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. 2019 Dec 15;9(6):274-281.
eCollection 2019.

Quantification methods comparison in brain 18F-FDOPA PET

Julieta E Arena  1 , Leandro Urrutia  2 , German Falasco  2 , Magdalena Ponce de Leon  2 , Silvia Vazquez  2
Affiliations

Quantification methods comparison in brain 18F-FDOPA PET

Julieta E Arena et al. Am J Nucl Med Mol Imaging. .

Abstract

18F-FDOPA PET is one of the most widely used molecular imaging techniques to assess presynaptic dopaminergic activity. A variety of analytical methods have been developed to quantify 18F-FDOPA PET images and in most, the striatal-to-occipital ratio (SOR) is used as a quantitative parameter. A manual strategy is typically used for quantification purposes, which can have some caveats, being time-consuming and having some inter-rater variability. In the present study we aimed to test whether automated quantification methods can provide an efficient alternative to manual quantification to overcome its limitations and compare each method's capacity to discriminate between normal and abnormal subjects. 18F-FDOPA PET images of 60 subjects were analyzed and quantified with one manual and two automated methods. SUVRs were obtained for caudate and putamen nucleus in both cases. We were able to reach the same level of discrimination with manual and automated strategies, and a threshold for normal/abnormal discrimination could be obtained. We believe automated strategies for VOI quantification can help molecular imaging physicians in the process of interpretation of studies, making the process faster, yet reliable and objective.

Keywords: 18F-FDOPA PET; PET quantification methods; parkinsonism; quantification.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Representative image of 18F-FDOPA PET image with manually placed striatal ROIs for quantification.
Figure 2
Figure 2
Bland Altman plot Manual vs. Semiautomatic strategies. 18F-FDOPA SUVr for bilateral caudate and putamen. Blue line: mean difference. Black lines: superior and inferior limits of agreements for 95% of the data.
Figure 3
Figure 3
Bland Altman plot Manual vs. Automatic strategies. 18F-FDOPA SUVr for bilateral caudate and putamen. Blue line: mean difference. Black lines: superior and inferior limits of agreements for 95% of the data.
Figure 4
Figure 4
18F-FDOPA Striatum SUVr value boxplot distribution for each method. NU: Normal Uptake. DU: Decrease Uptake.
Figure 5
Figure 5
ROC curves (Manual, Semiautomatic, Automatic) of 18F-FDOPA Striatum SUVr values for group discriminant between normal and decrease uptake. AUC: Area under the curve, TSH: Optimal threshold for discrimination. True/False positive rates for optimal threshold (green: Automatic; red: Manual and Semiautomatic).
Figure 6
Figure 6
Bland Altman plot FS_MRI vs. Automatic strategy. 18F-FDOPA SUVr for bilateral caudate and putamen. Blue line: mean difference. Black lines: superior and inferior limits of agreements for 95% of the data.
See this image and copyright information in PMC

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