Acquisition count dependence of the specific binding ratio in 123I-FP-CIT SPECT

Ann Nucl Med. 2021 Dec;35(12):1271-1278. doi: 10.1007/s12149-021-01668-7. Epub 2021 Aug 10.

Abstract

Objective: In the [123I]FP-CIT single-photon emission computed tomography (SPECT) examination, the specific binding ratio (SBR), calculated from the ratio of the striatal specific to extra-striatal background non-specific binding in the brain, is now commonly used as a quantitative index of parkinsonian syndrome. The purpose of this study was to examine the influence of count reduction on the SBR and to clarify the reliability of SBR values in patients with shorter scan times.

Methods: A striatum phantom was used in a phantom study, with the radioactivity concentration adjusted so that the right striatum:left striatum:brain parenchyma ratio was 8:4:1. Changes in SBR values and image quality, expressed as the % coefficient of variation (%CV) and normalized mean squared error (NMSE), with decreasing acquisition counts were evaluated. In the clinical study, 106 patients (73.1 ± 9.6 years) with suspected parkinsonian syndrome underwent [123I]FP-CIT SPECT, and SBR values from normal 30 min acquisitions (fullSBR) and half-count acquisitions (halfSBR) were compared. SBR values were calculated using the Tossici-Bolt (SBRTB) and a fully automatic count-based (SBRcb) methods.

Results: In the phantom study, image quality decreased with a reduction of acquisition counts. The %CV and NMSE decreased by up to 52.5% and 81.5%, respectively. SBR values decreased slightly as acquisition counts decreased. In the clinical study, the mean values of halfSBR were lower than those of fullSBR, and they were significantly different except for SBRTB without attenuation correction. halfSBR and fullSBR values correlated well, with halfSBR values 1-8% lower than fullSBR. The accuracy of diagnosis did not decrease even after acquisition counts were reduced by half.

Conclusion: This study demonstrated that SBR values decrease as a function of reduced acquisition counts. Since halfSBR and fullSBR showed excellent correlation, it is suggested that fullSBR can be estimated from halfSBR using a calibration formula when scan times are reduced.

Keywords: Acquisition counts; Dopamine transporter (DAT) imaging; Preparation ioflupane ([123I]FP-CIT); Single-photon emission computed tomography (SPECT); Specific Binding Ratio (SBR).

MeSH terms

  • Tropanes*

Substances

  • Tropanes
  • 2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane