Assessing the performance of SPM analyses of spect neuroactivation studies. Statistical Parametric Mapping.

Several simulations of SPECT neuroactivation studies have been performed in order to determine the influence of both study size and activation focus characteristics on the detection of brain activation foci following a pixel-based statistical analysis. This was achieved by developing a methodology based on the Hoffman software brain phantom, SPECT acquisition simulation software, standard reconstruction software, and the Statistical Parametric Mapping (SPM96) package. We present results on the minimal activation levels required for focus detection. Furthermore, the improved sensitivity of the analysis resulting from the use of an iterative reconstruction technique (OSEM) with regard to the classical filtered backprojection (FBP) is assessed quantitatively, and the various physical, processing, and physiological parameters that potentially influence the detection of foci are discussed. Finally, the influence is investigated of the height threshold as implemented in SPM96 upon the size of the detected foci. Practical guidelines are proposed with regard to the number of subjects per group for SPECT activation studies following the split-dose design.