A new quantitative index in the diagnosis of Parkinson syndrome by dopamine transporter single-photon emission computed tomography

• Published in: Annals of nuclear medicine 2021-04, Vol.35 (4), p.504-513
• Main Authors: Bando, Ryota, Otsuka, Hideki, Otani, Tamaki, Matsuda, Noritake, Azane, Shota, Kunikane, Yamato, Otomi, Yoichi, Sako, Wataru, Izumi, Yuishin, Harada, Masafumi
• Format: Article
• Language: English
• Subjects: Brain diseases; Computed tomography; Diagnostic systems; Dopamine; Dopamine receptors; Dopamine transporter; Evaluation; Imaging; Mathematical analysis; Medical diagnosis; Medicine; Medicine & Public Health; Neostriatum; Neurodegenerative diseases; Nuclear Medicine; Original Article; Photon emission; Photons; Radiology; Single photon emission computed tomography; Statistical analysis; Tomography
• ISSN: 0914-7187; 1864-6433
• DOI: 10.1007/s12149-021-01592-w

Objective Dopamine transporter single-photon emission computed tomography (DAT SPECT) has been widely used to diagnose Parkinson syndrome. Using the standardized uptake value (SUV) of DAT SPECT, we propose “functional dopamine transporter volume (f-DTV)” as a new quantitative index to evaluate the three-dimensional volume of functional dopamine transporters and assess its diagnostic ability in differentiating dopaminergic neurodegenerative diseases (dNDD) from non-dNDD. Methods Seventy-nine patients were enrolled (42 dNDD, 37 non-dNDD; 38 men; age 24–88 years). We analyzed seven quantitative indices. The specific binding ratio (SBR) was calculated using a program specialized for DAT SPECT (SBR_Bolt). The SUVmax, SUVpeak, and SUVmean were calculated using a quantification program for bone SPECT. SBR_SUV was calculated by dividing striatal SUVmean by the average of background SUVmean. The cutoff value of the active dopamine transporter level was examined using three methods (threshold of 40% of SUVmax, SUV 2, and SUV 3) to calculate the active dopamine transporter volume (ADV). The f-DTV was calculated by multiplying ADV and SUV mean . We assessed the correlations between SBR_Bolt and SBR_SUV, and compared the mean value of each index between the dNDD and non-dNDD groups. The abilities of SBR_Bolt, SBR_SUV, SUVmax, SUVpeak, SUVmean, ADV, and f-DTV in differentiating dNDD from non-dNDD were determined by the area under the receiver operating curve (AUC) generated by the receiver operating characteristics analysis. Results The SBR_Bolt and SBR_SUV highly correlated with each other ( r  = 0.71). The cutoff value of the active dopamine transporter level was determined as SUV 3. All seven quantitative indices showed lower values in the dNDD group than in the non-dNDD group, and the difference between the two groups was statistically significant ( p