Diagnostic accuracy of dual-phase 18F-FP-CIT PET imaging for detection and differential diagnosis of Parkinsonism
Minyoung Oh, Narae Lee, Chanwoo Kim, Hye Joo Son, Changhwan Sung, Seung Jun Oh, Sang Ju Lee, Sun Ju Chung, Chong Sik Lee, Jae Seung Kim
Abstract
Abstract Delayed phase 18 F-FP-CIT PET (dCIT) can assess the striatal dopamine transporter binding to detect degenerative parkinsonism (DP). Early phase 18 F-FP-CIT (eCIT) can assess the regional brain activity for differential diagnosis among parkinsonism similar with 18 F-FDG PET. We evaluated the diagnostic performance of dual phase 18 F-FP-CIT PET (dual CIT) and 18 F-FDG PET compared with clinical diagnosis in 141 subjects [36 with idiopathic Parkinson’s disease (IPD), 77 with multiple system atrophy (MSA), 18 with progressive supranuclear palsy (PSP), and 10 with non-DP)]. Visual assessment of eCIT, dCIT, dual CIT, 18 F-FDG and 18 F-FDG PET with dCIT was in agreement with the clinical diagnosis in 61.7%, 69.5%, 95.7%, 81.6%, and 97.2% of cases, respectively. ECIT showed about 90% concordance with non-DP and MSA, and 8.3% and 27.8% with IPD and PSP, respectively. DCIT showed ≥ 88% concordance with non-DP, IPD, and PSP, and 49.4% concordance with MSA. Dual CIT showed ≥ 90% concordance in all groups. 18 F-FDG PET showed ≥ 90% concordance with non-DP, MSA, and PSP, but only 33.3% concordance with IPD. The combination of 18 F-FDG and dCIT yielded ≥ 90% concordance in all groups. Dual CIT may represent a powerful alternative to the combination of 18 F-FDG PET and dCIT for differential diagnosis of parkinsonian disorders.