Jeong Eugene, Oh Sun Young, Pahk Kisoo, Lee Chan-Nyoung, Park Kun-Woo, Lee Jae Sung, Cheon Gi Jeong, Choe Jae Gol
Department of Nuclear Medicine, Korea University Medical Center, Seoul, 136-705 Korea.
Department of Neurology, Korea University Medical Center, Seoul, Korea.
Nucl Med Mol Imaging. 2013 Jun;47(2):73-80. doi: 10.1007/s13139-013-0196-6. Epub 2013 Mar 26.
The aim of this study was to evaluate the feasibility of FP-CIT PET template-based quantitative analysis on F-18 FP-CIT PET in patients with de novo Parkinson's disease (PD), compared with MR-based and manual methods. We also assessed the correlation of quantitative parameters of those methods with clinical severity of the disease.
Forty patients with de novo PD underwent both MRI and F-18 FP-CIT PET. Images were spatially normalized to a standardized PET template. Mean counts of 4 ROIs: putamen, caudate, occipital cortex and cerebellum, were obtained using the quantification program, Korean Statistical Probabilistic Anatomical Map (KSPAM). Putamen-to-caudate ratio (PCR), asymmetry index (ASI), specific-to-nonspecific ratios with two different references: to occipital cortex (SOR) and cerebellum (SCR) were compared. Parameters were also calculated from manually drawn ROI method and MR-coregistrated method.
All quantitative parameters showed significant correlations across the three different methods, especially between the PET-based and manual methods. Among them, PET-based SOR and SCR values showed an excellent correlation and concordance with those of manual method. In relationship with clinical severity, only ASI achieved significantly inverse correlations with H&Y stage and UPDRS motor score. There was no significant difference between the quantitative parameters of both occipital cortex and cerebellum in all three methods, which implied that quantitation using PET-based method could be reproducible regardless of the reference region.
Quantitative parameters using FP-CIT PET template-based method correlated well with those using laborious manual method with excellent concordance. Moreover, PET-based quantitation was less influenced by the reference region than MR-based method. It suggests that PET-based method can provide objective and quantitative parameters quickly and easily as a feasible analysis in place of conventional method.
本研究旨在评估基于FP-CIT PET模板的定量分析在初发帕金森病（PD）患者的F-18 FP-CIT PET检查中的可行性，并与基于磁共振成像（MR）的方法和手动方法进行比较。我们还评估了这些方法的定量参数与疾病临床严重程度之间的相关性。
40例初发PD患者同时接受了MRI和F-18 FP-CIT PET检查。图像在空间上被归一化到一个标准化的PET模板。使用定量程序韩国统计概率解剖图谱（KSPAM）获得4个感兴趣区（ROI）的平均计数，分别为壳核、尾状核、枕叶皮质和小脑。比较壳核与尾状核比值（PCR）、不对称指数（ASI）以及以枕叶皮质（SOR）和小脑（SCR）为两种不同参考的特异性与非特异性比值。还通过手动绘制ROI方法和MR配准方法计算参数。
所有定量参数在三种不同方法之间均显示出显著相关性，尤其是基于PET的方法和手动方法之间。其中，基于PET的SOR和SCR值与手动方法的值显示出极好的相关性和一致性。在与临床严重程度的关系方面，只有ASI与Hoehn-Yahr（H&Y）分期和统一帕金森病评定量表（UPDRS）运动评分呈显著负相关。在所有三种方法中，枕叶皮质和小脑的定量参数之间均无显著差异，这意味着无论参考区域如何，基于PET的方法进行定量分析都具有可重复性。
基于FP-CIT PET模板的方法获得的定量参数与费力的手动方法获得的参数相关性良好，一致性极佳。此外，基于PET的定量分析比基于MR的方法受参考区域的影响更小。这表明基于PET的方法可以快速、轻松地提供客观和定量参数，作为一种可行的分析方法替代传统方法。
