Differential diagnosis of Parkinson's disease and vascular parkinsonism byTc-99m-TRODAT-1

Citation
Ky. Tzen et al., Differential diagnosis of Parkinson's disease and vascular parkinsonism byTc-99m-TRODAT-1, J NUCL MED, 42(3), 2001, pp. 408-413
Citations number
40
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
Journal title
JOURNAL OF NUCLEAR MEDICINE
ISSN journal
0161-5505 → ACNP
Volume
42
Issue
3
Year of publication
2001
Pages
408 - 413
Database
ISI
SICI code
0161-5505(200103)42:3<408:DDOPDA>2.0.ZU;2-D
Abstract
The aim of this study was to use brain SPECT to differentiate vascular park insonism (VP) from Parkinson's disease. Methods: Fourteen VP patients (age range, 59-87 y; mean age, 70 +/- 7.5 y), 30 Parkinson's disease patients (a ge range, 54-84 y; mean age, 65 +/- 8.8 y), and 26 healthy (control) indivi duals (age range, 50-85 y; mean age, 60 +/- 9 y) were examined. A 925-MBq ( 25 mCi) dose of Tc-99m-TRODAT-1 was injected intravenously, and brain SPECT images were acquired 4 h after injection. The ratio of specific to nonspec ific striatal Tc-99m-TRODAT-1 binding was measured and compared. Results: A fter a region-oi-interest analysis of the images from VP patients, Parkinso n's disease patients, and healthy volunteers was performed to obtain ratios of putamen to occipital and striatal to occipital binding as a measurement of specific binding to the dopamine transporters in these regions of the b rain, where dopamine neurons are concentrated, the specific binding in the 14 VP patients was slightly lower than but not statistically different from that of the healthy individuals in both putamen and caudate areas. A signi ficant decrease in uptake of 99mTc-TRODAT-1 in the striatum (P < 0.01) was found in Parkinson's disease patients. Reduction of the uptake was more pro nounced in the contralateral putamen of Parkinson's disease patients than t hat of VP patients (P < 0.001). A significant bilateral striatal asymmetry was also observed in Parkinson's disease patients but not in VP patients (P < 0.01). Conclusion: Our findings clearly show that, for VP patients, Tc-9 9m-TRODAT-1 SPECT is a reliable method to differentiate VP from Parkinson's disease. Further studies, including those to differentiate Parkinson's dis ease from arteriosclerotic parkinsonism and patients with both VP and Parki nson's disease, are needed to help rule out the possibility of Parkinson's disease as early as possible.