Clinical impact of diagnostic SPET investigations with a dopamine re-uptake ligand

51 Citations (Scopus)

Abstract

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.
Original languageEnglish
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume29
Issue number12
Pages (from-to)1623-9
Number of pages7
ISSN1619-7070
DOIs
Publication statusPublished - Dec 2002

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Antiparkinson Agents
  • Basal Ganglia Diseases
  • Cocaine
  • Corpus Striatum
  • Diagnosis, Differential
  • Dopamine Plasma Membrane Transport Proteins
  • Dystonia
  • Essential Tremor
  • Female
  • Humans
  • Male
  • Membrane Glycoproteins
  • Membrane Transport Proteins
  • Middle Aged
  • Nerve Tissue Proteins
  • Parkinson Disease
  • Parkinsonian Disorders
  • Patient Care Management
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tomography, Emission-Computed, Single-Photon

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