Visual and semiquantitative accuracy in clinical baseline 123I-Ioflupane SPECT/CT imaging

Rudolf A. Werner, Charles Marcus, Sara Sheikhbahaei, Lilja B. Solnes, Jeffrey P. Leal, Yong Du, Steven P. Rowe, Takahiro Higuchi, Andreas K. Buck, Constantin Lapa, Mehrbod S. Javadi

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Purpose We aimed to (a) elucidate the concordance of visual assessment of an initial 123I-ioflupane scan by a human interpreter with comparison to results using a fully automatic semiquantitative method and (b) to assess the accuracy compared to follow-up (f/u) diagnosis established by movement disorder specialists. Methods An initial 123I-ioflupane scan was performed in 382 patients with clinically uncertain Parkinsonian syndrome. An experienced reader performed a visual evaluation of all scans independently. The findings of the visual read were compared with semiquantitative evaluation. In addition, available f/u clinical diagnosis (serving as a reference standard) was compared with results of the human read and the software. Results When comparing the semiquantitative method with the visual assessment, discordance could be found in 25 (6.5%) of 382 of the cases for the experienced reader (kg = 0.868). The human observer indicated region of interest misalignment as the main reason for discordance. With neurology f/u serving as reference, the results of the reader revealed a slightly higher accuracy rate (87.7%, kg = 0.75) compared to semiquantification (86.2%, kg = 0.719, P < 0.001, respectively). No significant difference in the diagnostic performance of the visual read versus software-based assessment was found. Conclusions In comparison with a fully automatic semiquantitative method in 123I-ioflupane interpretation, human assessment obtained an almost perfect agreement rate. However, compared to clinical established diagnosis serving as a reference, visual read seemed to be slightly more accurate as a solely software-based quantitative assessment.

Original languageEnglish
Pages (from-to)1-3
Number of pages3
JournalClinical Nuclear Medicine
Issue number1
Publication statusPublished - Jan 1 2019
Externally publishedYes


  • DaTscan
  • I-ioflupane
  • Parkinson disease
  • parkinsonism

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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