Reproducibility between brain uptake ratio method using anatomic standardization (BUR-AS) and patlak plot method

Abstract

Purpose: Patlak plot and brain uptake ratio (BUR) methods have some problems about reproducibility. We formulated BUR method using anatomic standardization (BUR-AS) in statistical parametric mapping algorithm to improve reproducibility. The objective of this study was to demonstrate inter- and intra- operator reproducibility of mean cerebral blood flow (mCBF) using BUR-AS in comparison to conventional BUR (C-BUR) and patlak plot methods. Methods: Images in thirty patients who underwent brain perfusion single photon emission computed tomography (SPECT) studies were retrospectively used in this study. The SPECT images were reconstructed by ordered subset expectation maximization method, which were processed using automatic quantitative analysis for cerebral blood flow of ECD tool. The mean SPECT was calculated from basal ganglia slices of normal side (slice No., 31-40) for a 3-dimensional stereotaxic regional of interest template drew axis images after anatomic standardization. The mCBF was calculated from the mSPECT. Evaluation of reproducibility used the coefficient of variation (CV) and Bland-Altman plot. Results: Both inter- and intra- operator reproducibility, BUR-AS method has lowest the CV and smallest error range about Bland-Altman plot. Then, BUR-AS method mCBF had highest reproducibility of other method. Conclusion: We were demonstrated that BUR-AS method can provide a stable cerebral blood flow to have high inter- and intra- operator reproducibility, compared to patlak plot and C-BUR methods.