![]() developed the Southampton method, a semi-quantitative method based on the volume of interest (VOI), that has gained widespread use. Quantitative assessments, such as the specific binding ratio (SBR), are particularly effective in cases with subtle reductions in striatal tracer uptake, which are difficult to register with visual interpretation alone. Quantitative assessments are therefore used in addition to visual interpretation when performing DAT SPECT, and previous reports have indicated that a combination of visual interpretation and quantitative assessment achieves more accurate diagnoses. However, a previous study indicated that a suboptimal inter-observer agreement may lead to variable interpretation of DAT SPECT images, indicating that the efficacy of DAT SPECT may rely on visual interpretation. The CSF-mask algorithm improved the performance of the SBR index in informing the diagnosis of PS, especially in cases with ventricle dilatation.ĭopamine transporter (DAT) single-photon emission computed tomography (SPECT) is an imaging modality that can effectively differentiate neurodegenerative parkinsonian syndromes (PS), including Parkinson’s disease (PD) and dementia with Lewy bodies (DLB) from other neurological disorders not characterized by dopaminergic degeneration, such as Alzheimer disease, drug-induced Parkinsonism, and essential tremor. When corrected for attenuation, significant differences in the AUC were observed in all three EI groups (low EI group, AUC = 0.961 vs. 0.942, p = 0.11) in the middle and high EI groups, the CSF-mask algorithm performed better than the non-CSF-mask algorithm (middle EI group, AUC = 0.894 vs. When not corrected for attenuation, no significant difference in the AUC was observed in the low EI group between the non-CSF-mask and CSF-mask algorithms (0.927 vs. ROC analyses demonstrated that the CSF-mask algorithm performed better than the non-CSF-mask (no correction, area under the curve = 0.917 vs. A receiver-operating characteristics (ROC) analysis was used for statistical analyses. We compared the diagnostic performance of the corresponding indices and evaluated whether the effect of the CSF-mask algorithm varied according to the extent of ventricle dilatation, as assessed with the Evans index (EI). Both the conventional SBR (non-CSF-mask) and SBR corrected with the CSF-mask algorithm (CSF-mask) were calculated from 123I-Ioflupane single-photon emission computed tomography (SPECT) images of these patients. We enrolled 163 and 158 patients with and without PS, respectively. We assessed the effect of the CSF-mask algorithm on the diagnostic performance of the SBR index for parkinsonian syndromes (PS), including Parkinson’s disease, and the influence of cerebral ventricle dilatation on the CSF-mask algorithm. A cerebrospinal fluid (CSF)-mask algorithm has been developed to reduce the adverse influence of CSF-low-counts on the diagnostic utility of the specific binding ratio (SBR) index calculated with Southampton method.
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