Early-stage [123I]β-CIT SPECT and long-term clinical follow-up in patients with an initial diagnosis of Parkinson’s disease

Stoffers, Diederick; Booij, Jan; Bosscher, Lisette; Winogrodzka, Ania; Wolters, Erik Ch.; Berendse, Henk W.

doi:10.1007/s00259-004-1733-4

Cited by 30 publications

(20 citation statements)

References 35 publications

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“…In this context, Knudsen et al observed that an asymmetry index of striatal DAT binding greater than 15% allowed discrimination between early-tomoderate PD and MSA, with a sensitivity of 86% (34). However, these results were obtained in a small sample and are contradictory to other findings (9,12,31), including our own results, which do not reveal significant asymmetry indices in drug-treated PD patients.…”

Section: Presynaptic Nigrostriatal Systemcontrasting

confidence: 95%

“…In summary, the present results on the stand-alone analyses of FP-CIT SPECT, IBZM SPECT, and MIBG scintigraphy concur with previous studies reporting presynaptic nerve terminal affection, striatal D 2 receptor involvement, and myocardial sympathetic dysfunction in both PD and APD patients (9,10,12,14,31,34,41). Specifically, the present data reproduce the lower cardiac MIBG uptake in PD (vs. APD).…”

Section: Multimodal Investigationssupporting

confidence: 92%

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Diagnostic Accuracy of Combined FP-CIT, IBZM, and MIBG Scintigraphy in the Differential Diagnosis of Degenerative Parkinsonism: A Multidimensional Statistical Approach

Südmeyer

Antke²,

Zizek³

et al. 2011

J Nucl Med

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In vivo molecular imaging of pre-and postsynaptic nigrostriatal neuronal degeneration and sympathetic cardiac innervation with SPECT is used to distinguish idiopathic Parkinson disease (PD) from atypical parkinsonian disorder (APD). However, the diagnostic accuracy of these imaging approaches as standalone procedures is often unsatisfying. The aim of this study was therefore to evaluate to which extent diagnostic accuracy can be increased by their combined use together with a multidimensional statistical algorithm. Methods: The SPECT radiotracers 123 , and meta-123 I-iodobenzylguanidine (MIBG) were used to assess striatal postsynaptic D 2 receptor binding, striatal presynaptic dopamine transporter binding, and myocardial adrenergic innervation, respectively. Thirty-one PD and 17 APD patients were prospectively investigated. PD and APD diagnoses were established using consensus criteria and reevaluated after 37.4 6 12.4 and 26 6 11.6 mo in PD and APD, respectively. Test accuracy (TA) for PD-APD differentiation was computed for all logical (Boolean) combinations of imaging modalities by receiver-operating-characteristic analysis-that is, after multidimensional optimization of cutoff values. Results: Analysis showed moderate TA for PD-APD differentiation using each molecular approach alone (IBZM, 79%; MIBG, 73%; and FP-CIT, 73%). For combined use, the highest TA resulted under the assumption that at least 2 of the 3 biologic markers had to be positive for APD using the following cutoff values: 1.46 or less for IBZM, less than 2.10 for FP-CIT, and greater than 1.43 for MIBG. This algorithm distinguished APD from PD with a sensitivity of 94%, specificity of 94% (TA, 94%), positive predictive value of 89%, and negative predictive value of 97%. Conclusion: Results suggest that the multidimensional combination of FP-CIT, IBZM, and MIBG scintigraphy is likely to significantly increase TA in differentiating PD from APD. The differential diagnosis of degenerative parkinsonism may thus be facilitated.

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Section: Presynaptic Nigrostriatal Systemcontrasting

confidence: 95%

Section: Multimodal Investigationssupporting

confidence: 92%

Diagnostic Accuracy of Combined FP-CIT, IBZM, and MIBG Scintigraphy in the Differential Diagnosis of Degenerative Parkinsonism: A Multidimensional Statistical Approach

Südmeyer

Antke²,

Zizek³

et al. 2011

J Nucl Med

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“…We expect that the PDRP will be especially informative, because in contrast to olfaction,31 the PDRP is a progression marker 11. Moreover, PDRP expression is useful in the differential diagnosis of parkinsonian disorders,32 whereas DAT imaging is not 33…”

Section: Discussionmentioning

confidence: 99%

FDG PET, dopamine transporter SPECT, and olfaction: Combining biomarkers in REM sleep behavior disorder

et al. 2017

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BackgroundIdiopathic REM sleep behavior disorder is a prodromal stage of Parkinson's disease and dementia with Lewy bodies. Hyposmia, reduced dopamine transporter binding, and expression of the brain metabolic PD‐related pattern were each associated with increased risk of conversion to PD. The objective of this study was to study the relationship between the PD‐related pattern, dopamine transporter binding, and olfaction in idiopathic REM sleep behavior disorder.MethodsIn this cross‐sectional study, 21 idiopathic REM sleep behavior disorder subjects underwent 18F‐fluorodeoxyglucose PET, dopamine transporter imaging, and olfactory testing. For reference, we included 18F‐fluorodeoxyglucose PET data of 19 controls, 20 PD patients, and 22 patients with dementia with Lewy bodies. PD‐related pattern expression z‐scores were computed from all PET scans.ResultsPD‐related pattern expression was higher in idiopathic REM sleep behavior disorder subjects compared with controls (P = 0.048), but lower compared with PD (P = 0.001) and dementia with Lewy bodies (P < 0.0001). PD‐related pattern expression was higher in idiopathic REM sleep behavior disorder subjects with hyposmia and in subjects with an abnormal dopamine transporter scan (P < 0.05, uncorrected).ConclusionPD‐related pattern expression, dopamine transporter binding, and olfaction may provide complementary information for predicting phenoconversion. © 2017 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

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“…Notably, reduced binding was observed not only in the striatum, and especially the putamen, corresponding to the symptomatic limbs but also already in the contralateral putamen associated with the clinically still yet asymptomatic side of the body (23)(24)(25). The reported binding values were significantly lowered compared with those of age-matched healthy controls and showed no or almost no overlap between patients and controls.…”

Section: Early Diagnosis Of Neurodegenerative Psmentioning

confidence: 92%

“…Furthermore, longitudinal imaging studies have proven capable of determining intraindividual disease progression (24,38). Concordantly, in those studies the annual rate of decline of DAT binding ranged from 6% to 8%.…”

Section: Assessment Of Disease Progressionmentioning

confidence: 93%

Nigrostriatal Dopamine Terminal Imaging with Dopamine Transporter SPECT: An Update

2013

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Learning Objectives: On successful completion of this activity, participants should be able to describe (1) the radiopharmaceuticals used to evaluate nigrostriatal dopamine imaging; (2) the pattern of uptake of these radiopharmaceuticals in parkinsonian syndromes; and (3) the role of these radiopharmaceuticals in the evaluation of parkinsonian syndromes.Financial Disclosure: Dr. Tatsch is a meeting participant/lecturer for GE Healthcare. The authors of this article have indicated no other relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, participants can access this activity through the SNMMI Web site (http:// www.snmmi.org/ce_online) through August 2016.This article gives an update on nigrostriatal dopamine terminal imaging, with emphasis on SPECT performed with the presynaptic dopamine transporter (DAT) ligand 123 I-FP-CIT. The paper covers the rational use of this technique in the diagnostic work-up of patients with known or suspected parkinsonian syndromes. In detail, it addresses the impact of the method for the proof or exclusion of neurodegenerative parkinsonism, for its early and preclinical diagnosis, and for the evaluation of disease progression. The importance of normal DAT binding for differentiating symptomatic parkinsonism and relevant tremor syndromes from neurodegeneration is highlighted. Particularly emphasized is the role of DAT SPECT for diagnosing Lewy body dementia and its separation from Alzheimer dementia. Finally, some remarks deal with the economic aspects of the use of these imaging techniques in the clinical setting.

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Early-stage [123I]β-CIT SPECT and long-term clinical follow-up in patients with an initial diagnosis of Parkinson’s disease

Cited by 30 publications

References 35 publications

Diagnostic Accuracy of Combined FP-CIT, IBZM, and MIBG Scintigraphy in the Differential Diagnosis of Degenerative Parkinsonism: A Multidimensional Statistical Approach

Diagnostic Accuracy of Combined FP-CIT, IBZM, and MIBG Scintigraphy in the Differential Diagnosis of Degenerative Parkinsonism: A Multidimensional Statistical Approach

FDG PET, dopamine transporter SPECT, and olfaction: Combining biomarkers in REM sleep behavior disorder

Nigrostriatal Dopamine Terminal Imaging with Dopamine Transporter SPECT: An Update

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