Clin Nucl Med. 2018 Jan;43(1):e1-e7. doi: 10.1097/RLU.0000000000001885.
Dopamine transporter (DaT) imaging is an adjunct diagnostic tool in parkinsonian disorders. Interpretation of DaT scans is based on visual reads. SBRquant is an automated method that measures the striatal binding ratio (SBR) in DaT scans, but has yet to be optimized. We aimed to (1) optimize SBRquant parameters to distinguish between patients with Parkinson disease (PD) and healthy controls using the Parkinson's Progression Markers Initiative (PPMI) database and (2) test the validity of these parameters in an outpatient cohort.
For optimization, 336 DaT scans (215 PD patients and 121 healthy controls) from the PPMI database were used. Striatal binding ratio was calculated varying the number of summed transverse slices (N) and positions of the striatal regions of interest (d). The resulting SBRs were evaluated using area under the receiver operating characteristic curve. The optimized parameters were then applied to 77 test patients (35 PD and 42 non-PD patients). Striatal binding ratios were also correlated with clinical measures in the PPMI-PD group.
The optimal parameters discriminated the training groups in the PPMI cohort with 95.8% sensitivity and 98.3% specificity (lowest putamen SBR threshold, 1.037). The same parameters discriminated the groups in the test cohort with 97.1% sensitivity and 100% specificity (lowest putamen SBR threshold, 0.875). A significant negative correlation (r = -0.24, P = 0.0004) was found between putamen SBRs and motor severity in the PPMI-PD group.
SBRquant discriminates DaT scans with high sensitivity and specificity. It has a high potential for use as a quantitative diagnostic aid in clinical and research settings.
多巴胺转运体（DaT）成像技术是帕金森病的辅助诊断工具。DaT 扫描的解读基于视觉读取。SBRquant 是一种自动测量 DaT 扫描纹状体结合率（SBR）的方法，但尚未进行优化。我们旨在：（1）使用帕金森病进展标志物倡议（PPMI）数据库优化 SBRquant 参数，以区分帕金森病（PD）患者和健康对照者；（2）在门诊队列中测试这些参数的有效性。
在优化过程中，使用 PPMI 数据库中的 336 个 DaT 扫描（215 名 PD 患者和 121 名健康对照者）。通过改变求和的横切片数量（N）和纹状体感兴趣区的位置（d）来计算纹状体结合率。使用受试者工作特征曲线下的面积评估得到的 SBR。然后将优化后的参数应用于 77 例测试患者（35 例 PD 和 42 例非 PD 患者）。还在 PPMI-PD 组中对纹状体结合率与临床测量值进行了相关性分析。
最佳参数可在 PPMI 队列中区分训练组，敏感性为 95.8%，特异性为 98.3%（最低壳核 SBR 阈值为 1.037）。相同的参数可在测试队列中区分组，敏感性为 97.1%，特异性为 100%（最低壳核 SBR 阈值为 0.875）。在 PPMI-PD 组中，壳核 SBR 与运动严重程度呈显著负相关（r = -0.24，P = 0.0004）。
SBRquant 可高度敏感和特异性地区分 DaT 扫描。它具有作为临床和研究环境中定量诊断辅助工具的高潜力。
