Role of dopamine transporter imaging in the diagnosis of atypical tremor disorders

Marshall, Vicky; Grosset, Donald G.

doi:10.1002/mds.10574

Cited by 43 publications

(30 citation statements)

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“…Reports on DAT binding in vascular PS provide heterogeneous results, which might indicate that vascular PS is a mixed entity that is not yet well characterized (40). Some authors have reported normal or only a slight but insignificant reduction of DAT binding in patients with suspected vascular PS (45,54,55); others have found significantly reduced binding values (56,57). This discrepancy may be attributed to differences in patient populations and the relatively small numbers of subjects investigated.…”

Section: Vascular Psmentioning

confidence: 99%

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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Section: Vascular Psmentioning

confidence: 99%

Nigrostriatal Dopamine Terminal Imaging with Dopamine Transporter SPECT: An Update

2013

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“…Singlephoton emission computerized tomography (SPECT) of the dopamine transporter (DAT) as a marker for nigrostriatal neuronal degeneration has been proven useful and feasible in the differential diagnosis of PD and essential tremor (ET) in numerous studies [1][2][3][4][5][6][7][8][9][10][11] with a sensitivity of up to 97% and a specificity of 100% [3,6]. Furthermore, DAT SPECT is able to detect preclinical ipsilateral reduction of DAT density in patients with hemiparkinsonism [7,8], whereas ET and dystonic tremor is defined by normal DAT density [12].…”

Section: Introductionmentioning

confidence: 99%

The role of 123I-FP-CIT-SPECT in the differential diagnosis of Parkinson and tremor syndromes: a critical assessment of 125 cases

et al. 2011

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(123)I-FP-CIT-SPECT is useful in the differential diagnosis of Parkinson's disease (PD) and tremor syndromes. Recently, there have been reports on normal nigrostriatal uptake of radio ligands in PD patients, referred to as scans without evidence of dopaminergic deficit (SWEDDs). Furthermore, a dopaminergic deficit has been described in some cases of different tremor types. We sought to clarify the occurrence of SWEDDs in PD and a possible association of various tremor types with PD. We performed a retrospective case analysis of 125 patients with diagnostically uncertain Parkinsonian or non-Parkinsonian tremor syndromes with clinical assessments and (123)I-FP-CIT-SPECT. A total of 36/40 (90%) patients with the predominant clinical feature of a postural and/or kinetic tremor showed normal DAT SPECT; 73/85 (86%) with predominant clinical symptoms of PD showed abnormal DAT SPECT with lower overall radio ligand uptake and a significant asymmetry contralateral to the clinically more affected side. In all, 4/40 (10%) of non-Parkinsonian tremor patients had abnormal DAT SPECT, but no corresponding asymmetry of radio ligand uptake. Probable essential tremor was considered clinically in follow-up assessments although final diagnosis of these four tremor cases remains inconclusive. A total of 12/85 (14%) clinically suspected PD patients had normal DAT SPECT (SWEDDs). Clinical reassessment identified two patients with dystonic tremor. Five patients with a positive response to levodopa remained unclear. In four cases of suspected PD with normal DAT SPECT, non-neurologic diseases were identified. One case showed a complete and spontaneous remission of symptoms. DAT SPECT offers an objective method to confirm or exclude a dopaminergic deficit in tremor predominant parkinsonism for clinically inconclusive cases. There was no evidence of a decrease in DAT binding in the majority of patients with postural and/or kinetic tremor. The striatal asymmetry index is a further helpful tool for differentiating PD from non-PD tremor syndromes.

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“…Imaging of the presynaptic DAT has evolved into an important diagnostic tool for patients with Parkinsonian syndromes [1, [23][24][25], and thus has become a routine clinical procedure. Visual assessment of DAT SPECT studies in many cases enables clinicians to decide whether neurodegeneration of presynaptic neurons has occurred and to confirm or exclude a neurodegenerative Parkinsonian syndrome [2].…”

Section: Discussionmentioning

confidence: 99%

3D-OSEM and FP-CIT SPECT quantification

Koch¹,

Bartenstein²,

Fougère³

2013

Nuclear Medicine Communications

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Fougè reObjectives Dopamine transporter imaging with singlephoton emission computed tomography (SPECT) is a valuable tool for both clinical routine and research studies. Recently, it was found that the image quality could be improved by introduction of the three-dimensional ordered subset expectation maximization (3D-OSEM) reconstruction algorithm, which provides resolution recovery. The aim of this study was to systematically evaluate the potential benefits of 3D-OSEM in comparison with 2D-OSEM under critical imaging conditions, for example, scans with a high radius of rotation. Materials and methodsMonte Carlo simulation scans of a digital brain phantom with various disease states and different radii of rotation ranging from 13 to 30 cm were reconstructed with both 2D-OSEM and 3D-OSEM algorithms. Specific striatal binding and putamen-tocaudate ratios were determined and compared with true values in the phantom.Results The percentage recovery of true striatal binding was similar between both reconstruction algorithms at the minimum rotational radius; however, at the maximum rotational radius, it decreased from 53 to 43% for 3D-OSEM and from 52 to 26% for 2D-OSEM. 3D-OSEM matched the true putamen-to-caudate ratios more closely than did 2D-OSEM in scans with high SPECT rotation radii.Conclusion 3D-OSEM offers a promising image quality gain. It outperforms 2D-OSEM, particularly in studies with limited resolutions (such as scans acquired with a high radius of rotation) but does not improve the accuracy of the putamen-to-caudate ratios. Whether the benefits of better recovery in studies with higher radii of rotation could potentially increase the diagnostic power of dopamine transporter SPECT in patients with borderline striatal radiotracer binding, however, needs to be further examined.

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Role of dopamine transporter imaging in the diagnosis of atypical tremor disorders

Cited by 43 publications

References 20 publications

Nigrostriatal Dopamine Terminal Imaging with Dopamine Transporter SPECT: An Update

Nigrostriatal Dopamine Terminal Imaging with Dopamine Transporter SPECT: An Update

The role of 123I-FP-CIT-SPECT in the differential diagnosis of Parkinson and tremor syndromes: a critical assessment of 125 cases

3D-OSEM and FP-CIT SPECT quantification

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