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Diagnosis of regional cerebral blood flow abnormalities using SPECT: agreement between individualized statistical parametric maps and visual inspection by nuclear medicine physicians with different levels of expertise in nuclear neurology
Rocha, Euclides Timóteo da; Buchpiguel, Carlos Alberto; Nitrini, Ricardo; Tazima, Sergio; Peres, Stela Verzinhase; Busatto Filho, Geraldo.
  • Rocha, Euclides Timóteo da; Fundação Pio XII. Hospital de Câncer. Department of Nuclear Medicine. Barretos. BR
  • Buchpiguel, Carlos Alberto; Hospital do Coração. Department of Nuclear Medicine. São Paulo. BR
  • Nitrini, Ricardo; Universidade de São Paulo. Faculdade de Medicina. Department of Neurology. São Paulo. BR
  • Tazima, Sergio; Hospital Alemão Oswaldo Cruz. Department of Nuclear Medicine. São Paulo. BR
  • Peres, Stela Verzinhase; Fundação Pio XII. Hospital de Câncer. Research Support Group. Barretos. BR
  • Busatto Filho, Geraldo; Universidade de São Paulo. Faculdade de Medicina. Institute of Psychiatry. Department of Radiology. São Paulo. BR
Clinics ; 64(12): 1145-1153, 2009. tab, ilus
Artigo em Inglês | LILACS | ID: lil-536217
ABSTRACT

INTRODUCTION:

Visual analysis is widely used to interpret regional cerebral blood flow (rCBF) SPECT images in clinical practice despite its limitations. Automated methods are employed to investigate between-group rCBF differences in research studies but have rarely been explored in individual analyses.

OBJECTIVES:

To compare visual inspection by nuclear physicians with the automated statistical parametric mapping program using a SPECT dataset of patients with neurological disorders and normal control images.

METHODS:

Using statistical parametric mapping, 14 SPECT images from patients with various neurological disorders were compared individually with a databank of 32 normal images using a statistical threshold of p<0.05 (corrected for multiple comparisons at the level of individual voxels or clusters). Statistical parametric mapping results were compared with visual analyses by a nuclear physician highly experienced in neurology (A) as well as a nuclear physician with a general background of experience (B) who independently classified images as normal or altered, and determined the location of changes and the severity.

RESULTS:

Of the 32 images of the normal databank, 4 generated maps showing rCBF abnormalities (p<0.05, corrected). Among the 14 images from patients with neurological disorders, 13 showed rCBF alterations. Statistical parametric mapping and physician A completely agreed on 84.37 percent and 64.28 percent of cases from the normal databank and neurological disorders, respectively. The agreement between statistical parametric mapping and ratings of physician B were lower (71.18 percent and 35.71 percent, respectively).

CONCLUSION:

Statistical parametric mapping replicated the findings described by the more experienced nuclear physician. This finding suggests that automated methods for individually analyzing rCBF SPECT images may be a valuable resource to complement visual inspection in clinical practice.
Assuntos

Texto completo: DisponíveL Índice: LILACS (Américas) Assunto principal: Encéfalo / Encefalopatias / Mapeamento Encefálico / Circulação Cerebrovascular / Medicina Nuclear Tipo de estudo: Estudo diagnóstico / Estudo observacional Limite: Adulto / Idoso / Aged80 / Feminino / Humanos / Masculino Idioma: Inglês Revista: Clinics Assunto da revista: Medicina Ano de publicação: 2009 Tipo de documento: Artigo País de afiliação: Brasil Instituição/País de afiliação: Fundação Pio XII/BR / Hospital Alemão Oswaldo Cruz/BR / Hospital do Coração/BR / Universidade de São Paulo/BR

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Texto completo: DisponíveL Índice: LILACS (Américas) Assunto principal: Encéfalo / Encefalopatias / Mapeamento Encefálico / Circulação Cerebrovascular / Medicina Nuclear Tipo de estudo: Estudo diagnóstico / Estudo observacional Limite: Adulto / Idoso / Aged80 / Feminino / Humanos / Masculino Idioma: Inglês Revista: Clinics Assunto da revista: Medicina Ano de publicação: 2009 Tipo de documento: Artigo País de afiliação: Brasil Instituição/País de afiliação: Fundação Pio XII/BR / Hospital Alemão Oswaldo Cruz/BR / Hospital do Coração/BR / Universidade de São Paulo/BR