Simultaneous 99mTC and 123I Dual-Isotope Brain Striatal Phantom Single Photon Emission Computed Tomography: Validation of 99mTC-Trodat-1 and 123I-IBZM Simultaneous Dopamine System Brain Imaging

[2[[2-[[[3-(4-chlorophenyl)-8-methyl-8-azabicyclo[3,2,1]-oct-2-yl]-methyl](2-mercaptoethyl)amino]ethyl]amino]ethanethiolato(3-)-N2,N2′,S2,S2]oxo-[1R-exo-exo)])-[99mTc]-technetium (99mTc-TRODAT-1) and 123I-iodobenzamide (123I-IBZM) are radiotracers for brain dopamine preand postsynaptic neuron imaging. The purpose of this study was to evaluate imaging parameters and crossed energy interference using simultaneous single photon emission computed tomography (SPECT) 99mTc and 123I data acquisition. A five-compartment brain striatal phantom was filled with 99mTc and/or 123I radioactive solutions with different striatal-to-background ratios, ranging from 3:1 to 9:1. SPECT data were acquired with energy window settings of 15% for the centered window at 140 keV for 99mTc and a 10% asymmetric window at 159 keV for 123I. The experiments were carried out using either individual (99mTc or 123I only) or both radionuclides. The striatal-to-background ratios and energy crossed interference between 99mTc and 123I were calculated. The phantom SPECT images demonstrated that the energy crossed interferences from 123I to 99mTc, and vice versa, were 22 ± 12.4% and 0.4 ± 1.0%, respectively. A net interference of 7.1 ± 4.0% for the counts in the 15% centered 99mTc window can be expected from 123I and a net interference of 1.6 ± 3.3% for the counts in the 10% asymmetric 123I window was derived from 99mTc. The correlation of striatal-to-background ratios between single isotope and simultaneous dual-isotope was excellent (R2 = 0.99). The imaging parameters used in this simultaneous dual-isotope SPECT imaging could be used in future clinical practice for imaging patients with movement disorders by using 99mTc-TRODAT-1 and 123I-IBZM. The striatal-to-background ratios were not affected by the crossed interference between 99mTc and 123I