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Reproducibility of a Standardized Quantitative Analysis Using Fixed Regions of Interest to Differentiate Movement Disorders on 123I-FP-CIT SPECT

Marcel P.M. Stokkel, Petra Dibbets-Schneider, Elke Koestering, Constantin Dragoiescu and Koos A.K. Blokland
Journal of Nuclear Medicine Technology March 2007, 35 (1) 21-26;
Marcel P.M. Stokkel
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Petra Dibbets-Schneider
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Elke Koestering
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Constantin Dragoiescu
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Koos A.K. Blokland
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  • FIGURE 1. 
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    FIGURE 1. 

    Correlation between results obtained from 123I-FP-CIT studies by 2 technologists (observers 1 and 2). Intra- and intertechnologist variabilities were 0.14 ± 0.13 (confidence value, 2.4%) and 0.19 ± 0.18 (confidence value, 3.1%), respectively. Cau le = left caudate nucleus; cau ri = right caudate nucleus; put le = left putamen; put ri = right putamen.

  • FIGURE 2. 
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    FIGURE 2. 

    Absolute difference between 2 technologists plotted against mean ratio of both, confirming good reproducibility of method used in current study. Intraclass correlation coefficients, defined as measure of consistency or agreement of values within cases, of 1 technologist was equal to 0.99. This value for 2 independent technologists was equal to 0.98. Cau le = left caudate nucleus; cau ri = right caudate nucleus; operA = technologist 1; operB = technologist 2; put le = left putamen; put ri = right putamen.

  • FIGURE 3. 
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    FIGURE 3. 

    Uptake values as obtained using automatic semiquantitative method of analysis. (A) Normal uptake in putamen and caudate nucleus of patient with essential tremor. (B) Patient with diminished uptake in caudate nucleus, suggesting early-onset PD; 2-y follow-up confirmed hypothesis. (C) Patient with diminished uptake in whole striatum, corresponding to PD.

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    TABLE 1

    Uptake Ratios on 123I-FP-CIT Studies Based on Standardized Analysis Method

    DiseaseNo. of patientsCRCLPRPL
    PD215.48 (1.52)5.39 (1.54)3.55 (1.35)3.62 (1.43)
    Hypokinetic rigid syndrome197.00 (0.92)7.00 (1.04)6.00 (1.29)6.08 (1.07)
    Dystonia87.39 (1.02)7.14 (1.27)5.65 (2.49)6.59 (0.96)
    Essential tremor47.63 (1.16)7.64 (0.69)5.90 (0.46)6.20 (0.74)
    Normalized reference values
     <40 y old8.2 (±2.4)8.2 (±2.4)7.8 (±3.5)7.8 (±3.5)
     >40 y old9.2 (±3.7)9.2 (±3.7)8.3 (±3.7)8.3 (±3.7)
    • CR = right caudate nucleus; CL = left caudate nucleus; PR = right putamen; PL = left putamen.

    • Values in parentheses are SDs.

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    TABLE 2

    Difference Between Mean Values Obtained with Fixed ROIs and Manually Drawn ROIs in Analysis of 123I-FP-CIT Studies

    Standardized methodManual methodP
    SiteNormalized valueT1T2T1T2Standardized T1 vs. standardized T2Manual T1 vs. manual T2Manual vs. standardized
    CR9.2 (3.7)6.6 (1.1)6.7 (1.2)5.1 (1.0)5.1 (1.0)0.8100.892<0.001
    CL9.2 (3.7)6.4 (1.2)6.6 (1.1)5.0 (1.0)4.9 (1.0)0.6650.703<0.001
    PR8.3 (3.7)5.7 (1.6)5.7 (1.6)4.4 (1.3)4.1 (1.3)0.9820.002<0.001
    PL8.3 (3.7)5.8 (1.5)5.8 (1.7)4.3 (1.3)4.0 (1.3)0.8350.014<0.001
    • T1 = technologist 1; T2 = technologist 2; CR = right caudate nucleus; CL = left caudate nucleus; PR = right putamen; PL = left putamen.

    • Values in parentheses are SDs.

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Journal of Nuclear Medicine Technology: 35 (1)
Journal of Nuclear Medicine Technology
Vol. 35, Issue 1
March 2007
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Reproducibility of a Standardized Quantitative Analysis Using Fixed Regions of Interest to Differentiate Movement Disorders on 123I-FP-CIT SPECT
Marcel P.M. Stokkel, Petra Dibbets-Schneider, Elke Koestering, Constantin Dragoiescu, Koos A.K. Blokland
Journal of Nuclear Medicine Technology Mar 2007, 35 (1) 21-26;

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Reproducibility of a Standardized Quantitative Analysis Using Fixed Regions of Interest to Differentiate Movement Disorders on 123I-FP-CIT SPECT
Marcel P.M. Stokkel, Petra Dibbets-Schneider, Elke Koestering, Constantin Dragoiescu, Koos A.K. Blokland
Journal of Nuclear Medicine Technology Mar 2007, 35 (1) 21-26;
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