The authors wish to thank Pencil and Papers s.r.l. (Italy) for language editing of the manuscript.
Original Research Article
Weighted registration of 123I-FP-CIT SPECT images improves accuracy of binding potential estimates in pathologically low striatal uptake
Article first published online: 20 JUN 2013
Copyright © 2013 Wiley Periodicals, Inc.
Journal of Cellular Physiology
Volume 228, Issue 10, pages 2086–2094, October 2013
How to Cite
Ciarmiello, A., Giovacchini, G., Guidotti, C., Meniconi, M., Lazzeri, P., Carabelli, E., Mansi, L., Mariani, G., Volterrani, D. and Del Sette, M. (2013), Weighted registration of 123I-FP-CIT SPECT images improves accuracy of binding potential estimates in pathologically low striatal uptake. J. Cell. Physiol., 228: 2086–2094. doi: 10.1002/jcp.24378
Conflicts of interest: None to declare.
- Issue published online: 20 JUN 2013
- Article first published online: 20 JUN 2013
- Accepted manuscript online: 4 APR 2013 11:57PM EST
- Manuscript Accepted: 25 MAR 2013
- Manuscript Received: 15 OCT 2012
To test whether the use of a striatum weighted image may improve registration accuracy and diagnostic outcome in patients with parkinsonian syndromes (PS), weighted images were generated by increasing signal intensity of striatal voxels and used as intermediate dataset for co-registering the brain image onto template. Experimental validation was performed using an anthropomorphic striatal phantom. 123I-FP-CIT SPECT binding ratios were manually determined in 67 PS subjects and compared to those obtained using unsupervised standard (UWR) and weighted registered (WR) approach. Normalized cost function was used to evaluate the accuracy of phantom and subjects registered images to the template. Reproducibility between unsupervised and manual ratios was assessed by using intra-class correlation coefficient (ICC) and Bland and Altman analysis. Correlation coefficient was used to assess the dependence of semi-quantitative ratios on clinical findings. Weighted method improves accuracy of brain registration onto template as determined by cost function in phantom (0.86 ± 0.06 vs. 0.98 ± 0.02; Student's t-test, P = 0.04) and in subject scans (0.69 ± 0.06 vs. 0.53 ± 0.06; Student's t-test, P < 0.0001). Agreement between manual and unsupervised derived binding ratios as measured by ICC was significantly higher on WR as compared to UWR images (0.91 vs. 0.76). Motor UPDRS score was significantly correlated with manual and unsupervised derived binding potential. In phantom, as well as in subjects studies, correlations were more significant using the WR method (BPm: R2 = 0.36, P = 0.0001; BPwr: R2 = 0.368, P = 0.0001; BPuwr: R2 = 0.300, P = 0.0008). Weighted registration improves accuracy of binding potential estimates and may be a promising approach to enhance the diagnostic outcome of SPECT imaging, correlation with disease severity, and for monitoring disease progression in Parkinsonian syndromes. J. Cell. Physiol. 228: 2086–2094, 2013. © 2013 Wiley Periodicals, Inc.