arnaldi
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Eugenia Cella
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Stefano Raffa
- Department of Health Science (DISSAL), University of Genoa, Genoa, Italy
| | | | | | - Federico Massa
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Alberto Miceli
- Department of Health Science (DISSAL), University of Genoa, Genoa, Italy
| | - Laura Filippi
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Andrea Chincarini
- Genoa Section, National Institute of Nuclear Physics (INFN), Genoa, Italy
| | - Flavio Nobili
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy. .,Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy.
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68
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Schmitz-Steinkrüger H, Lange C, Apostolova I, Mathies FL, Frings L, Klutmann S, Hellwig S, Meyer PT, Buchert R. Impact of age and sex correction on the diagnostic performance of dopamine transporter SPECT. Eur J Nucl Med Mol Imaging 2020; 48:1445-1459. [PMID: 33130960 PMCID: PMC8113204 DOI: 10.1007/s00259-020-05085-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/20/2020] [Indexed: 12/17/2022]
Abstract
Purpose The specific binding ratio (SBR) of 123I-FP-CIT (FP-CIT) in the putamen decreases with age by about 5% per decade and most likely is about 10% higher in females. However, the clinical utility of age and sex correction of the SBR is still a matter of debate. This study tested the impact of age and sex correction on the diagnostic performance of the putamen SBR in three independent patient samples. Methods Research sample: 207 healthy controls (HC) and 438 Parkinson’s disease (PD) patients. Clinical sample A: 183 patients with neurodegenerative parkinsonian syndrome (PS) and 183 patients with non-neurodegenerative PS from one site. Clinical sample B: 84 patients with neurodegenerative PS and 38 patients with non-neurodegenerative PS from another site. Correction for age and sex of the putamen SBR was based on linear regression in the HC or non-neurodegenerative PS, separately in each sample. The area under the ROC curve (AUC) was used as performance measure. Results The putamen SBR was higher in females compared to males (PPMI: 14%, p < 0.0005; clinical sample A: 7%, p < 0.0005; clinical sample B: 6%, p = 0.361). Age-related decline of the putamen SBR ranged between 3.3 and 10.4% (p ≤ 0.019). In subjects ≥ 50 years, age and sex explained < 10% of SBR between-subjects variance. Correction of the putamen SBR for age and sex resulted in slightly decreased AUC in the PPMI sample (0.9955 versus 0.9969, p = 0.025) and in clinical sample A (0.9448 versus 0.9519, p = 0.057). There was a small, non-significant AUC increase in clinical sample B (0.9828 versus 0.9743, p = 0.232). Conclusion These findings do not support age and sex correction of the putaminal FP-CIT SBR in the diagnostic workup of parkinsonian syndromes. This most likely is explained by the fact that the proportion of between-subjects variance caused by age and sex is considerably below the symptom threshold of about 50% reduction in neurodegenerative PS. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-020-05085-2.
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Affiliation(s)
- Helen Schmitz-Steinkrüger
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Catharina Lange
- Department of Nuclear Medicine, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ivayla Apostolova
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Franziska L Mathies
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Lars Frings
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Susanne Klutmann
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Sabine Hellwig
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Philipp T Meyer
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ralph Buchert
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
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Diagnostic Performance of 123I-FPCIT SPECT Specific Binding Ratio in Progressive Supranuclear Palsy: Use of Core Clinical Features and MRI for Comparison. AJR Am J Roentgenol 2020; 215:1443-1448. [PMID: 33021833 DOI: 10.2214/ajr.19.22436] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE. Progressive supranuclear palsy (PSP) is listed as a core clinical feature in the Movement Disorder Society 2017 criteria, along with ocular motor dysfunction, postural instability, akinesia, and cognitive dysfunction. Imaging evidence shows predominant mid-brain atrophy and postsynaptic striatal dopaminergic degeneration as two supportive features. The purpose of this study was to investigate the diagnostic performance of 123I-N- ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl) nortropane (123I-FP-CIT) SPECT by comparing it with evaluation of core clinical features and MRI in the diagnosis of PSP. MATERIALS AND METHODS. The study included 53 patients with clinically suspected PSP who had undergone 123I-FP-CIT SPECT and MRI examinations. MR parkinsonism index (MRPI) was used as the MRI index. For the 123I-FP-CIT SPECT index, specific binding ratio (SBR) was calculated as the average of the right and left SBRs. RESULTS. In regard to core clinical features, ocular motor dysfunction was present in 15 of 20 (75.0%) patients with the diagnosis of probable PSP (p < 0.0001). Calculation of the diagnostic performance of the imaging parameters showed that MRPI (cutoff > 11.6) had 85.0% sensitivity, 100% specificity, and 94.3% accuracy. SBR (cutoff < 3.7) had 95.0% sensitivity, 36.4% specificity, and 58.5% accuracy. CONCLUSION. Iodine-123-labeled FP-CIT SPECT has high sensitivity, and MRI has high specificity in the diagnosis of PSP. Because these tools have complementary roles, reach ing a more confident clinical diagnosis of PSP may be possible when both are used.
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123I-Ioflupane dopamine transporter imaging (DaTSCAN) appearances in relation to emotional responsiveness, impulsivity and olfaction in suspected Parkinsonian syndrome. Nucl Med Commun 2020; 41:1117-1127. [PMID: 32826621 DOI: 10.1097/mnm.0000000000001267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of our study was to ascertain relationships between DaTSCAN, olfactory loss, behavioural and subjective measurements of impulsivity and emotional responsiveness in patients with clinically suspected Parkinsonian syndrome (PS). METHODS A prospective study of 20 drug-naive patients with parkinsonism, underwent the University of Pennsylvania Smell Identification Test, impulsivity measurements and mood-state-questionnaires before visual and semi-quantitative DaTQUANT analyses. There were two subgroups: nine patients with scans without evidence of dopaminergic deficit (SWEDD - controls) and 11 patients with PS. RESULTS The PS group reported lower non-planning impulsivity than the SWEDD group (P = 0.039). A positive correlation was found between the non-planning impulsivity ratings and right anterior putamen/background (bck) ratio in PS group (r = 0.598, P = 0.068). Higher ratings of anger (r = 0.575, P = 0.016), fatigue (r = 0.746, P = 0.001), confusion (r = 0.561, P = 0.019) and depression were positively correlated with putamen/caudate ratios (R > L) on DaTSCAN. Higher self-reported arousal was associated with lower right putamen/caudate ratio (P = -0.581, P = 0.014). Only fatigue was positively correlated with putamen/bck (r = 0.564, P = 0.018). The degree of smell deficit correlated negatively with performance on reflection impulsivity tasks (r = -0.470, P = 0.049). CONCLUSION DaTSCAN appearances correlated with emotional dysfunction and self-reported impulsivity in patients with PS. Olfactory impairment was associated with increased reflection impulsivity and the age of patients. Higher DaTSCAN putamen/caudate ratios were associated with higher emotional responsiveness and higher non-planning impulsivity in PS patients. These preliminary findings may be relevant in clinical practice in differentiating PS from SWEDD and identifying susceptibility to impulse control disorder although larger studies are warranted.
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Tecklenburg K, Forgács A, Apostolova I, Lehnert W, Klutmann S, Csirik J, Garutti E, Buchert R. Performance evaluation of a novel multi-pinhole collimator for dopamine transporter SPECT. Phys Med Biol 2020; 65:165015. [PMID: 32369781 DOI: 10.1088/1361-6560/ab9067] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
There is a tradeoff between spatial resolution and count sensitivity in SPECT with conventional collimators. Multi-pinhole (MPH) collimator technology has potential for concurrent improvement of resolution and sensitivity in clinical SPECT of 'small' organs. This study evaluated a novel MPH collimator specifically designed for dopamine transporter (DAT) SPECT with a triple-head SPECT camera. Count sensitivity was measured with a 99mTc point source placed on the lattice points of a 1 cm grid covering the whole field-of-view (FOV). Spatial resolution was assessed with a Derenzo type hot rod phantom. An anthropomorphic striatum phantom was scanned with total activity representative of a typical patient scan and different striatum-to-background activity concentration ratios. Recovery of striatum-to-background contrast was assessed by the contrast-recovery-coefficient. Measurements were repeated with double-head SPECT with fan-beam or low-energy-high-resolution-high-sensitivity (LEHRHS) collimators. A patient referred to DAT SPECT because of suspicion of Parkinson's disease was scanned with both LEHRHS and MPH collimators after a single tracer injection. The axial MPH sensitivity profile was approximately symmetrical around its peak, although it was shifted 7 cm towards the patient to simplify positioning. Peak sensitivity of the triple-head MPH system in the center of the FOV was 620 cps MBq-1 compared to 225 cps MBq-1 for the double-head fan-beam system. Sensitivity of the MPH system decreased towards the edges of the FOV. The full width of the sensitivity profile at 200 cps MBq-1 was 21 cm transaxially and 11 cm axially. In MPH SPECT of the Derenzo phantom all rods with ≥ 5 mm diameter were clearly visible. MPH SPECT improved striatal contrast recovery by ≥ 20% compared to fan-beam SPECT. The patient scan demonstrated good image quality of MPH SPECT with almost PET-like delineation of putamen and caudate nucleus. SPECT with dedicated MPH collimators provides considerable improvement of the resolution-sensitivity tradeoff in DAT SPECT compared to SPECT with fan-beam or LEHRHS collimators.
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Affiliation(s)
- K Tecklenburg
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Institute of Experimental Physics, Faculty of Mathematics, Informatics and Natural Sciences, University of Hamburg, Hamburg, Germany
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Kotikova K, Zogala D, Ptacnik V, Trnka J, Kupka K, Vaneckova M, Seidl Z, Diblik P, Heissigerova J, Navratil T, Komarc M, Zak I, Polakova K, Brozova H, Zakharov S. Efficiency of 123I-ioflupane SPECT as the marker of basal ganglia damage in acute methanol poisoning: 6-year prospective study. Clin Toxicol (Phila) 2020; 59:235-245. [PMID: 32762574 DOI: 10.1080/15563650.2020.1802033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
CONTEXT Investigate whether 123I-ioflupane SPECT (DaT SPECT) has the potential as a marker of basal ganglia damage in acute methanol poisoning. METHODS Prospective, single-centre, cohort study of patients with confirmed methanol poisoning was conducted. DaT SPECT was performed twice with semi-quantification using DaTQUANTTM and MRI-based volumetry was calculated. Specific binding ratios (SBR) of striatum, caudate nucleus, and putamen were correlated with laboratory parameters of outcome, volumetric data, and retinal nerve fibres layer (RNFL) thickness measurements. RESULTS Forty-two patients (mean age 46.3 ± 4.2 years; 8 females), including 15 with MRI-detected putamen lesions (group I) and 27 patients with intact putamen (group II), underwent DaT SPECT. Volumetry was calculated in 35 of the patients assessed. SBR values for the left putamen correlated with putamen volume (r = 0.665; p < 0.001). Decreased bilateral SBR values were determined for the striatum and the putamen, but not for the nucleus caudate, in group I (p < 0.05). Significant correlation was observed between the SBR of the posterior putamen and arterial blood pH (r = 0.574; p < 0.001) and other toxicological parameters of severity of poisoning/outcome including serum lactate, glucose, and creatinine concentrations (p < 0.05). The SBR of the posterior putamen positively correlated with the global RNFL thickness (p < 0.05). ROC analysis demonstrated a significant discriminatory ability of SBR of the posterior putamen with AUC = 0.753 (95%CI 0.604-0.902; p = 0.007). The multivariate regression model demonstrated that arterial blood pH, age, and gender were the most significant factors associated with SBR of the posterior putamen. CONCLUSION DaT SPECT demonstrates significant potential for the diagnosis of methanol-induced basal ganglia damage.
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Affiliation(s)
- Katerina Kotikova
- Department of Occupational Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic.,Toxicological Information Centre, General University Hospital, Prague, Czech Republic
| | - David Zogala
- Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Vaclav Ptacnik
- Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Jiri Trnka
- Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Karel Kupka
- Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Manuela Vaneckova
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Zdenek Seidl
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Pavel Diblik
- Department of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Jarmila Heissigerova
- Department of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Tomas Navratil
- Department of Occupational Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic.,Department of Electrochemistry at the Nanoscale, J. Heyrovsky Institute of Physical Chemistry of the Czech Academy of Sciences, Prague, Czech Republic
| | - Martin Komarc
- Department of Methodology, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Ivan Zak
- Department of Occupational Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic.,Toxicological Information Centre, General University Hospital, Prague, Czech Republic
| | - Kamila Polakova
- Department of Neurology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Hana Brozova
- Department of Neurology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Sergey Zakharov
- Department of Occupational Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic.,Toxicological Information Centre, General University Hospital, Prague, Czech Republic
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Hopelessness, Dissociative Symptoms, and Suicide Risk in Major Depressive Disorder: Clinical and Biological Correlates. Brain Sci 2020; 10:brainsci10080519. [PMID: 32764310 PMCID: PMC7465542 DOI: 10.3390/brainsci10080519] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 07/30/2020] [Accepted: 08/04/2020] [Indexed: 01/21/2023] Open
Abstract
Background: Major depressive disorder (MDD) has different clinical presentations and is associated with neurobiological alterations. Hopelessness, anhedonia, and dissociation represent some of the most pervasive psychopathological symptoms that often lead to suicidal thoughts, attempts, and actions. To further research on the concept of depression endophenotypes, this study aimed to assess the possible relationships between hopelessness and other clinical and biological correlates (i.e., striatal dopaminergic dysfunction) in depressed patients. Methods: We recruited 51 subjects with MDD. All subjects underwent 123I-FP-CIT SPECT to assess striatal dopamine transporter (DAT) availability and a psychometric evaluation using the psychometric scale to assess depressive, anxious, dissociative, and hopelessness symptoms aside from suicidal ideation. Result: An inverse correlation between the hopelessness score and dopamine transporter availability in all basal ganglia was bilaterally found. (Right Putamen, r = −0.445, p < 0.01; Left Putamen, r = −0.454, p < 0.01; Right Caudate, r = −0.398, p < 0.01; Left Caudate, r = −0.467, p < 0.01) Moreover, a positive correlation was also found between hopelessness and dissociative symptoms. Conclusions: These results provide important evidence on the neurobiological and clinical correlates of different psychopathological symptoms of depression with potential implications in terms of devising more effective treatment programs.
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Chang WH, Chen KC, Tseng HH, Chiu NT, Lee IH, Chen PS, Yang YK. Bridging the associations between dopamine, brain volumetric variation and IQ in drug-naïve schizophrenia. Schizophr Res 2020; 220:248-253. [PMID: 32204972 DOI: 10.1016/j.schres.2020.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 03/02/2020] [Accepted: 03/04/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Although patients with schizophrenia are well-known to exhibit significant brain volume reduction and cognitive function impairment, it remains unclear as to whether the reduction/impairment is correlated with dopaminergic activity under drug-naïve conditions. METHODS 51 drug-naïve patients with and 128 healthy subjects were recruited in this study. DAT by [99mTc]TRODAT-1 single-photon emission computed tomography (SPECT), regional gray matter volume (GMV) by voxel-based morphometry (VBM) analysis, and cognitive function in terms of IQ were measured in both groups. RESULT A significantly lower DAT availability existed in the drug-naïve group as compared with the healthy subjects (1.67 ± 0.45 vs. 1.98 ± 0.37, P < 0.005). DAT availability was significantly positively correlated with GMV in the left middle frontal lobe (r = 0.58, P < 0.005), the GMV being significantly reduced in the patients with schizophrenia (0.45 ± 0.10 vs. 0.49 ± 0.07, P < 0.005). Furthermore, the GMV in the left middle frontal lobe was significantly and positively correlated with full IQ (r = 0.34, P = 0.02) in the patients with schizophrenia, but not in the controls. CONCLUSIONS Dysregulated dopaminergic activity may modulate volume variation in specific brain areas, and brain volume might alter IQ in drug-naïve patients with schizophrenia.
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Affiliation(s)
- Wei Hung Chang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
| | - Kao Chin Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Huai-Hsuan Tseng
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Nan Tsing Chiu
- Department of Nuclear Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - I Hui Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan.
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Schmitz-Steinkrüger H, Lange C, Apostolova I, Amthauer H, Lehnert W, Klutmann S, Buchert R. Impact of the size of the normal database on the performance of the specific binding ratio in dopamine transporter SPECT. EJNMMI Phys 2020; 7:34. [PMID: 32435936 PMCID: PMC7239986 DOI: 10.1186/s40658-020-00304-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study investigated the impact of the size of the normal database on the classification performance of the specific binding ratio (SBR) in dopamine transporter (DAT) SPECT with [123I]FP-CIT in different settings. METHODS The first subject sample comprised 645 subjects from the Parkinson's Progression Marker Initiative (PPMI), 207 healthy controls (HC), and 438 Parkinson's disease (PD) patients. The second sample comprised 372 patients from clinical routine patient care, 186 with non-neurodegenerative parkinsonian syndrome (PS) and 186 with neurodegenerative PS. Single-photon emission computed tomography (SPECT) images of the clinical sample were reconstructed with two different reconstruction algorithms (filtered backprojection, iterative ordered subsets expectation maximization (OSEM) reconstruction with resolution recovery). The putaminal specific binding ratio (SBR) was computed using an anatomical region of interest (ROI) predefined in standard (MNI) space in the Automated Anatomic Labeling (AAL) atlas or using hottest voxels (HV) analysis in large predefined ROIs. SBR values were transformed to z-scores using mean and standard deviation of the SBR in a normal database of varying sizes (n = 5, 10, 15,…, 50) randomly selected from the HC subjects (PPMI sample) or the patients with non-neurodegenerative PS (clinical sample). Accuracy, sensitivity, and specificity for identifying patients with PD or neurodegenerative PS were determined as performance measures using a predefined fixed cutoff on the z-score. This was repeated for 10,000 randomly selected normal databases, separately for each size of the normal database. Mean and 5th percentile of the performance measures over the 10,000 realizations were computed. Accuracy, sensitivity, and specificity when using the whole set of HC or non-neurodegenerative PS subjects as normal database were used as benchmark. RESULTS Mean loss of accuracy of the putamen SBR z-score was below 1% when the normal database included at least 15 subjects, independent of subject sample (PPMI or clinical), reconstruction method (filtered backprojection or OSEM), and ROI method (AAL or HV). However, the variability of the accuracy of the putamen SBR z-score decreased monotonically with increasing size of normal database and was still considerable at size 15. In order to achieve less than 5% "maximum" loss of accuracy (defined by the 5th percentile) in all settings required at least 25 to 30 subjects in the normal database. Reduction of mean and "maximum" loss of accuracy of the putamen SBR z-score by further increasing the size of the normal database was very small beyond size 40. CONCLUSIONS The results of this study suggest that 25 to 30 is the minimum size of the normal database to reliably achieve good performance of semi-quantitative analysis in dopamine transporter (DAT) SPECT, independent of the algorithm used for image reconstruction and the ROI method used to estimate the putaminal SBR.
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Affiliation(s)
- Helen Schmitz-Steinkrüger
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Catharina Lange
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ivayla Apostolova
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Holger Amthauer
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Wencke Lehnert
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Klutmann
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Ralph Buchert
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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EANM practice guideline/SNMMI procedure standard for dopaminergic imaging in Parkinsonian syndromes 1.0. Eur J Nucl Med Mol Imaging 2020; 47:1885-1912. [PMID: 32388612 PMCID: PMC7300075 DOI: 10.1007/s00259-020-04817-8] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 04/06/2020] [Indexed: 02/05/2023]
Abstract
Purpose This joint practice guideline or procedure standard was developed collaboratively by the European Association of Nuclear Medicine (EANM) and the Society of Nuclear Medicine and Molecular Imaging (SNMMI). The goal of this guideline is to assist nuclear medicine practitioners in recommending, performing, interpreting, and reporting the results of dopaminergic imaging in parkinsonian syndromes. Methods Currently nuclear medicine investigations can assess both presynaptic and postsynaptic function of dopaminergic synapses. To date both EANM and SNMMI have published procedural guidelines for dopamine transporter imaging with single photon emission computed tomography (SPECT) (in 2009 and 2011, respectively). An EANM guideline for D2 SPECT imaging is also available (2009). Since the publication of these previous guidelines, new lines of evidence have been made available on semiquantification, harmonization, comparison with normal datasets, and longitudinal analyses of dopamine transporter imaging with SPECT. Similarly, details on acquisition protocols and simplified quantification methods are now available for dopamine transporter imaging with PET, including recently developed fluorinated tracers. Finally, [18F]fluorodopa PET is now used in some centers for the differential diagnosis of parkinsonism, although procedural guidelines aiming to define standard procedures for [18F]fluorodopa imaging in this setting are still lacking. Conclusion All these emerging issues are addressed in the present procedural guidelines for dopaminergic imaging in parkinsonian syndromes.
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Vriend C, van Balkom TD, van Druningen C, Klein M, van der Werf YD, Berendse HW, van den Heuvel OA. Processing speed is related to striatal dopamine transporter availability in Parkinson's disease. Neuroimage Clin 2020; 26:102257. [PMID: 32344372 PMCID: PMC7186552 DOI: 10.1016/j.nicl.2020.102257] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/27/2020] [Accepted: 04/02/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Parkinson's disease (PD) affects the integrity of the dopamine and serotonin system, and is characterized by a plethora of different symptoms, including cognitive impairments of which the pathophysiology is not yet fully elucidated. OBJECTIVES Investigate the role of the integrity of the dopaminergic and serotonergic system in cognitive functioning in early-stage PD using Single Photon Emission Computed Tomography (SPECT) combined with the radiotracer 123I-N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane (123I-FP-CIT). METHODS We studied the association between cognitive functions and dopamine transporter (DAT) availability in the caudate nucleus and putamen - as a proxy for striatal dopaminergic integrity - and serotonin transporter (SERT) availability as a proxy for serotonergic integrity in the thalamus and hippocampus using bootstrapped multiple regression. One-hundred-and-twenty-nine (129) PD patients underwent a 123I-FP-CIT SPECT scan and a neuropsychological assessment. RESULTS We showed a positive association between DAT availability in the head of the caudate nucleus and the Stroop Color Word Task - card I (reading words; β = 0.32, P = 0.001) and a positive association between DAT availability in the anterior putamen and the Trail Making Test part A (connecting consecutively numbered circles; β = 0.25, P = 0.02). These associations remained after adjusting for motor symptom severity or volume of the region-of-interest and were most pronounced in medication-naïve PD patients. There were no associations between cognitive performance and SERT availability in the thalamus or hippocampus. CONCLUSIONS We interpret these results as a role for striatal dopamine - and its PD-related decline - in aspects of processing speed.
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Affiliation(s)
- Chris Vriend
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Anatomy and Neurosciences, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam 1007 MB, the Netherlands.
| | - Tim D van Balkom
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Corné van Druningen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Martin Klein
- Amsterdam UMC, Vrije Universiteit Amsterdam, Medical Psychology, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Ysbrand D van der Werf
- Amsterdam UMC, Vrije Universiteit Amsterdam, Anatomy and Neurosciences, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam 1007 MB, the Netherlands
| | - Henk W Berendse
- Amsterdam UMC, Vrije Universiteit Amsterdam, Neurology, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Odile A van den Heuvel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Anatomy and Neurosciences, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam 1007 MB, the Netherlands
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Sakamoto F, Shiraishi S, Ogasawara K, Tsuda N, Nakagawa M, Tomiguchi S, Yamashita Y. A diagnostic strategy for Lewy body disease using DAT-SPECT, MIBG and Combined index. Ann Nucl Med 2020; 34:415-423. [PMID: 32301068 DOI: 10.1007/s12149-020-01464-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/24/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE The functional imaging methods widely used for the diagnosis of Lewy body disease (LBD) are 123I-N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl) nortropan (FP-CIT) with dopamine transporter single photon emission computed tomography (DAT-SPECT) and 123I-iodobenzylguanidine (MIBG) myocardial scintigraphy. The aim of this study was to determine whether DAT-SPECT or 123I-MIBG myocardial scintigraphy should be examined first and to evaluate whether the combined use of DAT-SPECT and MIBG myocardial scintigraphy is superior to using either modality alone for diagnosing suspected LBD. METHODS In this retrospective study, a total of 117 patients suspected of having LBD underwent DAT-SPECT imaging followed by MIBG myocardial scintigraphy. The delayed heart-to-mediastinum (H/M) ratio of MIBG scintigraphy, and the specific binding ratio (SBR) of DAT-SPECT imaging, and Combined index (defined as SBR mean × H/M in the delayed phase) were used as semi-quantitative measures. The diagnostic ability was evaluated using these indexes. RESULTS The sensitivity, specificity, and accuracy of diagnosing Lewy body disease were 59.6%, 71.4%, and 67.5% by SBR mean of DAT-SPECT, 85.1%, 91.4%, and 88.9% by delayed H/M ratio of MIBG myocardial scintigraphy, 76.6%, 74.3%, and 75.2% by Combined index, respectively. CONCLUSION In the diagnosis of LBD, DAT-SPECT, MIBG myocardial scintigraphy, and Combined index may be reliable indices. In particular, MIBG myocardial scintigraphy was the specific modality for LBD diagnosis. Understanding the effectiveness and limits of DAT-SPECT and MIBG myocardial scintigraphy and using both properly will lead to a more accurate diagnosis and better treatment.
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Affiliation(s)
- Fumi Sakamoto
- Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Kumamoto, Kumamoto, 8608550, Japan. .,Department of Diagnostic Medical Imaging, School of Health Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
| | - Shinya Shiraishi
- Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Kumamoto, Kumamoto, 8608550, Japan
| | - Koji Ogasawara
- Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Kumamoto, Kumamoto, 8608550, Japan
| | - Noriko Tsuda
- Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Kumamoto, Kumamoto, 8608550, Japan
| | - Masataka Nakagawa
- Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Kumamoto, Kumamoto, 8608550, Japan
| | - Seiji Tomiguchi
- Department of Diagnostic Medical Imaging, School of Health Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yasuyuki Yamashita
- Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjyo, Kumamoto, Kumamoto, 8608550, Japan
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Maltais DD, Jordan LG, Min HK, Miyagawa T, Przybelski SA, Lesnick TG, Reichard RR, Dickson DW, Murray ME, Kantarci K, Boeve BF, Lowe VJ. Confirmation of 123I-FP-CIT SPECT Quantification Methods in Dementia with Lewy Bodies and Other Neurodegenerative Disorders. J Nucl Med 2020; 61:1628-1635. [PMID: 32198310 DOI: 10.2967/jnumed.119.239418] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 03/16/2020] [Indexed: 02/07/2023] Open
Abstract
Our rationale was to conduct a retrospective study comparing 3 123I-N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane (123I-FP-CIT) SPECT quantitative methods in patients with neurodegenerative syndromes as referenced to neuropathologic findings. Methods: 123I-FP-CIT-SPECT and neuropathologic findings among patients with neurodegenerative syndromes from the Mayo Alzheimer Disease Research Center and Mayo Clinic Study of Aging were examined. Three 123I-FP-CIT SPECT quantitative assessment methods-MIMneuro, DaTQUANT, and manual region-of-interest creation on a workstation-were compared with neuropathologic findings describing the presence or absence of Lewy body disease (LBD). Striatum-to-background ratios (SBRs) generated by DaTQUANT were compared with the calculated SBRs of the manual method and MIMneuro. The left and right SBRs for caudate, putamen, and striatum were evaluated with the manual method. For DaTQUANT and MIMneuro, the left, right, total, and average SBRs and z scores for whole striatum, caudate, putamen, anterior putamen, and posterior putamen were calculated. Results: The cohort included 24 patients (20 [83%] male, mean age for all patients at death, 75.4 ± 10.0 y). The antemortem clinical diagnoses were Alzheimer disease dementia (n = 6), probable dementia with Lewy bodies (n = 12), mixed Alzheimer disease dementia and probable dementia with Lewy bodies (n = 1), Parkinson disease with mild cognitive impairment (n = 2), corticobasal syndrome (n = 1), idiopathic rapid-eye-movement sleep behavior disorder (n = 1), and behavioral-variant frontotemporal dementia (n = 1). Seventeen (71%) had LBD. All 3 123I-FP-CIT SPECT quantitative methods had an area under the receiver-operating-characteristics curve ranging from more than 0.93 to up to 1.000 (P < 0.001) and showed excellent discrimination between LBD and non-LBD patients in each region assessed (P < 0.001). There was no significant difference between the accuracy of the regions in discriminating the 2 groups, with good discrimination for both caudate and putamen. Conclusion: All 3 123I-FP-CIT SPECT quantitative methods showed excellent discrimination between LBD and non-LBD patients in each region assessed, using both SBRs and z scores.
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Affiliation(s)
| | | | - Hoon-Ki Min
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Toji Miyagawa
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Scott A Przybelski
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Timothy G Lesnick
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Robert R Reichard
- Department of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota; and
| | | | | | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | | | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
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Fahmi R, Platsch G, Sadr AB, Gouttard S, Thobois S, Zuehlsdorff S, Scheiber C. Single-site 123I-FP-CIT reference values from individuals with non-degenerative parkinsonism-comparison with values from healthy volunteers. Eur J Hybrid Imaging 2020; 4:5. [PMID: 34191214 PMCID: PMC8218096 DOI: 10.1186/s41824-020-0074-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 01/29/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose Iodine 123-radiolabeled 2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane (123I-FP-CIT) SPECT can be performed to distinguish degenerative forms of movement disorders/parkinsonism/tremor from other entities such as idiopathic tremor or drug-induced parkinsonism. For equivocal cases, semi-quantification and comparison to reference values are a necessary addition to visual interpretation of 123I-FP-CIT scans. To overcome the challenges of multi-center recruitment and scanning of healthy volunteers, we generated 123I-FP-CIT reference values from individuals with various neurological conditions but without dopaminergic degeneration, scanned at a single center on the same SPECT-CT system following the same protocol, and compared them to references from a multi-center database built using healthy volunteers’ data. Methods From a cohort of 1884 patients, we identified 237 subjects (120 men, 117 women, age range 16–88 years) through a two-stage selection process. Every patient had a final clinical diagnosis after a mean follow-up of 4.8 ± 1.3 years. Images were reconstructed using (1) Flash3D with scatter and CT-based attenuation corrections (AC) and (2) filtered back projection with Chang AC. Volume-of-interest analysis was performed using a commercial software to calculate specific binding ratios (SBRs), caudate-to-putamen ratios, and asymmetry values on different striatal regions. Generated reference values were assessed according to age and gender and compared with those from the ENC-DAT study, and their robustness was tested against a cohort of patients with different diagnoses. Results Age had a significant negative linear effect on all SBRs. Overall, the reduction rate per decade in SBR was between 3.80 and 5.70%. Women had greater SBRs than men, but this gender difference was only statistically significant for the Flash3D database. Linear regression was used to correct for age-dependency of SBRs and to allow comparisons to age-matched reference values and “normality” limits. Generated regression parameters and their 95% confidence intervals (CIs) were comparable to corresponding European Normal Control Database of DaTscan (ENC-DAT) results. For example, 95% CI mean slope for the striatum in women is − 0.015 ([− 0.019, − 0.011]) for the Flash3D database versus − 0.015 ([− 0.021, − 0.009]) for ENC-DAT. Caudate-to-putamen ratios and asymmetries were not influenced by age or gender. Conclusion The generated 123I-FP-CIT references values have similar age-related distribution, with no increase in variance due to comorbidities when compared to values from a multi-center study with healthy volunteers. This makes it possible for sites to build their 123I-FP-CIT references from scans acquired during routine clinical practice.
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Affiliation(s)
- Rachid Fahmi
- Siemens Medical Solutions USA, Inc., Molecular Imaging, Knoxville, TN, USA
| | | | | | | | - Stephane Thobois
- Movement Disorder Clinic, Pierre Wertheimer Neurologic Hospital, Hospices Civils de Lyon, 69500, Bron, France.,Faculté de Médecine Lyon Sud, Université Claude Bernard Lyon 1, Lyon, France.,Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, CNRS, Bron, France
| | - Sven Zuehlsdorff
- Siemens Medical Solutions USA, Inc., Molecular Imaging, Knoxville, TN, USA
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81
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Nigrostriatal Degeneration in the Cognitive Part of the Striatum in Parkinson Disease Is Associated With Frontomedial Hypometabolism. Clin Nucl Med 2020; 45:95-99. [PMID: 31876812 DOI: 10.1097/rlu.0000000000002869] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE The present study investigated possible associations between cortical dysfunction/degeneration as measured by F-FDG PET and nigrostriatal degeneration according to the specific I-FP-CIT binding ratio (SBR) in striatal subregions defined by striato-cortical anatomical connectivity in Parkinson disease (PD) patients. MATERIALS AND METHODS The study included 41 patients (61.4 ± 12.8 years) with PD-typical reduction of striatal FP-CIT SBR and no sign of atypical parkinsonian syndrome on FDG PET. FP-CIT SBR was determined separately in the cognitive (composite of executive and limbic) and sensorimotor part of the striatum according to the Oxford-GSK-Imanova Striatal Connectivity Atlas. Scaled FDG uptake was tested voxelwise for correlation with FP-CIT SBR (familywise error corrected P < 0.05). RESULTS A large cluster (17.6 mL) of significant correlation of scaled FDG uptake with FP-CIT SBR in the cognitive part of the striatum, corrected for SBR in the sensorimotor part, was detected in the bilateral medial frontal cortex and the anterior cingulate cortex (partial correlation coefficient R = 0.767); small clusters were detected in ipsilateral caudate and ipsilateral thalamus. There was a small contralateral occipital cluster (3.0 mL) of significant correlation between FDG uptake and sensorimotor SBR corrected for cognitive SBR (R = 0.709). CONCLUSIONS The correlation between nigrostriatal degeneration in the cognitive striatum and reduced cerebral glucose metabolism in the medial parts of the frontal cortex including the anterior cingulate suggests that nigrostriatal degeneration is specifically involved in the pathogenesis of cognitive deficits associated with medial frontal dysfunction such as impaired inhibitory control.
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82
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Arnaldi D, Chincarini A, De Carli F, Famà F, Girtler N, Brugnolo A, Pardini M, Massa F, Meli R, Schenone C, Bauckneht M, Morbelli S, Nobili F. The fate of patients with REM sleep behavior disorder and mild cognitive impairment. Sleep Med 2020; 79:205-210. [PMID: 32451160 DOI: 10.1016/j.sleep.2020.02.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 07/22/2019] [Accepted: 02/17/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate clinical and dopaminergic pre-synaptic brain imaging characteristics of subjects with idiopathic rapid eye movement (REM) behavior disorder (iRBD) and mild cognitive impairment (MCI), and to evaluate the combined predictive value of risk factors for short-term conversion to synucleinopathy. METHOD In sum, 44 polysomnography (PSG)-confirmed iRBD patients (68.5 ± 7.2 years; 38 males) underwent 123I-FP-CIT-SPECT, comprehensive neuropsychological evaluation, clinical examination and clinical follow-up every six months (30.6 ± 21.5 months). Step-wise logistic regression was applied to identify those features discriminating iRBD patients with (iRBD-MCI; n = 14) and without MCI (normal cognition [NC], iRBD-NC; n = 30). The risk of neurodegeneration was estimated with Kaplan-Meier analysis. Predictors of phenoconversion were assessed with Cox proportional-hazards analysis, adjusting for age, gender and education. A generalized linear model (GLM) was applied to define the best combination of risk factors predicting conversion at follow-up. RESULTS At baseline, patients with iRBD-MCI showed reduced striatal dopamine transporter (DAT) specific to non-displaceable binding ratio (SBR) and more constipation compared with iRBD-NC patients (p < 0.0001). During the follow-up, 10 patients (22.7%) develop an overt synucleinopathy. GLM analysis showed that patients with orthostatic hypotension, non-motor experiences of daily living, reduced putaminal DAT-SPECT SBR, and cognitive impairment in verbal memory/visuoconstruction abilities were at higher risk of phenoconversion (Hazard Ratio [HR] 26.05; Sensitivity 90%; Specificity 100%; Accuracy 97.73%; Positive Predictive Value 100%; Negative Predictive Value 97.14%). CONCLUSIONS iRBD-MCI patients showed a more severe dopaminergic neuroimaging and clinical phenotype. Combining clinical and neuroimaging markers allowed to achieve excellent ability in identifying iRBD patients at high risk of developing a synucleinopathy within about three years from diagnosis.
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Affiliation(s)
- Dario Arnaldi
- Clinical Neurology, Dept. of Neuroscience (DINOGMI), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Andrea Chincarini
- National Institute of Nuclear Physics (INFN), Genoa Section, Genoa, Italy
| | - Fabrizio De Carli
- Institute of Molecular Bioimaging and Physiology, National Research Council, Genoa, Italy
| | - Francesco Famà
- Clinical Neurology, Dept. of Neuroscience (DINOGMI), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Nicola Girtler
- Clinical Neurology, Dept. of Neuroscience (DINOGMI), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Brugnolo
- Clinical Neurology, Dept. of Neuroscience (DINOGMI), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Pardini
- Clinical Neurology, Dept. of Neuroscience (DINOGMI), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Federico Massa
- Clinical Neurology, Dept. of Neuroscience (DINOGMI), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Riccardo Meli
- Clinical Neurology, Dept. of Neuroscience (DINOGMI), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Cristina Schenone
- Clinical Neurology, Dept. of Neuroscience (DINOGMI), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Bauckneht
- Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Silvia Morbelli
- Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Flavio Nobili
- Clinical Neurology, Dept. of Neuroscience (DINOGMI), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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83
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Determination of Parkinson Disease Laterality After Deep Brain Stimulation Using 123I FP-CIT SPECT. Clin Nucl Med 2020; 45:e178-e184. [DOI: 10.1097/rlu.0000000000002955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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84
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Quantitative SPECT: a survey of current practice in the UK Nuclear Medicine Community. Nucl Med Commun 2020; 40:986-994. [PMID: 31343611 DOI: 10.1097/mnm.0000000000001059] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Nuclear Medicine is a quantitative imaging modality. However, until recently, quantitative single photon emission computed tomography (SPECT) has been limited to ratios or comparisons to databases, or indeed volume measurements, and therefore has not truly quantified uptake in areas of interest. Following the growth of dosimetry associated with nuclear medicine therapies, tools to perform quantitative SPECT in terms of kBq/cc or standardised uptake value (SUV) have become more readily available, although its use does not appear to be widespread. The aim of this study was to get a snapshot of quantitative SPECT use, and to determine where the future of this technology may lie. METHODS The data for this survey were collected through a web-based form made available at a national quantitative SPECT meeting, and later distributed to the UK nuclear medicine community. A series of questions looking at current practice, technique and future thoughts were presented to respondents in the form of multiple-choice questions where single and multiple selections could be made. RESULTS The responses showed significant use of quantitative SPECT for established techniques, in alignment with the prevalence of the relevant imaging studies. There was a significant minority of respondents performing kBq/cc and SUV SPECT, and SPECT for radionuclide therapy dosimetry. Technique for quantitative SPECT varied significantly typically but nevertheless the predicted future for quantitative SPECT was positive: particularly for kBq/cc and SUV SPECT. Impediments to the success of the technology were mostly around software availability and uncertainties around usefulness. CONCLUSION The results of this survey suggest that the future of truly quantitative SPECT looks promising.
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Shiiba T, Arimura Y, Nagano M, Takahashi T, Takaki A. Improvement of classification performance of Parkinson's disease using shape features for machine learning on dopamine transporter single photon emission computed tomography. PLoS One 2020; 15:e0228289. [PMID: 31978154 PMCID: PMC6980558 DOI: 10.1371/journal.pone.0228289] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 01/10/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To assess the classification performance between Parkinson's disease (PD) and normal control (NC) when semi-quantitative indicators and shape features obtained on dopamine transporter (DAT) single photon emission computed tomography (SPECT) are combined as a feature of machine learning (ML). METHODS A total of 100 cases of both PD and normal control (NC) from the Parkinson's Progression Markers Initiative database were evaluated. A summed image was generated and regions of interests were set to the left and right striata. Area, equivalent diameter, major axis length, minor axis length, perimeter and circularity were calculated as shape features. Striatum binding ratios (SBRputamen and SBRcaudate) were used as comparison features. The classification performance of the PD and NC groups according to receiver operating characteristic analysis of the shape features was compared in terms of SBRs. Furthermore, we compared the classification performance of ML when shape features or SBRs were used alone and in combination. RESULTS The shape features (except minor axis length) and SBRs indicated significant differences between the NC and PD groups (p < 0.05). The top five areas under the curves (AUC) were as follows: circularity (0.972), SBRputamen (0.972), major axis length (0.945), SBRcaudate (0.928) and perimeter (0.896). When classification was done using ML, AUC was as follows: circularity and SBRs (0.995), circularity alone (0.990), and SBRs (0.973). The classification performance was significantly improved by combining SBRs and circularity than by SBRs alone (p = 0.018). CONCLUSION We found that the circularity obtained from DAT-SPECT images could help in distinguishing NC and PD. Furthermore, the classification performance of ML was significantly improved using circularity in SBRs together.
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Affiliation(s)
- Takuro Shiiba
- Department of Radiological Technology, Faculty of Fukuoka Medical Technology, Teikyo University, Misakimachi, Omuta-shi, Fukuoka, Japan
| | - Yuki Arimura
- Department of Radiology, Kokura Medical Center, Harugaoka, Kokura Minami-ku, Kitakyushu-shi, Fukuoka, Japan
| | - Miku Nagano
- Department of Radiology, University of Miyazaki Hospital, Kihara, Kiyotake-cho, Miyazaki-shi, Miyazaki, Japan
| | - Tenma Takahashi
- Department of Radiology, University of Miyazaki Hospital, Kihara, Kiyotake-cho, Miyazaki-shi, Miyazaki, Japan
| | - Akihiro Takaki
- Department of Radiological Technology, Faculty of Fukuoka Medical Technology, Teikyo University, Misakimachi, Omuta-shi, Fukuoka, Japan
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Suwijn SR, Samim H, Eggers C, Espay AJ, Fox S, Lang AE, Samuel M, Silverdale M, Verschuur CV, Dijk JM, Verberne HJ, Booij J, de Bie RMA. Value of Clinical Signs in Identifying Patients with Scans without Evidence of Dopaminergic Deficit (SWEDD). JOURNAL OF PARKINSON'S DISEASE 2020; 10:1561-1569. [PMID: 32597819 PMCID: PMC7683040 DOI: 10.3233/jpd-202090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/06/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND In clinical trials that recruited patients with early Parkinson's disease (PD), 4-15% of the participants with a clinical diagnosis of PD had normal dopamine transporter single photon emission computed tomography (DAT SPECT) scans, also called "scans without evidence of dopaminergic deficit" (SWEDD). OBJECTIVE To investigate in patients with a clinical diagnosis of PD, if specific clinical features are useful to distinguish patients with nigrostriatal degeneration from those that have no nigrostriatal degeneration. METHODS We performed a diagnostic test accuracy study. Patients that participated in the Levodopa in Early Parkinson's disease trial, a clinical trial in patients with early PD, were asked to participate if they had not undergone DAT SPECT imaging earlier. The index tests were specific clinical features that were videotaped. A panel of six neurologists in training (NT), six general neurologists (GN), and six movement disorders experts (MDE) received a batch of ten videos consisting of all SWEDD subjects and a random sample of patients with abnormal DAT SPECT scans. The raters analyzed the videos for presence of specific signs and if they suspected the patient to have SWEDD. The reference test was visually assessed DAT SPECT imaging. RESULTS Of a total of 87 participants, three subjects were SWEDDs (3.4%). The overall intraclass correlation coefficient (ICC) of the Parkinsonian signs was poor to moderate with ICCs ranging from 0.14 to 0.67. NT correctly identified 50.0% of the SWEDD subjects, GN 33.3%, and MDE 66.7%. CONCLUSION Our study suggests that the selected videotaped clinical features cannot reliably distinguish patients with a clinical diagnosis of PD and an abnormal DAT SPECT from patients with clinical PD and a SWEDD.
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Affiliation(s)
- Sven R. Suwijn
- Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Hamdia Samim
- Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Carsten Eggers
- Department of Neurology, University Medical Center Gießen und Marburg, Marburg, Germany
| | - Alberto J. Espay
- James J. and Joan A. Gardner Family Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, OH, USA
| | - Susan Fox
- Edmond J. Safra Program in Parkinson’s Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University of Toronto, Toronto, Canada
| | - Anthony E. Lang
- Edmond J. Safra Program in Parkinson’s Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University of Toronto, Toronto, Canada
| | - Mike Samuel
- Department of Neurology, National Parkinson Foundation Centre Of Excellence, King’s College Hospital, London, United Kingdom
| | - Monty Silverdale
- Salford Royal NHS Foundation Trust, University of Manchester, Manchester, United Kingdom
| | - Constant V.M. Verschuur
- Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Department of Neurology, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Joke M. Dijk
- Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Hein J. Verberne
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan Booij
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Rob M. A. de Bie
- Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
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Papanastasiou E, Katsiva C, Doumas A, Gerasimou G, Siountas A. The effect of scatter correction and radius of rotation on semiquantitative measurements in SPECT 123I-FP-CIT imaging. A phantom study. Phys Med 2020; 69:120-125. [DOI: 10.1016/j.ejmp.2019.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/07/2019] [Accepted: 12/10/2019] [Indexed: 10/25/2022] Open
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Frings L, Henninger F, Treppner M, Köber G, Boeker M, Hellwig S, Buchert R, Meyer PT. [123I]FP-CIT SPECT in Clinically Uncertain Parkinsonism Predicts Survival: A Data-Driven Analysis. JOURNAL OF PARKINSON'S DISEASE 2020; 10:1457-1465. [PMID: 33044193 DOI: 10.3233/jpd-202214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Dopamine transporter SPECT is an established method to investigate nigrostriatal integrity in case of clinically uncertain parkinsonism. OBJECTIVE The present study explores whether a data-driven analysis of [123I]FP-CIT SPECT is able to stratify patients according to mortality after SPECT. METHODS Patients from our clinical registry were included if they had received [123I]FP-CIT SPECT between 10/2008 and 06/2016 for diagnosis of parkinsonism and if their vital status could be determined in 07/2017. Specific binding ratios (SBR) of the whole striatum, its asymmetry (asymmetry index, AI; absolute value), and the rostrocaudal gradient of striatal binding (C/pP: caudate SBR divided by posterior putamen SBR) were used as input for hierarchical clustering of patients. We tested differences in survival between these groups (adjusted for age) with a Cox proportional hazards model. RESULTS Data from 518 patients were analyzed. Median follow-up duration was 3.3 years [95% C.I. 3.1 to 3.7]. Three subgroups identified by hierarchical clustering were characterized by relatively low striatal SBR, high AI, and low C/pP (group 1), low striatal SBR, high AI, and high C/pP (group 2), and high striatal SBR, low AI, and low C/pP (group 3). Mortality was significantly higher in group 1 compared to each of the other two groups (p = 0.029 and p = 0.003, respectively). CONCLUSION Data-driven analysis of [123I]FP-CIT SPECT identified a subgroup of patients with significantly increased mortality during follow-up. This suggests that [123I]-FP-CIT SPECT might not only serve as a diagnostic tool to verify nigrostriatal degeneration but also provide valuable prognostic information.
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Affiliation(s)
- Lars Frings
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Franziska Henninger
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Martin Treppner
- Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Göran Köber
- Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Martin Boeker
- Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sabine Hellwig
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ralph Buchert
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Philipp T Meyer
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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A visual rating scale for cingulate island sign on 18F-FDG-PET to differentiate dementia with Lewy bodies and Alzheimer's disease. J Neurol Sci 2019; 410:116645. [PMID: 31911283 DOI: 10.1016/j.jns.2019.116645] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/17/2019] [Accepted: 12/21/2019] [Indexed: 12/27/2022]
Abstract
Valid diagnosis of dementia with Lewy bodies (DLB) is essential to establish appropriate treatment and care. However, the diagnostic accuracy is complicated by clinical and pathological overlap with Alzheimer's disease (AD). Cingulate island sign (CIS), defined as sparing of posterior cingulate cortex (PCC) relative to precuneus and cuneus on 18F-fluoro-deoxy-glucose positron emission tomography (18F-FDG-PET), is included in the revised diagnostic DLB criteria. There are no guidelines for the visual grading of CIS, although visual rating is a fast-applicable method in a clinical setting. The objective was to develop a robust visual CIS scale and evaluate the performance in differentiating DLB with and without amyloid beta pathology (Aβ+/-), and AD. 18F-FDG-PET scans from 35 DLB patients, 36 AD patients, and 23 healthy controls were rated according to a visual CIS scale based on specific reading criteria. The visual CIS scale was validated against a quantitative CIS ratio derived from a region of interest analysis of PCC, precuneus, and cuneus. DLB patients had a significantly higher visual CIS score compared to AD patients, and controls. A cut-off visual CIS score of 4 significantly differentiated DLB Aβ- patients from DLB Aβ+ patients. In conclusion, the visual CIS scale is clinically useful to differentiate DLB from AD. The degree of CIS may be related to Aβ pathology in DLB patients.
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90
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Könik A, Auer B, De Beenhouwer J, Kalluri K, Zeraatkar N, Furenlid LR, King MA. Primary, scatter, and penetration characterizations of parallel-hole and pinhole collimators for I-123 SPECT. Phys Med Biol 2019; 64:245001. [PMID: 31746783 DOI: 10.1088/1361-6560/ab58fe] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Multi-pinhole (MPH) collimators are known to provide better trade-off between sensitivity and resolution for preclinical, as well as for smaller regions in clinical SPECT imaging compared to conventional collimators. In addition to this geometric advantage, MPH plates typically offer better stopping power for penetration than the conventional collimators, which is especially relevant for I-123 imaging. The I-123 emits a series of high-energy (>300 keV, ~2.5% abundance) gamma photons in addition to the primary emission (159 keV, 83% abundance). Despite their low abundance, high-energy photons penetrate through a low-energy parallel-hole (LEHR) collimator much more readily than the 159 keV photons, resulting in large downscatter in the photopeak window. In this work, we investigate the primary, scatter, and penetration characteristics of a single pinhole collimator that is commonly used for I-123 thyroid imaging and our two MPH collimators designed for I-123 DaTscan imaging for Parkinson's Disease, in comparison to three different parallel-hole collimators through a series of experiments and Monte Carlo simulations. The simulations of a point source and a digital human phantom with DaTscan activity distribution showed that our MPH collimators provide superior count performance in terms of high primary counts, low penetration, and low scatter counts compared to the parallel-hole and single pinhole collimators. For example, total scatter, multiple scatter, and collimator penetration events for the LEHR were 2.5, 7.6 and 14 times more than that of MPH within the 15% photopeak window. The total scatter fraction for LEHR was 56% where the largest contribution came from the high-energy scatter from the back compartments (31%). For the same energy window, the total scatter for MPH was 21% with only 1% scatter from the back compartments. We therefore anticipate that using MPH collimators, higher quality reconstructions can be obtained in a substantially shorter acquisition time for I-123 DaTscan and thyroid imaging.
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Affiliation(s)
- Arda Könik
- Department of Imaging, Dana Farber Cancer Institute, Boston, MA 02215, United States of America
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91
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Pharmacokinetic evaluation of [18F]PR04.MZ for PET/CT imaging and quantification of dopamine transporters in the human brain. Eur J Nucl Med Mol Imaging 2019; 47:1927-1937. [DOI: 10.1007/s00259-019-04594-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/23/2019] [Indexed: 11/26/2022]
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92
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Okizaki A, Yamamoto W, Saito W, Miyano T, Kimura T, Suzuki Y, Nakayama M. An investigation of asymmetric reduction in dopamine transporter density in patients with Parkinson’s disease. Nucl Med Commun 2019; 40:1187-1192. [DOI: 10.1097/mnm.0000000000001087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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93
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Dušek P, Ibarburu VLYL, Bezdicek O, Dall'antonia I, Dostálová S, Kovalská P, Krupička R, Nepožitek J, Nikolai T, Novotný M, Peřinová P, Rusz J, Serranová T, Tykalová T, Ulmanová O, Mecková Z, Ptáčník V, Trnka J, Zogala D, Růžička E, Šonka K. Relations of non-motor symptoms and dopamine transporter binding in REM sleep behavior disorder. Sci Rep 2019; 9:15463. [PMID: 31664065 PMCID: PMC6820530 DOI: 10.1038/s41598-019-51710-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 10/07/2019] [Indexed: 01/15/2023] Open
Abstract
The aim of this study was to evaluate associations of motor and non-motor symptoms with dopamine transporter binding in prodromal stage of synucleinopathies. We examined 74 patients with idiopathic REM sleep behavior disorder (RBD), which is a prodromal synucleinopathy, and 39 controls using Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), Montreal Cognitive Assessment, University of Pennsylvania Smell Identification Test (UPSIT), Farnsworth-Munsell 100 hue test, orthostatic test, Scales for Outcomes in PD-Autonomic, Beck depression inventory-II, State-Trait Anxiety Inventory, and video-polysomnography. Electromyographic muscle activity during REM sleep was quantified according to Sleep Innsbruck-Barcelona criteria. In 65 patients, dopamine transporter single-photon emission computed tomography (DAT-SPECT) imaging was performed, putaminal binding ratio was calculated and scans were classified as normal, borderline, or abnormal. Compared to controls, RBD patients had significantly more severe scores in all examined tests. Patients with abnormal DAT-SPECT had higher MDS-UPDRS motor score (p = 0.006) and higher prevalence of orthostatic hypotension (p = 0.008). Putaminal binding ratio was positively associated with UPSIT score (p = 0.03) and negatively associated with tonic (p = 0.003) and phasic (p = 0.01) muscle activity during REM sleep. These associations likely reflect simultaneous advancement of underlying pathology in substantia nigra and susceptible brainstem and olfactory nuclei in prodromal synucleinopathy.
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Affiliation(s)
- Petr Dušek
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
| | - Veronika Lorenzo Y Losada Ibarburu
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Ondrej Bezdicek
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Irene Dall'antonia
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Simona Dostálová
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Petra Kovalská
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Radim Krupička
- Department of Biomedical Informatics, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
| | - Jiří Nepožitek
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Tomáš Nikolai
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Michal Novotný
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Pavla Peřinová
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jan Rusz
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.,Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Tereza Serranová
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Tereza Tykalová
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Olga Ulmanová
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Zuzana Mecková
- Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Václav Ptáčník
- Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jiří Trnka
- Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - David Zogala
- Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Evžen Růžička
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Karel Šonka
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
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Illés A, Balicza P, Molnár V, Bencsik R, Szilvási I, Molnar MJ. Dynamic interaction of genetic risk factors and cocaine abuse in the background of Parkinsonism - a case report. BMC Neurol 2019; 19:260. [PMID: 31660902 PMCID: PMC6816197 DOI: 10.1186/s12883-019-1496-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 10/13/2019] [Indexed: 11/16/2022] Open
Abstract
Background Parkinsonism is a complex multifactorial neurodegenerative disorder, in which genetic and environmental risk factors may both play a role. Among environmental risk factors cocaine was earlier ambiguously linked to Parkinsonism. Former single case reports described Parkinsonism in chronic cocaine users, but an epidemiological study did not confirm an increased risk of Parkinson’s disease. Here we report a patient, who developed Parkinsonism in young age after chronic cocaine use, in whom a homozygous LRRK2 risk variant was also detected. Case presentation The patient was investigated because of hand tremor, which started after a 1.5-year period of cocaine abuse. Neurological examination suggested Parkinsonism, and asymmetrical pathology was confirmed by the dopamine transporter imaging study. The genetic investigations revealed a homozygous risk allele in the LRRK2 gene. After a period of cocaine abstinence, the patient’s symptoms spontaneously regressed, and the dopamine transporter imaging also returned to near-normal. Conclusions This case report suggests that cocaine abuse indeed might be linked to secondary Parkinsonism and serves as an example of a potential gene-environmental interaction between the detected LRRK2 risk variant and cocaine abuse. The reversible nature of the DaTscan pathology is a unique feature of this case, and needs further evaluation, whether this is incidental or can be a feature of cocaine related Parkinsonism.
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Affiliation(s)
- Anett Illés
- Institute of Genomic Medicine and Rare Disorders, Semmelweis University, Budapest, Hungary
| | - Péter Balicza
- Institute of Genomic Medicine and Rare Disorders, Semmelweis University, Budapest, Hungary
| | - Viktor Molnár
- Institute of Genomic Medicine and Rare Disorders, Semmelweis University, Budapest, Hungary
| | - Renáta Bencsik
- Institute of Genomic Medicine and Rare Disorders, Semmelweis University, Budapest, Hungary
| | - István Szilvási
- Department of Nuclear Medicine, Hungarian Defence Force Medical Center, Budapest, Hungary
| | - Maria Judit Molnar
- Institute of Genomic Medicine and Rare Disorders, Semmelweis University, Budapest, Hungary.
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95
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Pettorruso M, Martinotti G, Cocciolillo F, De Risio L, Cinquino A, Di Nicola M, Camardese G, Migliara G, Moccia L, Conte E, Janiri L, Di Giuda D. Striatal presynaptic dopaminergic dysfunction in gambling disorder: A 123 I-FP-CIT SPECT study. Addict Biol 2019; 24:1077-1086. [PMID: 30226290 DOI: 10.1111/adb.12677] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 05/11/2018] [Accepted: 08/01/2018] [Indexed: 01/17/2023]
Abstract
Although the involvement of dopamine in gambling disorder (GD) has long been hypothesized, its precise role remains unclear. The action of dopamine in the synapses is regulated by the dopamine transporter (DAT). We hereinafter present significant differences between a sample of 15 treatment-seeking GD subjects and 17 healthy controls in terms of striatal DAT availability, and we explore its association with reward-based decision making. We performed 123 I-FP-CIT Single-photon emission computed tomography (SPECT) and correlated DAT binding ratios in the bilateral caudate and putamen with gambling symptoms (G-SAS, PG-YBOCS) and behaviors, as well as other psychometric variables (anhedonia and impulsivity). Gambling disorder (GD) subjects were also administered a computerized version of the Iowa gambling task (IGT) to assess reward-based decision making. We found reduced DAT availability in GD subjects compared with healthy controls (-13.30% in right caudate, -11.11% in right putamen, -11.44% in left caudate, and -11.46% in the left putamen). We also found that striatal DAT availability was inversely correlated with days spent gambling and IGT performance in GD subjects. These results provide evidence for a presynaptic dopaminergic dysfunction in striatal regions of GD subjects. Functional DAT down-regulation possibly sustains the transition towards compulsive gambling addiction, characterized both by hyperdopaminergic and hypodopaminergic states in the context of a sensitized dopaminergic system.
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Affiliation(s)
- Mauro Pettorruso
- Institute of Psychiatry and Psychology; Fondazione Policlinico Universitario “A. Gemelli” Università Cattolica del Sacro Cuore; Rome Italy
| | - Giovanni Martinotti
- Department of Neuroscience Imaging and Clinical Science, “G. d'Annunzio” University of Chieti, Italy; Department of Pharmacy, Pharmacology and Clinical Science; University of Hertfordshire; Herts UK
| | - Fabrizio Cocciolillo
- Institute of Nuclear Medicine; Fondazione Policlinico Universitario “A. Gemelli” Università Cattolica del Sacro Cuore; Rome Italy
| | - Luisa De Risio
- Institute of Psychiatry and Psychology; Fondazione Policlinico Universitario “A. Gemelli” Università Cattolica del Sacro Cuore; Rome Italy
| | - Annarita Cinquino
- Institute of Nuclear Medicine; Fondazione Policlinico Universitario “A. Gemelli” Università Cattolica del Sacro Cuore; Rome Italy
| | - Marco Di Nicola
- Institute of Psychiatry and Psychology; Fondazione Policlinico Universitario “A. Gemelli” Università Cattolica del Sacro Cuore; Rome Italy
| | - Giovanni Camardese
- Institute of Psychiatry and Psychology; Fondazione Policlinico Universitario “A. Gemelli” Università Cattolica del Sacro Cuore; Rome Italy
| | - Giuseppe Migliara
- Department of Public Health and Infectious Diseases; Sapienza University of Rome; Rome Italy
| | - Lorenzo Moccia
- Institute of Psychiatry and Psychology; Fondazione Policlinico Universitario “A. Gemelli” Università Cattolica del Sacro Cuore; Rome Italy
| | - Eliana Conte
- Institute of Psychiatry and Psychology; Fondazione Policlinico Universitario “A. Gemelli” Università Cattolica del Sacro Cuore; Rome Italy
| | - Luigi Janiri
- Institute of Psychiatry and Psychology; Fondazione Policlinico Universitario “A. Gemelli” Università Cattolica del Sacro Cuore; Rome Italy
| | - Daniela Di Giuda
- Institute of Nuclear Medicine; Fondazione Policlinico Universitario “A. Gemelli” Università Cattolica del Sacro Cuore; Rome Italy
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96
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Wenzel M, Milletari F, Krüger J, Lange C, Schenk M, Apostolova I, Klutmann S, Ehrenburg M, Buchert R. Automatic classification of dopamine transporter SPECT: deep convolutional neural networks can be trained to be robust with respect to variable image characteristics. Eur J Nucl Med Mol Imaging 2019; 46:2800-2811. [DOI: 10.1007/s00259-019-04502-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 08/22/2019] [Indexed: 01/29/2023]
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97
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Suwijn SR, Verschuur CVM, Slim MA, Booij J, de Bie RMA. Reliability of visual assessment by non-expert nuclear medicine physicians and appropriateness of indications of [ 123I]FP-CIT SPECT imaging by neurologists in patients with early drug-naive Parkinson's disease. EJNMMI Res 2019; 9:63. [PMID: 31342202 PMCID: PMC6656843 DOI: 10.1186/s13550-019-0537-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 07/16/2019] [Indexed: 11/10/2022] Open
Abstract
Purpose To determine the reliability of visual assessment of [123I]FP-CIT SPECT imaging by non-experts in dopamine transporter (DAT) SPECT imaging in patients with early drug-naive Parkinson’s disease (PD). Also, we explored the indications of DAT SPECT imaging in clinical practice by neurologists. Methods We collected [123I]FP-CIT SPECT scans of the Levodopa in EArly Parkinson’s disease (LEAP) trial participants that were made prior to recruitment, as part of routine clinical work-up. All scans were reassessed by an expert in DAT imaging. A survey on the use of DAT SPECT imaging was sent to all referring neurologists. Results The concordance of the initial local assessment and the expert reassessment was 98.7%. The survey showed that neurologists requested DAT SPECT imaging in only 73.6% of patients to differentiate between a neurodegenerative disease and non-neurodegenerative parkinsonism. Conclusions Visual assessment of [123I]FP-CIT SPECT imaging by community nuclear medicine physicians in patients with early PD is reliable. Neurologists who request DAT SPECT scans are not always aware that the high accuracy is limited only to the differentiation between neurodegenerative and non-neurodegenerative parkinsonism. A significant portion of neurologists who request DAT SPECT scans is not always aware that the high accuracy is limited to the differentiation between neurodegenerative and non-neurodegenerative parkinsonism as DAT SPECT cannot reliably distinguish the various Parkinsonian syndromes.
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Affiliation(s)
- Sven R Suwijn
- Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
| | - Constant V M Verschuur
- Department of Neurology, Albert Schweitzer Hospital, PO BOX 444, 3300 AK, Dordrecht, The Netherlands
| | - Marleen A Slim
- Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, PO Box 22660, 1100 DD, Amsterdam, The Netherlands
| | - Jan Booij
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, PO Box 22660, 1100DD, Amsterdam, The Netherlands
| | - Rob M A de Bie
- Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, PO Box 22660, 1100 DD, Amsterdam, The Netherlands
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98
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Matsutomo N, Takano E, Yamamoto T, Sato E. Continuous Repetitive Data Acquisition with 123I-FP-CIT SPECT: Effects of Rotation Speed and Rotation Time. J Nucl Med Technol 2019; 47:319-325. [PMID: 31182658 DOI: 10.2967/jnmt.119.228783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 05/13/2019] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to evaluate the effects of the acquisition rotation speed and the rotation time for continuous repetitive rotation acquisition (CRRA) on image quality and quantification in 123I-FP-CIT SPECT. Methods: An anthropomorphic striatal phantom filled with 123I solution was acquired with CRRA and the step-and-shoot (SS) mode. The following combinations of acquisition rotation speed and rotation time for CRRA were used: 0.50 rpm by 30 frames, 0.17 rpm by 10 frames, 0.10 rpm by 6 frames, and 0.05 rpm by 3 frames. SPECT images were reconstructed using ordered-subset expectation maximization with resolution recovery, scatter, and CT-based attenuation correction. Two kinds of image processing patterns-image reconstruction after the addition of projection data (the added-projection-data process) and image addition after data reconstruction (the added-reconstructed-image process)-were investigated in this study. The effects of the acquisition parameters and the image processes were evaluated by the full width at half maximum, percentage coefficient of variation (%CV), and specific binding ratio (SBR). Results: With full width at half maximum, there were no clear differences between CRRA images obtained with the various rotation speeds before rotation and the SS mode. Although the combination of a slow rotation speed and a short rotation time improved image uniformity compared with the SS mode, the %CV obtained by CRRA increased as the rotation speed increased. The %CVs were 11.9% ± 0.9% for 0.50 rpm by 30 frames, 6.9% ± 0.9% for 0.05 rpm by 3 frames, and 9.6% ± 0.5% for SS mode. SBRs obtained by CRRA with the added-projection-data process were equal to those obtained by SS mode. However, SBRs obtained with the added-reconstructed-image process were clearly decreased compared with the SS mode. Conclusion: The combination of rotation speed and rotation times affects the image quality and quantification of 123I-FP-CIT SPECT using CRRA. When CRRA is applied in 123I-FP-CIT SPECT, it is necessary to use added-projection-data processes and proper rotation speeds (e.g., 0.10-0.17 rpm rotation speed).
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Affiliation(s)
- Norikazu Matsutomo
- Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University, Tokyo, Japan; and
| | - Eri Takano
- Department of Radiology, Saku Central Hospital, Nagano, Japan
| | - Tomoaki Yamamoto
- Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University, Tokyo, Japan; and
| | - Eisuke Sato
- Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University, Tokyo, Japan; and
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Pilotto A, Schiano di Cola F, Premi E, Grasso R, Turrone R, Gipponi S, Scalvini A, Cottini E, Paghera B, Garibotto V, Rizzetti MC, Bonanni L, Borroni B, Morbelli S, Nobili F, Guerra UP, Perani D, Padovani A. Extrastriatal dopaminergic and serotonergic pathways in Parkinson’s disease and in dementia with Lewy bodies: a 123I-FP-CIT SPECT study. Eur J Nucl Med Mol Imaging 2019; 46:1642-1651. [DOI: 10.1007/s00259-019-04324-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 03/31/2019] [Indexed: 02/07/2023]
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100
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Buchert R, Lange C, Spehl TS, Apostolova I, Frings L, Jonsson C, Meyer PT, Hellwig S. Diagnostic performance of the specific uptake size index for semi-quantitative analysis of I-123-FP-CIT SPECT: harmonized multi-center research setting versus typical clinical single-camera setting. EJNMMI Res 2019; 9:37. [PMID: 31065816 PMCID: PMC6505020 DOI: 10.1186/s13550-019-0506-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/15/2019] [Indexed: 11/30/2022] Open
Abstract
Introduction The specific uptake size index (SUSI) of striatal FP-CIT uptake is independent of spatial resolution in the SPECT image, in contrast to the specific binding ratio (SBR). This suggests that the SUSI is particularly appropriate for multi-site/multi-camera settings in which camera-specific effects increase inter-subject variability of spatial resolution. However, the SUSI is sensitive to inter-subject variability of striatum size. Furthermore, it might be more sensitive to errors of the estimate of non-displaceable FP-CIT binding. This study compared SUSI and SBR in the multi-site/multi-camera (MULTI) setting of a prospective multi-center study and in a mono-site/mono-camera (MONO) setting representative of clinical routine. Methods The MULTI setting included patients with Parkinson’s disease (PD, n = 438) and healthy controls (n = 207) from the Parkinson Progression Marker Initiative. The MONO setting included 122 patients from routine clinical patient care in whom FP-CIT SPECT had been performed with the same double-head SPECT system according to the same acquisition and reconstruction protocol. Patients were categorized as “neurodegenerative” (n = 84) or “non-neurodegenerative” (n = 38) based on follow-up data. FP-CIT SPECTs were stereotactically normalized to MNI space. SUSI and SBR were computed for caudate, putamen, and whole striatum using unilateral ROIs predefined in MNI space. SUSI analysis was repeated in native patient space in the MONO setting. The area (AUC) under the ROC curve for identification of PD/“neurodegenerative” cases was used as performance measure. Results In both settings, the highest AUC was achieved by the putamen (minimum over both hemispheres), independent of the semi-quantitative method (SUSI or SBR). The putaminal SUSI provided slightly better performance with ROI analysis in MNI space compared to patient space (AUC = 0.969 vs. 0.961, p = 0.129). The SUSI (computed in MNI space) performed slightly better than the SBR in the MULTI setting (AUC = 0.993 vs. 0.991, p = 0.207) and slightly worse in the MONO setting (AUC = 0.969 vs. AUC = 0.976, p = 0.259). There was a trend toward larger AUC difference between SUSI and SBR in the MULTI setting compared to the MONO setting (p = 0.073). Variability of voxel intensity in the reference region was larger in misclassified cases compared to correctly classified cases for both SUSI and SBR (MULTI setting: p = 0.007 and p = 0.012, respectively). Conclusions The SUSI is particularly useful in MULTI settings. SPECT images should be stereotactically normalized prior to SUSI analysis. The putaminal SUSI provides better diagnostic performance than the SUSI of the whole striatum. Errors of the estimate of non-displaceable count density in the reference region can cause misclassification by both SUSI and SBR, particularly in borderline cases. These cases might be identified by visual checking FP-CIT uptake in the reference region for particularly high variability.
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Affiliation(s)
- Ralph Buchert
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Catharina Lange
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Timo S Spehl
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ivayla Apostolova
- Department for Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Lars Frings
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Cathrine Jonsson
- Medical Radiation Physics and Nuclear Medicine, Imaging and Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Philipp T Meyer
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sabine Hellwig
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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