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Am J Nucl Med Mol Imaging 2012;2(4):475-482
Original Article
18F-DOPA PET with and without MRI fusion, a receiver operator characteristics
comparison
Aaron F Struck, Lance T Hall, Joanna E Kusmirek, Catherine L Gallagher, John M Floberg, Christine J Jaskowiak, Scott B Perlman
Department of Radiology University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; William S. Middleton
Memorial VA, Madison, WI, USA; 3Department of Neurology University of Wisconsin School of Medicine and Public Health, Madison,
WI, USA; Department of Medical Physics, University of Wisconsin – Madison, Madison, WI, USA
Received August 3, 2012; Accepted August 19, 2012; Epub October 15, 2012; Published October 30, 2012
Abstract: This study is a retrospective analysis of the diagnostic accuracy of FDOPA PET with MRI fusion to FDOPA PET without MRI
fusion. Clinical FDOPA PET scans obtained between 2000 and 2008 at the University of Wisconsin Hospital and Clinics were
assessed using measures derived from regions of interest (ROI) generated with fused MRI (fused group) and again with ROIs
derived solely from PET data (non-fused groups). The ROIs were used to calculate ratios (Striatum/Occipital cortex,
Striatum/Cerebellum) pertinent to Parkinson’s disease (PD) pathology. The clinical records were assessed for demographic data,
follow-up length, and diagnosis. Receiver Operator Characteristics with area under the curve (AUC) measures were calculated and
compared using confidence intervals and hypothesis testing. 27 patients had FDOPA PET with median clinical follow-up of 4 years.
Of these, 17 patients had FDOPA PET with a fusible MR image. Seven of the 27 had a non-PD movement disorder. AUCs for the ratio
measures ranged from 0.97-1.0 (fused), 0.73-0.83 (non-fused), and 0.63-0.82 (matched non-fused). The fused images had improved
accuracy compared to the matched non-fused and all non-fused groups for the striatum to occipital group (p=0.04, p=0.03), while the
striatum to cerebellum ratio had improvement over the non-fused all group (p=0.041). MR fusion to FDOPA PET improves the
accuracy of at least some measures (Striatum/Occiput, Striatum/Cerebellum) in the diagnosis of PD. )ajnmmi1208001).
Keywords: 18F-Fluorodopa, positron emission tomography, image fusion, receiver operator characteristics, Parkinson’s
disease
Address all correspondence to:
Dr. Lance Hall
Box 3252 Clinical Science Center-E3 600 Highland Ave
Madison, WI 53792, USA.
Phone: (608) 263-5585; Fax: (608) 265-7390
E-mail: lhall@uwhealth.org
Original Article
18F-DOPA PET with and without MRI fusion, a receiver operator characteristics
comparison
Aaron F Struck, Lance T Hall, Joanna E Kusmirek, Catherine L Gallagher, John M Floberg, Christine J Jaskowiak, Scott B Perlman
Department of Radiology University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; William S. Middleton
Memorial VA, Madison, WI, USA; 3Department of Neurology University of Wisconsin School of Medicine and Public Health, Madison,
WI, USA; Department of Medical Physics, University of Wisconsin – Madison, Madison, WI, USA
Received August 3, 2012; Accepted August 19, 2012; Epub October 15, 2012; Published October 30, 2012
Abstract: This study is a retrospective analysis of the diagnostic accuracy of FDOPA PET with MRI fusion to FDOPA PET without MRI
fusion. Clinical FDOPA PET scans obtained between 2000 and 2008 at the University of Wisconsin Hospital and Clinics were
assessed using measures derived from regions of interest (ROI) generated with fused MRI (fused group) and again with ROIs
derived solely from PET data (non-fused groups). The ROIs were used to calculate ratios (Striatum/Occipital cortex,
Striatum/Cerebellum) pertinent to Parkinson’s disease (PD) pathology. The clinical records were assessed for demographic data,
follow-up length, and diagnosis. Receiver Operator Characteristics with area under the curve (AUC) measures were calculated and
compared using confidence intervals and hypothesis testing. 27 patients had FDOPA PET with median clinical follow-up of 4 years.
Of these, 17 patients had FDOPA PET with a fusible MR image. Seven of the 27 had a non-PD movement disorder. AUCs for the ratio
measures ranged from 0.97-1.0 (fused), 0.73-0.83 (non-fused), and 0.63-0.82 (matched non-fused). The fused images had improved
accuracy compared to the matched non-fused and all non-fused groups for the striatum to occipital group (p=0.04, p=0.03), while the
striatum to cerebellum ratio had improvement over the non-fused all group (p=0.041). MR fusion to FDOPA PET improves the
accuracy of at least some measures (Striatum/Occiput, Striatum/Cerebellum) in the diagnosis of PD. )ajnmmi1208001).
Keywords: 18F-Fluorodopa, positron emission tomography, image fusion, receiver operator characteristics, Parkinson’s
disease
Address all correspondence to:
Dr. Lance Hall
Box 3252 Clinical Science Center-E3 600 Highland Ave
Madison, WI 53792, USA.
Phone: (608) 263-5585; Fax: (608) 265-7390
E-mail: lhall@uwhealth.org
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