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Automated Stereotactic Standardization of Brain SPECT Receptor Data Using Single-Photon Transmission Images

Koenraad Van Laere, Michel Koole, Yves D’Asseler, Jan Versijpt, Kurt Audenaert, Filip Dumont and Rudi Dierckx
Journal of Nuclear Medicine February 2001, 42 (2) 361-375;

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    Representative radioligand studies used for emission registration and transmission images used for transmission registration. Images show transaxial (trx) and sagittal (sag) normal [99mTc]ECD (A), patient with corticobasal degeneration [99mTc]ECD (trx) (B), [123I]IBZM (trx) (C), [123I]β-CIT (striatal phantom, 7:1 ratio of striatum/background; trx) (D), normal [123I]R91150 5-HT2a study (trx + sag; note absence of specific binding in the cerebellum) (E), patient post-suicide attempt (deliberate self-injury) [123I]R91150 5-HT2a (sag) (F), and 153Gd transmission map (trx + sag) (G).

  • FIGURE 2.
    FIGURE 2.

    Stereotactic VOI maps for automated quantification. Maps include representative slices in stereotactic reference frame for [99mTc]ECD perfusion and neocortical receptor ligand [123I]R91150 quantification (A) and stereotactic VOI map for striatal [123I]IBZM and [123I]β-CIT (1.08-cm thickness, centered at site of standard anatomic striatum) (B).

  • FIGURE 3.
    FIGURE 3.

    Accuracy of template registration for different radioligand studies, shown as box-and-whisker plots. The accuracy of emission registration (top four charts) and transmission registration (bottom chart) is given as square root of quadratic sum of subdimensional deviations for translation (open boxes, pixels (1 pixel = 3.59 mm)), rotation (black boxes (degrees)), and scaling (striped boxes (%)). Obs. 1, observer 1; Obs. 2, observer 2.

  • FIGURE 4.
    FIGURE 4.

    Mean error on quantification for perfusion and receptor ligand studies as function of shift, scaling, and rotation errors, calculated for a normal study. ○, [99mTc]ECD; ▴, [123I]IBZM; □, dashed line, [123I]β-CIT; ◊, [123I]R91150.

  • FIGURE 5.
    FIGURE 5.

    Residual registration error for count difference in TCT matching as function of incomplete sampling of infratentorial skull, shown as clustered error bar plot. y-axis, 95% CI limits on registration difference. Data are squared quadratic sums of translation (A), rotation (B), and scaling (C) errors.

Tables

  • TABLE 1.

    Overview of Radioligand Types, Subject Demographics, and Scan Description for Perfusion and Receptor Images

    Scan no.RadioligandAge (y)SexDescription
    1[99mTc]ECD33MNormal healthy volunteer
    2[99mTc]ECD60FNormal healthy volunteer
    3[99mTc]ECD67FCortico-basal degeneration, z-score, left frontal, −3.2
    4[123I]IBZM52FNormal uptake (Parkinson)
    5[123I]IBZM68MNormal uptake (Parkinson)
    6[123I]β-CITPhantomNormal
    7[123I]β-CITPhantomBackground uptake R head caudate nucleus
    8[123I]R9115025FNormal healthy volunteer
    9[123I]R9115016FEating disorder, slight decreased frontal binding potential (z-score, −1.0)
    10[123I]R9115043MSuicide attempt (deliberate self-injury), global decreased uptake (z-score ≤ −3)
  • TABLE 2.

    Coregistration Accuracy for Intrasubject and Template Matching for Perfusion and Receptor Ligand Studies

    Study typeIntrasubject registration*Template registration*
    Δtot (pixels)Φtot (degrees)Σtot (%)Δtot (pixels)Φtot (degrees)Σtot (%)
    [99mTc]ECD
     Obs. 11.1  (0.6)3.0  (2.1)4.4  (2.3)1.4  (0.6)3.1  (1.6)7.8  (3.3)†
     Obs. 21.0  (0.4)3.1  (1.8)3.2  (1.8)1.3  (0.5)3.9  (1.7)4.2  (2.0)
     M.I.0.8  (0.4)1.0  (0.6)0.8  (0.3)0.9  (0.4)4.2  (3.5)†3.1  (1.7)†
     C.D.0.9  (0.4)1.0  (0.6)1.1  (1.1)0.9  (0.4)2.0  (0.7)†2.2  (1.6)‡
     U.I.0.9  (0.4)1.1  (0.6)1.1  (0.3)3.1  (1.5)§§
    [123I]IBZM
     Obs. 11.1  (0.3)2.8  (1.3)2.9  (1.5)1.4  (0.3)3.8  (1.7)6.6  (2.1)†
     Obs. 21.1  (0.4)2.2  (0.7)3.1  (2.0)0.9  (0.2)2.6  (1.0)3.7  (2.5)
     M.I.0.9  (0.3)1.0  (0.6)1.6  (0.4)0.9  (0.3)1.6  (1.0)1.9  (1.7)
     C.D.0.9  (0.3)0.9  (0.6)1.2  (1.3)1.0  (0.4)1.2  (1.0)1.3  (1.2)
     U.I.0.8  (0.3)1.0  (0.6)3.4  (5.2)1.0  (0.4)1.3  (0.7)6.7  (4.6)
    [123I]β-CIT
     Obs. 12.1  (1.8)7.2  (4.2)7.5  (2.5)1.9  (1.5)8.4  (3.0)7.1  (3.7)
     Obs. 21.8  (1.6)8.1  (5.9)9.5  (6.6)2.0  (1.6)7.7  (5.0)6.5  (4.4)
     M.I.1.3  (1.4)3.4  (4.7)§2.3  (2.2)8.6  (8.3)§
     C.D.1.7  (1.5)6.9  (9.4)6.7  (7.5)3.1  (3.3)§§
     U.I.4.8  (4.4)5.7  (4.8)8.7  (3.9)§§§
    [123I]R91150
     Obs. 11.7  (2.5)2.5  (1.4)2.9  (1.9)1.9  (1.4)6.9  (3.6)†7.9  (4.3)†
     Obs. 21.2  (0.4)3.2  (1.9)3.2  (2.0)1.7  (0.8)‡6.0  (2.2)†8.3  (3.6)†
     M.I.0.9  (0.3)1.1  (0.6)0.8  (0.3)0.9  (0.6)2.9  (1.6)†3.0  (2.5)†
     C.D.0.9  (0.5)1.1  (0.6)0.9  (0.7)1.3  (0.9)3.7  (2.4)†4.3  (3.9)†
     U.I.0.9  (0.3)1.0  (0.6)1.6  (0.5)§§§
    TCT
     Obs. 11.3  (1.2)1.8  (1.0)2.4  (1.5)1.3  (0.5)3.5  (2.3)‡3.7  (1.8)
     Obs. 21.1  (0.6)1.7  (1.1)2.5  (2.3)1.6  (0.7)‡2.5  (1.4)3.6  (1.9)
     M.I.0.9  (0.4)1.3  (0.6)1.6  (2.4)0.8  (0.3)4.2  (3.3)†2.8  (3.0)
     C.D.0.9  (0.4)1.2  (0.7)1.0  (0.8)0.9  (0.4)2.4  (1.5)†1.2  (0.7)
     U.I.§§§§§§

    • ↵* Values are given as mean and SD.

    • ↵† P < 0.01.

    • ↵‡ P < 0.05.

    • ↵§ Out of limits (>6 pixels or >10° or >10% mismatch).

  • TABLE 3.

    Mean Quantification Error for Emission Versus Transmission Template Matching for Perfusion and Receptor Ligand Studies Based on Count Difference Registration Accuracy

    Parameter[99mTc]ECD[123I]IBZM[123I]β-CIT[123I]R91150
    ECTTCTECTTCTECTTCTECTTCT
    Translation
     Δx1.61.70.90.93.01.42.01.9
     Δy1.41.62.72.89.81.42.42.1
     Δz1.21.11.41.619.83.23.63.2
     All Δ2.42.63.23.322.33.84.84.3
    Rotation
     Φxy0.30.20.60.75.51.51.90.7
     Φxz0.20.10.80.710.51.61.30.3
     Φyz0.30.21.20.811.21.64.61.5
     All Φ0.50.31.61.316.32.75.11.7
    Scaling
     Σx0.31.00.71.32.91.51.11.0
     Σy0.80.50.71.07.00.81.71.0
     Σz0.70.51.21.44.23.55.83.0
     All Σ1.11.21.62.28.03.96.13.3
    All dimensions2.72.93.94.228.96.19.35.7
    Significance (paired t test)NS (P = 0.9)NS (P = 0.2)P = 0.006P = 0.021

    • NS = not significant.

    • All values are expressed as percentages.

  • TABLE 4.

    Processing Time (Mean and SD) for Manual and Automated Registration of All Data Types

    Radioligand or data typeAverage processing time (s) (mean (SD)) for registration type
    ManualAutomatic
    Obs. 1Obs. 2M.I.C.D.U.I.
    [99mTc]ECD790  (216)688  (320)192 (86)221 (88)244 (105)
    [123I]IBZM381  (105)384  (122)234 (98)207 (78)232 (126)
    [123I]β-CIT402  (141)483  (247)189 (58)177 (88)180 (34)
    [123I]R91150378  (106)308  (58)192 (65)207 (88)226 (116)
    TCT456  (180)412  (148)206 (86)217 (72)344 (182)
    All495  (228)458  (242)201 (80)208 (83)250 (134)
    Mean no. of iterations (all)360365464
    Average processing time/iteration (all)0.560.570.54

    • Calculations were performed on a 300-MHz Pentium Pro processor (128-Mb RAM).

  • TABLE 5.

    Translation and Rotation Registration Accuracy for Intrasubject Coregistration Comparing Constrained Versus Unconstrained Scaling, for Mutual Information Minimization

    Study typeConstrained scalingScaling free
    Δtot (pixels)Φtot (degrees)Δtot (pixels)Φtot (degrees)
    [99mTc]ECD0.90  (0.26)0.92  (0.25)0.89  (0.25)0.88  (0.31)
    [123I]IBZM1.01  (0.12)0.92  (0.37)1.01  (0.13)0.83  (0.31)
    [123I]β-CIT0.78  (0.33)1.44  (0.62)0.78  (0.36)2.33  (2.01)*
    [123I]R911500.89  (0.28)0.86  (0.28)0.90  (0.27)0.99  (0.30)
    TCT0.89  (0.29)0.92  (0.21)0.92  (0.31)0.93  (0.31)

    • ↵* P < 0.05.

    • All values are expressed as mean (SD).

  • TABLE 6.

    Template Registration Accuracy for Patient Studies Versus Normal Studies

    Study typeMinimizationNormal emission scans*Patient emission scans
    Δtot (pixels)Φtot (degrees)Σtot (%)Δtot (pixels)Φtot (degrees)Σtot (%)
    [99mTc]ECDM.I.0.80  (0.45)4.1 (3.9)3.0 (1.6)1.09 (0.11)4.4  (3.1)3.3 (2.0)
    C.D.0.87  (0.37)1.95 (0.48)2.0 (1.9)0.88 (0.52)2.1  (1.1)2.5 (0.8)
    [123I]β-CITM.I.0.80  (0.37)2.3 (0.8)2.05 (1.0)3.8 (2.3)†∞†∞†
    C.D.0.81  (0.40)1.34 (0.49)2.3 (1.4)5.5 (3.1)†∞†∞†
    [123I]R91150M.I.0.94  (0.50)2.4 (0.6)1.32 (0.49)0.95 (0.65)3.2  (2.0)3.9 (2.7)†
    C.D.1.09  (0.41)2.1 (1.3)2.3 (0.9)1.43 (1.02)4.5  (2.5)*5.3 (4.4)
    TCTM.I.0.81  (0.26)4.9 (4.8)2.9 (2.3)0.85 (0.38)4.0  (2.6)2.8 (3.4)
    C.D.1.00  (0.51)2.4 (1.9)1.20 (0.83)0.88 (0.43)2.5  (1.4)1.14 (0.75)

    • ↵* All values are expressed as mean (SD).

    • ↵† P < 0.05.

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