unselected population. Consequently the remaining 56%
of patients had either other forms of dementia (AD,
FTD, VaD) or represented the ‘worried well’. Occipital
hypoperfusion was demonstrated in 28% (11/39) of
patients with DLB and in 31% (14/45) of non-DLB cases.
Conclusion Occipital hypoperfusion on HMPAO SPECT
is only demonstrated in a minority of patients with DLB.
Furthermore, occipital hypoperfusion is equally likely in
patients with DLB as opposed to all other dementias.
It is important for reporting clinicians to be aware
that the appearances of the occipital lobe on HMPAO
SPECT imaging may not be sufficiently reliable to either
rule in, or rule out, a diagnosis of DLB. A DaTSCAN is
essential.
7 DaTSCANt in clinical practice: qualitative or
quantitative analysis?
K.E. Gannon
1
, J. Deeb
2
, R. Gunasekera
1
and C.H. Hawkes
2
1
Nuclear Medicine Department,
2
Essex Neuroscience Centre,
Queen’s Hospital, Romford, Essex, UK.
Introduction Essential Tremor (ET) is commonly
misdiagnosed as Parkinson’s disease (PD), particularly
at early stages. DaTSCANt (
123
I-FP-CIT) SPECT
imaging provides a useful diagnostic tool for assessing
patients with suspected PD. Uptake of activity is usually
normal in ET patients and reduced in PD patients.
Methods 22 ET and 35 PD patients were recruited from
neurology clinics along with 15 healthy controls. All
patients underwent DaTSCANt tomography using a
Siemens E.CAM gamma camera at Oldchurch Hospital.
Images were assessed visually by the same nuclear
medicine consultant. They were also assessed quantita-
tively by a single operator using QuantiSPECT software.
Both the 2-Box and crescent ROI techniques were
employed, and all ET and PD patients were compared
to a normal range generated from the healthy controls. All
results, both visual and quantitative were compared to
the final clinical diagnosis (FCD).
Results
Table U2
Whole Striatum 2-Box Whole Striatum Crescent
FCD vs.
Visual
All Agree FCD vs.
QuantiSPECT
All Agree FCD vs
QuantiSPECT
ET 86% 73% 82% 82% 95%
PD 97% 80% 83% 69% 71%
Conclusion Visual analysis is consistent with FCD in 97%
of cases. Quantitative analysis reveals a high specificity
using the crescent ROI method. It is possible that ET
patients with abnormal scans are at a higher risk of
developing Parkinson’s disease. Further clinical follow up
is required.
8 Factor analysis of rCBF SPECT images to
mimic experienced observer
R. Peare and R.T. Staff
Department of Nuclear Medicine, Aberdeen Royal Infirmary,
Aberdeen, UK.
Purpose To investigate whether the use of principal
component analysis of rCBF SPECT images can model
experienced observer interpretation.
Method SPECT images from 227 patients were used
in this analysis. The images were categorised by an
experienced observer as normal (35), Alzheimer’s disease
(AD) (113), vascular (30), mixed (45) or frontal disease
(4). The SPECT images were spatially normalised to the
SPM SPECT template. Regions of interest were
generated using WFU PickAtlas 2.0. All regions were
normalised to the cerebellum. Principal component
analysis was performed using SPSS. Predictive models
were created using Z scores and a centroid technique.
Results The model was able to distinguish normal from
not normal with a sensitivity of 83% and a specificity of
84%. It distinguished AD from other forms of dementia
with a sensitivity of 65% and a specificity of 71%. It
differentiated between vascular and mixed disease with a
sensitivity of 83% and a specificity of 80%.
Conclusion This method has the potential to be a useful
tool in analysing clinical rCBF SPECT images. In
particular, principal component factors could be used to
curate images and allow appropriate database interroga-
tion: (‘I have an image show me a similar image’).
9 Evaluation of 1808 acquisition for DaTSCAN
using a brain phantom
J. O’Brien
1
, E. Clarke
2
, W.H. Thomson
1
and A. Notghi
1
1
City Hospital Birmingham, and
2
GE Healthcare Medical
Diagnostics, Birmingham, UK.
Purpose Recommended acquisition for DaTSCAN is a
circular (E13 cm radius) 3601 SPECT acquisition. This
can be difficult in patients with claustrophobia or severe
tremor. The vertex view has been used, but result can be
inconclusive [1]. We evaluated the feasibility of 1801
acquisition for such patients.
Methods We used a DaTSCAN phantom (courtesy of
GE Healthcare). Standard images were acquired over
3601 in 30 min with a dual-headed Philips Axis camera.
1801 images were acquired with the same acquisition
time in three ways: using two heads configured at 901 and
also at 1021, and with single head only (other head moved
far out). These open configurations are acceptable for
claustrophobic patients.
Results Comparison was made with 3601 images. Some
distortion occurred in all 1801 images. Due to camera
head limitations, 901 gave a poor orbit radius (18.3 cm)
compared with 1021 and single head (15.1cm and
12.1 cm). Resolution was therefore degraded which
BNMS Oral and Poster Abstracts 2007 A3
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