• Proceedings of the KSMRM Conference
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• 2002.11a
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• pp.107-107
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• 2002

목적： I-123 IPT SPECT에서 striatum에 ROI를 설정하여 Strial Binding Ratio를 측정하기 위해 사용되는 육안적인 방법과 MR Template based Coregistration 방법을 비교 평가하였다. 대상 및 방법： 파킨슨씨병 환자(IPD) 15명(남/녀：8/7, 63.3$\pm$4.8세)과 정상인 8명(남/녀：2/6, 61.4$\pm$16.5세) 에서 I-123 IPT(259MBq)를 주사한 후 2시간에 SPECT 영상을 얻었고 미상핵과 조가비핵의 전, 후부 및 후두엽에 각각 육안적인 방법과 MR Template based Coregistration방법으로 ROI를 설정하였다. MR Template based Coregistration 방법은 MNI TIMR template을 이용하여 SPECT영상을 voxel based intensity matching 방법으로 coregistration한 후midthalamic level에서 striatum의 경계를 따라 설정된 ROI를 이용하였다. 육안적인 방법은 striatal uptake가 가장 높은 level에서 3개의 ROI template를 striatum에 위치하였다. 두 방법으로 SBR과 nnterior/posterior ratio of SBR(APR)를 측정하였고 정상인과 파킨슨씨병 환자에서 두 방법을 비교하였다.

• Progress in Medical Physics
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• v.14 no.4
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• pp.268-278
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• 2003

Purpose：The aim of this study was to evaluate the striatal binding ratio, the anterior/posterior ratio and reproducibility using a template based registration method using the standard MR template as a replacement for each patients MR image. Materials and Methods：This study analyzed the 123I IPT SPECT images of 30 patients with IPD, who were subdivided into 17 patients (56.6$\pm$10.8 yr, M/F : 8/9.) with mild IPD, and 13 patients (56.4$\pm$11.1 yr, M/F : 8/5) with severe IPD. In addition, 11 normal controls (57.8$\pm$14.4 yr, M/F : 4/7) were also analyzed. The ROIs were positioned manually in the same slice showing the highest striatal activity using the traditional manual method, whereas those were positioned automatically in a mid striatal slice of the SPECT image coregistered to the standard T1 weighted MR template. Results : The specific binding ratio (SBR) obtained using the template based registration method strongly correlated with those using the manual method in all groups : normal controls (r=0.85, P<0.001), mild IPD (r=0.84, P<0.001) and severe IPD (r=0.7, P=0.01). The SBRs obtained using both methods were significantly different among the three groups (P=0.05) and the SBRs obtained by the template based registration method were higher than those by the manual method (P=0.05) in all three groups. The APRs obtained by the template based registration correlated with those using manual method in only mild IPD (r=0.72, P=0.0). The APRs obtained by the template based registration method were significantly different from the normal controls and those with mild or severe IPD (P<0.05), whereas those obtained using the manual method were not significantly different among the three groups (P＞0.1). The reproducibility (rmsCV) of the template based registration method was 7.2% (normal controls：5.2%, mild IPD：4.2%, severe IPD：10.8%), whereas the reproducibility of the manual method was 31% (normal controls：19.7%, mild IPD：21.7%, severe IPD：46.2%). Conclusion：These results show that the use of $^{123}$ I-IPT SPECT for assessing IPD is affected by the methods used to position the striatal ROI. The template based registration method using the standard MR template can be useful in diagnosing IPD and assessing the disease severity with a high reproducibility. Therefore, the template based registration method appears to be a good replacement for the manual method.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.2
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• pp.100-106
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• 2009

Purpose: The study was to assess I-123-N-(3-iodopropen-2-yl)-2[beta]-carbomethoxy-3[beta]-(4-cholorophenyl) tropane(IPT) SPECT in differential diagnosis among early stage of Parkinson's disease(PD) and essential tremor(ET) and normal control(NL) groups quantitatively. Materials and Methods: I-123 IPT brain SPECT of 50 NL, 20 early PD, 30 advanced PD, and 20 ET were performed at 20 minutes and 2 hours. Specific/nonspecific binding of striatum was calculated by using right and left striatal specific to occipital non-specific uptake ratio(striatum-OCC/OCC). Results: Mean value of specific/nonspecific binding ratio was significantly different between advanced PD group and NL group. However, significant overlap of striatal specific/nonspecific binding ratio was observed between PD group and ET group. Bilateral striatal specific/nonspecific binding ratios were decreased in advanced PD. Lateralized differences in the striatal uptake of I-123 IPT correlated with asymmetry in clinical findings in PD group. Conclusion: I-123 IPT SPECT may be a useful method for the diagnosis of PD and objective evaluation of progress of clinical stages. Care should be made in the differential diagnosis of early stage of PD and other motor disturbances mimicking PD such as ET in view of significant overlap in striatal I-123 specific/nonspecific binding ratio.

• The Korean Journal of Nuclear Medicine
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• v.31 no.4
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• pp.421-426
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• 1997

We evaluated the in vivo kinetics, distribution, and pharmacology of N-(4-[$^{18}F$]fluoromethylbenzyl)spiperone ([$^{18}F$]FMBS), a newly developed derivative of spiperone, as a potentially more selective radiotracer for the dopamine (DA) $D_2$ receptors. Mice received 1.9-3.7 MBq (1.8-3.6 nmol/kg) of [$^{18}F$]FMBS by tail vein injection. The time course and regional distribution of the tracer in brain were assessed. Blocking studies were carried out by intravenously preinjecting DA $D_2$ receptor blockers (spiperone, butaclamol) as well as drugs with high affinity for DA $D_1$ (SCH 23390), DA transporter (GBR 12909), and serotonin $S_2$ ($5-HT_2$) (ketanserin) sites. After injection of the tracer, the radioactivity in striatum increased steadily over time, resulting in a striatal-to-cerebellar ratio of 4.8 at 120 min postinjection. By contrast, the radioactivity in cerebellum, frontal cortex, and remaining cortex washed out rapidly. Preinjection of unlabeled FMBS (1 mg/kg) and spiperone (1 mg/kg) reduced [$^{18}F$]FMBS striatal-to-cerebellar ratio by 41% and 80%, respectively. (+)-Butaclamol (1 mg/kg) blocked 80% of the striatal [$^{18}F$]FMBS binding, while (-)-butaclamol (1 mg/kg) did not. Preinjection of SCH 23390 (1 mg/kg) and GBR 12909 (5 mg/kg) had no significant effect on [$^{18}F$]FMBS binding. Ketanserin (1 mg/kg), a ligand for the $5-HT_2$ receptors, did not cause significant inhibition either in striatum, in frontal cortex, or the remaining cortex. The results demonstrate that [$^{18}F$]FMBS labels DA $D_2$ receptors selectively in vivo in the mouse brain. It may hold promise as a selective radiotracer for studying DA $D_2$ receptors in vivo by PET.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.1
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• pp.10-18
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• 2009

Purpose: We investigated quantification of dopaminergic transporter (DAT) and serotonergic transporter (SERT) on $^{123}I$-FP-CIT SPECT for differentiating between multiple systemic atrophy (MSA) and idiopathic Parkinson's disease (IPD). Materials and Methods: N-fluoropropyl-$2{\beta}$-carbomethoxy-$3{\beta}$-4-[$^{123}I$]-iodophenylnortropane SPECT ($^{123}I$-FP-CIT SPECT) was performed in 8 patients with MSA (mean age: $64.0{\pm}4.5yrs$, m:f=6:2), 13 with early IPD (mean age: $65.5{\pm}5.3yrs$, m:f=9:4), and 12 healthy controls (mean age: $63.3{\pm}5.7yrs$, m:f=8:4). Standard regions of interests (ROls) of striatum to evaluate DAT, and hypothalamus and midbrain for SERT were drawn on standard template images and applied to each image taken 4 hours after radiotracer injection. Striatal specific binding for DAT and hypothalamic and midbrain specific binding for SERT were calculated using region/reference ratio based on the transient equilibrium method. Group differences were tested using ANOVA with the postHoc analysis. Results: DAT in the whole striatum and striatal subregions were significantly decreased in both patient groups with MSA and early IPD, compared with healthy control (p<0.05 in all). In early IPD, a significant increase in the uptake ratio in anterior and posterior putamen and a trend of increase in caudate to putamen ratio was observed. In MSA, the decrease of DAT was accompanied with no difference in the striatal uptake pattern compared with healthy controls. Regarding the brain regions where $^{123}I$-FP-CIT binding was predominant by SERT, MSA patients showed a decrease in the binding of $^{123}I$-FP-CIT in the pons compared with controls as well as early IPD patients (MSA: $0.22{\pm}0.1$ healthy controls: $0.33{\pm}0.19$, IPD: $0.29{\pm}0.19$), however, it did not reach the statistical significance. Conclusion: In this study, the differential patterns in the reduction of DAT in the striatum and the reduction of pontine $^{123}I$-FP-CIT binding predominant by SERT could be observed in MSA patients on $^{123}I$-FP-CIT SPECT. We suggest that the quantification of SERT as well as DAT using $^{123}I$-FP-CIT SPECT is helpful to differentiate parkinsonian disorders in early stage.