Assessing the accuracy and reproducibility of computer-assisted analysis of (123) I-FP-CIT SPECT using BasGan (V2)

Over the last two decades (123) I-FP-CIT-SPECT, has been used to discriminate neurodegenerative Parkinsonian syndrome from other diseases. BasGan is a freely available software that assists (123) I-FP-CIT-SPECT evaluation by estimating semiquantitative values for each basal nucleus and compares the results to a database of healthy subjects. The aims of this study were: (1) to assess the accuracy of qualitative analysis and of semiquantitative, BasGan-assisted evaluations of (123) I-FP-CIT-SPECT; (2) to compare the accuracy of both methods when applied to "doubtful" cases; (3) to appreciate the reproducibility of the BasGan-assisted evaluations. Seventy-eight patients were included in this 4-year follow-up study. The diagnostic cut-off for semiquantitative uptake values of each basal nucleus was determined based on ROC curves analysis. Accuracy scores were calculated for the entire population and for "doubtful" cases. Intra- and interoperator reproducibility was assessed. Accuracy of the software-assisted analyses was high for data from each nucleus. In "doubtful" exams accuracy was higher when using BasGan as opposed to relying solely on visual assessment. Intra- and interoperator reproducibility of the BasGan-assisted evaluations was good to excellent. BasGan-assisted evaluations of (123) I-FP-CIT-SPECT were very useful, particularly in "doubtful" cases. Multicenter studies are mandatory before routine use of BasGan.