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Annals of Nuclear Medicine
Published in: Annals of Nuclear Medicine 6/2013

Open Access 01-07-2013 | Original Article

Voxel-based analysis of 201Tl SPECT for grading and diagnostic accuracy of gliomas: comparison with ROI analysis

Authors: Tomoyuki Kuwako, Sunao Mizumura, Ryusuke Murakami, Tamiko Yoshida, Masato Shiiba, Hidetaka Sato, Yoshimitsu Fukushima, Akira Teramoto, Shin-ichiro Kumita

Published in: Annals of Nuclear Medicine | Issue 6/2013

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Abstract

Purpose

The aim of this retrospective study was to assess the utility of a voxel-based analysis (VBA) method for 201Tl SPECT in glioma, compared to conventional ROI analysis.

Methods

We recruited 24 patients with glioma (high-grade 15; low-grade 9), for whom pre-operative 201Tl SPECT and MRI were performed. SPECT images were coregistered with MRI. The uptake ratio (UR) images of tumor to contralateral normal tissue were measured on early and delayed images, and the 201Tl retention index (RI) map was calculated from the early and delayed uptake ratio maps. In the ROI analysis, tumors were traced on a UR map, and the mean and maximal uptake ratio values on the early images were, respectively, defined as the mean and maximal UR. The mean and maximal RI values (mean and maximal RI) were calculated by division of the mean and maximal UR, respectively, on the delayed image by the mean and maximal UR on the early image. For the RI map calculated voxel by voxel, the maximal RI value was defined as VBA-RI. We evaluated sensitivity and accuracy of differential analysis with the mean and maximal UR, RI, and VBA-RI.

Results

The high- and low-grade groups showed no significant difference in mean and maximal RI (0.98 ± 0.12 vs. 1.05 ± 0.09 and 0.98 ± 0.18 vs. 1.05 ± 0.14, respectively). The AUC and accuracy of the mean and maximal RI were 0.681 and 66.7 %, and 0.622 and 62.5 %, respectively. In contrast, VBA-RI was higher in high-grade than in low-grade glioma (1.69 ± 0.27 vs. 0.68 ± 0.66, p < 0.001). The AUC and accuracy of VBA-RI were 0.963 and 95.8 %, which are higher than those obtained for mean (p < 0.05) and maximal RI (p < 0.01). There was no significant difference in ROC between the VBA-RI and the mean UR (0.911, p = 0.456) and maximal UR (0.933, p = 0.639); however, the AUC, sensitivity, and diagnostic accuracy of VBA-RI were all higher than those of the mean and maximal UR.

Conclusion

The voxel-based analysis method of 201Tl SPECT may improve diagnostic performance for gliomas, compared with ROI analysis.
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Metadata
Title
Voxel-based analysis of 201Tl SPECT for grading and diagnostic accuracy of gliomas: comparison with ROI analysis
Authors
Tomoyuki Kuwako
Sunao Mizumura
Ryusuke Murakami
Tamiko Yoshida
Masato Shiiba
Hidetaka Sato
Yoshimitsu Fukushima
Akira Teramoto
Shin-ichiro Kumita
Publication date
01-07-2013
Publisher
Springer Japan
Published in
Annals of Nuclear Medicine / Issue 6/2013
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-013-0711-y

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