TITLE:
Standardized Semi-Quantitative Evaluation of [123I]FP-CIT SPECT in a Multicenter Study
AUTHORS:
Andrea Skanjeti, Giancarlo Castellano, Baldassarre Elia, Francesca Dazzara, Michela Zotta, Gabriela Mariam Delgado Yabar, Matteo Manfredi, Marco Iudicello, Maurizio Zibetti, Patrizia Ferrero, Paola Filippi, Riccardo Emanuele Pellerito, Valerio Podio
KEYWORDS:
Movement Disorder; Parkinson Disease; [123I]FP-CIT-SPECT; Semi-Quantitative Evaluation; Multicenter Study
JOURNAL NAME:
Advances in Molecular Imaging,
Vol.3 No.4,
October
11,
2013
ABSTRACT: To the best of our knowledge
no multicenter studies have been published using standardized
semi-quantitative evaluation of [123I]FP-CIT scan (DAT-SPECT). The aims of this
study were: 1) to cross-compare semi-quantitative software-assisted
evaluations of DAT-SPECTs performed in three centers with different equipments;
2) to assess the accuracy of semi-quantitative evaluations of DAT-SPECT and 3)
to identify the threshold with the best accuracy, sensitivity and specificity
in a patient population with suspected parkinsonian syndrome. Materials and Methods: Two
hundred twenty patients (mean age at the time of SPECT acquisition, 67.4 ± 9.5 yy) acquired
in three centers (Ospedale San Luigi Gonzaga; Ospedale San Giovanni Battista
Molinette; Ospedale Mauriziano Umberto I) were included. All of them underwent
DAT-SPECT from January 2006 to July 2010. All exams were analyzed with the
freely available software BASGAN and semi-quantitative data were used to
predict disease. In particular, analyses were based on the values from the most
deteriorated putamen and caudate, normalized for age and corrected for equipment.
ROC analysis was performed and area under the curve (AUC) was estimated. Results: Analysis showed high AUCs (0.898,
0.864, 0.900 and 0.891 for each center and for the multicenter setting,
respectively) confirming the very good accuracies reached. The best cut-off
were 0.72 and 0.82 for putamen and caudate respectively. These thresholds
allowed sensitivities and specificities in each center and in the multicenter
setting of 76% and 96%, 91% and 82%, 93% and 90%, 86% and 89% respectively. No
significant differences were observed between sensibility and specificity in
each center. Conclusion: A unique
threshold useful for all centers with high and similar sensitivities and
specificities is possible after correction for age and equipments. The high
accuracy reached in this multicenter trial by the semi-quantitative analysis
seems similar to accuracies from qualitative analysis in other multicenter
studies.