应用于帕金森病的纹状体中¹²³I-碘苄胍摄取自动定量分析的优化

Optimization of automated quantification of 123I-IBZM uptake in the striatum applied to parkinsonism.

作者信息

Radau P E, Linke R, Slomka P J, Tatsch K

机构信息

Department of Medical Biophysics, University of Western Ontario, London, Canada.

出版信息

J Nucl Med. 2000 Feb;41(2):220-7.

PMID:10688103

Abstract

UNLABELLED

Evaluation of therapies for parkinsonism by dopamine receptor SPECT requires a reproducible, optimized quantitation technique. This study presents a new, objective, automated technique for semiquantitative analysis of dopamine receptor density, as applied to the differential diagnosis of parkinsonism.

METHODS

Dopamine receptor density measured by 123I-iodobenzamide (IBZM) SPECT was retrospectively analyzed in nonidiopathic parkinsonism (NIPS), in Parkinson's disease (PD), and in healthy volunteers (n = 19, 38, and 13, respectively). A mean template was created from coregistered control studies. Registration errors were assessed using studies with simulated binding deficits. Patient studies were registered to the mean template, and striatal binding was calculated from a corresponding map of 3-dimensional regions of interest (ROIs). The striatal binding ratio and deficits determined by voxelwise comparison with the normal template were investigated and tested with various 3-dimensional ROI sizes and positions. Separation of patient groups was determined by tscore after automatically processing all studies. Results were compared with manual ROI analyses.

RESULTS

The automatic method was completely reproducible in 64 of 70 cases. The best diagnostic discriminator was the minimum binding ratio of the 2 striatal nuclei, with the following values: NIPS, 1.33+/-0.13; PD, 1.50+/-0.12; healthy volunteers, 1.49+/-0.08 (+/-SD). The deficit size from voxelwise analysis was: NIPS, 20.5+/-8.2 mL; PD, 9.5+/-8.3; healthy volunteers, 8.9+/-6.0 (+/-SD). The accuracy, measured by receiver operating characteristic areas, was 0.85+/-0.05, 0.77+/-0.06, and 0.80+/-0.06 (+/-SE) for the optimal predictor (automated) and 2 blinded observers (manual), respectively.

CONCLUSION

A new 3-dimensional, automated technique has been developed to semiquantitate receptor density that dramatically improves reproducibility. The optimal diagnostic discriminator of parkinsonism determined by the automatic technique has good accuracy compared with the manual technique.

摘要

未标注

通过多巴胺受体单光子发射计算机断层扫描（SPECT）评估帕金森综合征的治疗方法需要一种可重复、优化的定量技术。本研究提出了一种新的、客观的、自动化技术，用于多巴胺受体密度的半定量分析，应用于帕金森综合征的鉴别诊断。

方法

回顾性分析了非特发性帕金森综合征（NIPS）、帕金森病（PD）和健康志愿者（分别为19例、38例和13例）通过123I - 碘苄酰胺（IBZM）SPECT测量的多巴胺受体密度。从配准的对照研究中创建了一个平均模板。使用具有模拟结合缺陷的研究评估配准误差。将患者研究配准到平均模板，并根据相应的三维感兴趣区域（ROI）图计算纹状体结合。研究了纹状体结合率以及通过与正常模板进行体素级比较确定的缺陷，并使用各种三维ROI大小和位置进行测试。在自动处理所有研究后，通过t检验确定患者组的分离情况。将结果与手动ROI分析进行比较。

结果

自动方法在70例中的64例中完全可重复。最佳诊断判别指标是两个纹状体核的最小结合率，其值如下：NIPS，1.33±0.13；PD，1.50±0.12；健康志愿者，1.49±0.08（±标准差）。体素级分析得出的缺陷大小为：NIPS，20.5±8.2 mL；PD，9.5±8.3；健康志愿者，8.9±6.0（±标准差）。对于最佳预测指标（自动化）和两名盲法观察者（手动），通过受试者操作特征曲线面积测量的准确率分别为0.85±0.05、0.77±0.06和0.80±0.06（±标准误）。