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Free fluid mask 36/12/2023 ![]() Of these patients, 208 were excluded from the study on account of having duplicated or clinically undiagnosed cases ( n = 14 and 177, respectively) or insufficient image quality ( n = 17), which included cases with cerebral hemorrhage or brain infarction. This single-center retrospective study included 529 consecutive patients who underwent DAT SPECT from February 2014 to May 2017. To the best of our knowledge, no prior clinical reports have assessed the performance of the CSF-mask algorithm in diagnosing PS. The purpose of this study was to assess the impact of the CSF-mask algorithm on the diagnostic accuracy of the SBR index for PS, and to examine whether the effect of the CSF-mask algorithm differed depending on the extent of cerebral ventricular dilatation indeed, we hypothesized that the more brain atrophy progresses, the better the effect of the CSF-mask algorithm. Therefore, the CSF-mask algorithm is expected to be useful when calculating an SBR index in such cases. reported that ventricular dilatation occurs early in the course of significant cognitive decline in patients with PD, and possibly reflect losses of both gray and white matter. Recently, the CSF-mask algorithm has been developed to reduce the aforementioned influence of CSF-low-counts. previously demonstrated the impact of ventricular enlargement on the SBR index with a three-dimensional (3D)-striatum digital brain phantom. Another disadvantage is that it is marred by SBR index fluctuations in cases of brain atrophy or cerebral ventricle dilatation because the low-count areas caused by cerebrospinal fluid (CSF) have negative influences on both the striatal and reference VOI counts. One disadvantage is that the striatal VOI cannot be divided into the caudate nucleus and the putamen thus, the diagnostic performance is not superior compared to the VOI settings where the striatal VOI is divided. Although this method reduces the harmful influence of the partial-volume effect and inter-operator variability, it has some disadvantages. This method defines the SBR index as the count concentration of the striatal VOI (reflecting specific binding) divided by the count concentration of the whole brain except for the striatum (reflecting non-specific binding). ![]() Specifically, the method applies a large pentagonal prism-shaped VOI setting that encompasses a wide area around the striatum, thereby reducing the partial-volume effect. ![]() developed the Southampton method, a semi-quantitative method based on the volume of interest (VOI), that has gained widespread use. ![]() Quantitative assessments, such as the specific binding ratio (SBR), are particularly effective in cases with subtle reductions in striatal tracer uptake, which are difficult to register with visual interpretation alone. Quantitative assessments are therefore used in addition to visual interpretation when performing DAT SPECT, and previous reports have indicated that a combination of visual interpretation and quantitative assessment achieves more accurate diagnoses. However, a previous study indicated that a suboptimal inter-observer agreement may lead to variable interpretation of DAT SPECT images, indicating that the efficacy of DAT SPECT may rely on visual interpretation. 0.917, p < 0.005).ĭopamine transporter (DAT) single-photon emission computed tomography (SPECT) is an imaging modality that can effectively differentiate neurodegenerative parkinsonian syndromes (PS), including Parkinson’s disease (PD) and dementia with Lewy bodies (DLB) from other neurological disorders not characterized by dopaminergic degeneration, such as Alzheimer disease, drug-induced Parkinsonism, and essential tremor. When corrected for attenuation, significant differences in the AUC were observed in all three EI groups (low EI group, AUC = 0.961 vs. 0.942, p = 0.11) in the middle and high EI groups, the CSF-mask algorithm performed better than the non-CSF-mask algorithm (middle EI group, AUC = 0.894 vs. When not corrected for attenuation, no significant difference in the AUC was observed in the low EI group between the non-CSF-mask and CSF-mask algorithms (0.927 vs. ROC analyses demonstrated that the CSF-mask algorithm performed better than the non-CSF-mask (no correction, area under the curve = 0.917 vs.
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