Validation of Optimum ROI Size for 123I-FP-CIT SPECT Imaging Using a 3D Mathematical Cylinder Phantom

Document Type : Original Article


1 Program in Health and Welfare Graduate School of Comprehensive Scientific Research Prefectural university of Hiroshima

2 1-1, Sonekitamachi, Kokura-Minami-ku, Kitakyusyu, Fukuoka, 800-0296, Japan

3 Program in Health and Welfare Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima 1-1, Gakuenmachi, Mihara, Hiroshima, 723-0053, Japan

4 Department of Nursing,Hyogo University of Health Sciences


Objective(s): The partial volume effect (PVE) of single-photon emission computed tomography (SPECT) on corpus striatum imaging is caused by the underestimation of specific binding ratio (SBR). A large ROI (region of interest) set using the Southampton method is independent of PVE for SBR. The present study aimed to determine the optimal ROI size with contrast and SBR for striatum images and validate the Southampton method using a three-dimensional mathematical cylinder (3D-MAC) phantom.
Methods: We used ROIs sizes of 27, 36, 44, 51, 61, 68, and 76 mm for targets with diameters 40, 20, and 10 mm on reference and processed images reconstructed using the 3D-MAC phantom. Contrast values and SBR were compared with the theoretical values to obtain the optimal ROI size.
Results: The contrast values in the ROI with diameters of 51 (target: 40 mm in diameter) and 44 (target: 20 mm in diameter) mm matched the theoretical values. However, this value did not correspond with the 10-mm-diameter target. The SBR matched the theoretical value with an ROI of > 44 mm in the 20-mm-diameter target;but, it was under- and overestimated under any other conditions.
Conclusion: These results suggested that an ROI should be 4-2 folds larger than the target size without PVE, and that the Southampton method was remarkably accurate.


Main Subjects

1.Brucke T, Asenbaum S, Pirker W, Diamshidian S, Wenger S, Wober C, et al. Measurement of the dopamine degeneration in Parkinson’s disease with [123I]β-CIT and SPECT. Correlation with clinical findings and comparison with multiple system atrophy and progressive supranuclear palsy. J Neural Transm Suppl. 1997;50:9-24.
2.Booij J, Tissingh G, Boer GJ, Speelman JD, Stoof JC, Janssen AG, et al. [123 I]FP-CIT SPECT shows a pronounced decline of striatal dopamine transporter labelling in early and advanced Parkinson’s disease. J Neurol Neurosurg Psychiatry. 1997;62(2):133-40.
3.Booij J, Habraken JB, Bergmans P, Tissingh G, Winogrodzka A, Wolters EC, et al. Imaging of dopamine transporters with iodine-123-FP-CIT SPECT in healthy controls and patients with Parkinson’s disease. J Nucl Med. 1998;39(11):1879-84.
4.Asenbaum S, Pirker W, Angelberger P, Bencsits G, Pruckmayer M, Brücke T. [123I]beta-CIT and SPECT in essential tremor and Parkinson’s disease. J Neural Transm. 1998;105(10-12):1213-28.
5.McKeith I, O’Brien J, Walker Z, Tatsch K, Booij J, Darcourt J, et al. Sensitivity and specificity of dopamine transporter imaging with 123I-FP-CIT SPECT in dementia with Lewy bodies: a phase III, multicentre study. Lancet Neurol. 2007;6(4):305-13.
6.Benamer TS, Sips HJ, Dierckx RA, Versijpt J, Decoo D, Van Der Linden C, et al. Accurate differentiation of parkinsonism and essential tremor using visual assessment of [123I]-FP-CIT SPECT imaging: the [123I]-FP-CIT study group. Mov Disord. 2000;15:503-10.
7.Albert NL, Unterrainer M, Diemling M, Xiong G, Bartenstein P, Koch W, et al. Implementation of the European multicentre database of healthy controls for [(123)I]FP-CIT SPECT increases diagnostic accuracy in patients with clinically uncertain parkinsonian syndromes. Eur J Nucl Med Mol Imaging. 2016;43(7):1315-22.
8.Soret M, Koulibaly PM, Darcourt J, Buvat I. Partial volume effect correction in SPECT for striatal uptake measurements in patients with neurodegenerative diseases: impact upon patient classification. Eur J Nucl Med Mol Imaging. 2006;33(9):1062-72.
9.David R, Koulibaly M, Benoit M, Garcia R, Caci H, Darcourt J, et al. Striatal dopamine transporter levels correlate with apathy in neurodegenerative diseases A SPECT study with partial volume effect correction. Clin Neurol Neurosurg. 2008;110(1):19-24.
10.Tossici-Bolt L, Hoffmann SM, Kemp PM, Mehta RL, Fleming JS. Quantification of 123-I-FP-CIT SPECT brain images: an accurate technique for measurement of the specific binding ratio. Eur J Nucl Med Mol Imaging. 2006;33(12):1491-9.
11.Tossici-Bolt L, Dickson JC, Sera T, de Nijs R, Bagnara MC, Jonsson C, et al. Calibration of gamma camera systems for a multicentre European (123)I-FP-CIT SPECT normal database. Eur J Nucl Med Mol Imaging. 2011;38(8):1529-40.
12.Buchert R, Kluge A, Tossici-Bolt L, Dickson J, Bronzel M, Lange C, et al. Reduction in camera-specific variability in [(123)I]FP-CIT SPECT outcome measures by image reconstruction optimized for multisite settings: impact on age-dependence of the specific binding ratio in the ENC-DAT database of healthy controls. Eur J Nucl Med Mol Imaging. 2016;43(7):1323-36.
13.Fleming JS, Bolt L, Stratford JS, Kemp PM. The specific uptake size index for quantifying radiopharmaceutical uptake. Phys Med Biol. 2004;49(14):N227-34.
14.Onishi H, Motomura N, Takahashi M, Yanagisawa M, Ogawa K. A 3-diemnsional mathematic cylinder phantom for the evaluation of the fundamental performance of SPECT. J Nucl Med Technol. 2010;38(1):42-8.
15.Hirayama H. EGS4 shower display system (EGS4PICT), windows version 2.0. KEK Int. 1996;651:96-9.
16.Narita Y, Eberl S, Iida H, Hutton BF, Braun M, Nakamura T, et al. Monte Carlo and experimental evaluation of accuracy and noise properties of two scatter correction methods for SPECT. Phys Med Biol. 1996;41(11):2481-96.
17.Soret M, Koulibaly PM, Darcourt J, Hapdey S, Buvat I. Quantitative accuracy of dopaminergic neurotransmission imaging with (123)I SPECT. J Nucl Med. 2003;44(7):1184-93.
18.Tossici-Bolt L, Dickson JC, Sera T, Booij J, Asenbaun-Nan S, Bagnara MC, et al. [123I]FP-CIT ENC-DAT normal database: the impact of the reconstruction and quantification methods. EJNMMI Phys. 2017;4(1):8.
19.Dickson JC, Tossici-Bolt L, Sera T, Booij J, Ziebell M, Morbelli S, et al. The impact of reconstruction and scanner characterisation on the diagnostic capability of a normal database for [123I] FP-CIT SPECT imaging. EJNMMI Res. 2017;7(1):10.