Analysis of brain SPECT with the statistical parametric mapping package SPM99

Full text: The Statistical Parametric Mapping (SPM) package of the Welcome Department of Cognitive Neurology permits detection in the brain of different regional uptake in an individual subject or a population of subjects compared to a normal population. SPM does not require a-priori specification of regions of interest. Recently SPM has been upgraded from SPM96 to SPM99. Our aim was to vary brain SPECT processing options in the application of SPM to optimise the final statistical map in three clinical trials. The sensitivity of SPM depends on the fidelity of the preliminary spatial normalisation of each scan to the standard anatomical space defined by a template scan provided with SPM. We generated our own SPECT template and compared spatial normalisation to it and to SPM's internal PET template. We also investigated the effects of scatter subtraction, stripping of scalp activity, reconstruction algorithm, non-linear deformation and derivation of spatial normalisation parameters using co-registered MR. Use of our SPECT template yielded better results than with SPM's PET template. Accuracy of SPECT to MR co-registration was 2.5mm with SPM96 and 1.2mm with SPM99. Stripping of scalp activity improved results with SPM96 but was unnecessary with SPM99. Scatter subtraction increased the sensitivity of SPM. Non-linear deformation additional to linear (affine) transformation only marginally improved the final result. Use of the SPECT template yielded more significant results than those obtained when co registered MR was used to derive the transformation parameters. SPM99 is more robust than SPM96 and optimum SPECT analysis requires a SPECT template. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc