TY - JOUR
T1 - Clinical impact of diagnostic SPET investigations with a dopamine re-uptake ligand
AU - Løkkegaard, Annemette
AU - Werdelin, Lene M
AU - Friberg, Lars
PY - 2002/12
Y1 - 2002/12
N2 - The diagnosis of Parkinson's disease is based on clinical features with pathological verification. However, autopsy has been found to confirm a specialist diagnosis in only about 75% of cases. Especially early in the course of the disease, the clinical diagnosis can be difficult. Imaging of presynaptic dopamine transporters (DAT receptors) has provided a possible diagnostic probe in the evaluation of Parkinson's disease. The cocaine analogue [(123)I]-2-beta-carboxymethoxy-3-beta(4-iodophenyl)tropane ([(123)I]-beta-CIT) is one of several radioligands that have been developed for single-photon emission tomography (SPET). The purpose of this study was to evaluate the impact of [(123)I]-beta-CIT SPET on the diagnosis and clinical management of patients with a primary, tentative diagnosis of parkinsonism. We undertook a retrospective evaluation of the clinical records of 90 consecutive patients referred to [(123)I]-beta-CIT SPET from the neurological department, Bispebjerg Hospital. In 58 subjects the scans revealed altered tracer uptake consistent with Parkinson's disease, progressive supranuclear palsy and multiple system atrophy. A significant change in the management or treatment because of the scan was found in 25 patients (28%). The sensitivity of the examination was 97% and the specificity 83%. In conclusion, a significant clinical impact of DAT receptor SPET imaging was found. DAT receptor imaging is a useful diagnostic probe in patients with a possible diagnosis of parkinsonism.
AB - The diagnosis of Parkinson's disease is based on clinical features with pathological verification. However, autopsy has been found to confirm a specialist diagnosis in only about 75% of cases. Especially early in the course of the disease, the clinical diagnosis can be difficult. Imaging of presynaptic dopamine transporters (DAT receptors) has provided a possible diagnostic probe in the evaluation of Parkinson's disease. The cocaine analogue [(123)I]-2-beta-carboxymethoxy-3-beta(4-iodophenyl)tropane ([(123)I]-beta-CIT) is one of several radioligands that have been developed for single-photon emission tomography (SPET). The purpose of this study was to evaluate the impact of [(123)I]-beta-CIT SPET on the diagnosis and clinical management of patients with a primary, tentative diagnosis of parkinsonism. We undertook a retrospective evaluation of the clinical records of 90 consecutive patients referred to [(123)I]-beta-CIT SPET from the neurological department, Bispebjerg Hospital. In 58 subjects the scans revealed altered tracer uptake consistent with Parkinson's disease, progressive supranuclear palsy and multiple system atrophy. A significant change in the management or treatment because of the scan was found in 25 patients (28%). The sensitivity of the examination was 97% and the specificity 83%. In conclusion, a significant clinical impact of DAT receptor SPET imaging was found. DAT receptor imaging is a useful diagnostic probe in patients with a possible diagnosis of parkinsonism.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Antiparkinson Agents
KW - Basal Ganglia Diseases
KW - Cocaine
KW - Corpus Striatum
KW - Diagnosis, Differential
KW - Dopamine Plasma Membrane Transport Proteins
KW - Dystonia
KW - Essential Tremor
KW - Female
KW - Humans
KW - Male
KW - Membrane Glycoproteins
KW - Membrane Transport Proteins
KW - Middle Aged
KW - Nerve Tissue Proteins
KW - Parkinson Disease
KW - Parkinsonian Disorders
KW - Patient Care Management
KW - Reproducibility of Results
KW - Retrospective Studies
KW - Sensitivity and Specificity
KW - Tomography, Emission-Computed, Single-Photon
U2 - 10.1007/s00259-002-0938-7
DO - 10.1007/s00259-002-0938-7
M3 - Journal article
C2 - 12458397
SN - 1619-7070
VL - 29
SP - 1623
EP - 1629
JO - European Journal of Nuclear Medicine and Molecular Imaging
JF - European Journal of Nuclear Medicine and Molecular Imaging
IS - 12
ER -