engleski

The quantification of 123I-FP-CIT (DaTSCAN) imaging: statistical differentiation between Parkinson's disease and essential tremor

Aim: Qualitatively and semiquantitatively, 123I- FP-CIT brain SPECT was used to estimate the possibility of precise and early differentiation of Parkinson's disease (PD) from essential tremor (ET) for the purpose of an adequate and early treatment of patients with PD. Methods: 123I-FP- CIT binding, expressed as normalized specific to nonspecific (occipital cortex) uptake ratio, was investigated in 134 patients with clinically uncertain PD (58 male, 76 female, median 67, interquartile range 58-72 years). PD versus ET differentiation was based on visual interpretation and quantification of 123I-FP-CIT accumulation within regions of interest including the whole striatum, nucleus caudatus and putamen (3-4 h p.i., 128x128 matrix, 64x30 s, 360°, LEHR parallel collimator, FBP).Results: Reduced striatal dopamine transporter (DAT) density [0.85 (0.44- 1.3)] was detected in 64 PD patients. The 123I-FP- CIT SPECT images were normal in 70 patients with ET [median striatal uptake ratio 2.44 (1.78-3.1)]. DAT density was significantly reduced in PD patients when compared to the ET patients (for striatum, p=5.8x10-32 ; for putamen p=1.7x10-36, and caudate of advanced PD p=1.3x10-27). The 123I- FP-CIT uptake in PD patients was progressively reduced with disease stage in the striatum, putamen and caudate (all p<10-17, Kruskall-Wallis test).Conclusion: 123I-FP-CIT SPECT is a reliable and sensitive biomarker of nigrostriatal neuronal integrity in vivo, thus enabling an early introduction of neuroprotective therapy.

ioflupane ; I-123 ; Parkinson's disease ; essential tremor

Abstract of 10th Congress of the World Federation of Nuclear Medicine and Biology (WFNMB), September 18 - 23, 2010. Cape Town, South Africa.