Comparison of [18F]-FDOPA PET and [123I]-FP-CIT SPECT acquired in clinical practice for assessing nigrostriatal degeneration in patients with a clinically uncertain parkinsonian syndrome
Elon Wallert, Erwann Letort, F. van der Zant, Ania Winogrodzka, Henk W. Berendse, Martijn Beudel, Rob M.A. de Bie, Jan Booij, Pieter G. Raijmakers, Elsmarieke van de Giessen
Abstract
Abstract Purpose Two commonly used imaging techniques to aid in the diagnosis of neurodegenerative parkinsonian syndromes are dopamine transporter (DAT) imaging with [ 123 I]-FP-CIT single-photon emission computed tomography (DAT-SPECT) and positron emission tomography with [ 18 F]-FDOPA (FDOPA-PET). This paper provides a unique series of parkinsonian patients who received both FDOPA-PET and DAT-SPECT in routine clinical practice and compares the reported results to assess potential differences between these two imaging techniques. Methods We present 11 patients with a clinically uncertain parkinsonian syndrome (CUPS), who received both FDOPA-PET and DAT-SPECT. All patients received an FDOPA-PET scan and DAT-SPECT as part of routine clinical care. Results The median time between the F-DOPA-PET scan and DAT-SPECT scan was 6 months (range 0–15 months). There was a discrepancy in the reported results of the FDOPA-PET and DAT-SPECT scans in nine patients, including 7 patients whose FDOPA-PET scan was reportedly normal, whereas their DAT-SPECT scan was abnormal. Conclusions In this case series of CUPS patients, DAT-SPECT was more often rated as abnormal than FDOPA-PET. The striatal loss of FDOPA uptake can be less pronounced than that of DAT binding in CUPS patients in early disease stages. Consequently, the interpretation of FDOPA-PET scans in CUPS can sometimes be challenging in routine practice.