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Reproducibility of SPECT Measurement of Benzodiazepine Receptors in Human Brain with Iodine-123-Iomazenil

Departments of Psychiatry and Diagnostic Radiology, Yale University School of Medicine, New Haven, Connecticut and West Haven VA Medical Center, West Haven, Connecticut

Correspondence: For correspondence and reprints contact: Anissa Abi-Dargham, MD, Department of Psychiatry, Yale University and West Haven VA Medical Center/116A2, 950 Campbell Avenue, West Haven, CT 06516.

ABSTRACT

Iodine-123-iomazenil is a SPECT radiotracer used to image and quantify benzodiazepine receptors. The reproducibility of the measurement of benzodiazepine receptors in human brain with [¹²³I]iomazenil and SPECT was investigated with a test/retest paradigm. Methods: Six subjects underwent two experiments during a 1-wk interval, Iodine-123-iomazenil was injected as a single bolus (12 mCi). The time-activity curves of the tracer in the arterial plasma were measured and corrected for metabolites. Regional time-activity curves of five brain regions were measured with the CERASPECT camera for 145 min postinjection with serial 2-min acquisitions. Data were analyzed using three kinetic models that included a two-compartment model, an unconstrained three-compartment model and a three-compartment model with a constraint on the nondisplaceable compartment. Results: The results from the various analyses and fitting strategies were compared. The variability (average absolute difference between test and retest, expressed as a percentage of the mean of both measurements) was 10% to 17%, depending on the outcome measure and the fitting procedure. The most reproducible outcome measure was the regional tracer distribution volume relative to the total arterial concentration (V_T'). V_T' showed an average regional variability of 10% ± 2%, with an intraclass correlation coefficient of 0.81. Conclusion: SPECT measurement of regional [¹²³I]iomazenil V_T' is reproducible and reliable. The use of regional ratios results in a significant loss of information.

Key Words: SPECT • iodine-123-iomazenil • reproducibility • benzodiazepine receptor

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