123I-FP-CIT semi-quantitative SPECT detects preclinical bilateral dopaminergic deficit in early Parkinsonʼs disease with unilateral symptoms

Filippi, Luca; Manni, C.; Pierantozzi, Mariangela; Brusa, Livia; Danieli, Roberta; Stanzione, Paolo; Schillaci, Orazio

doi:10.1097/00006231-200505000-00005

Cited by 78 publications

(50 citation statements)

References 19 publications

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“…One of them acquired mild unilateral rigidity and parkinsonian facies (masklike expression), and the other is symptom free after a follow-up of 24 mo. These findings agree with those of previous studies showing that abnormal SPECT or PET findings may precede the diagnosis of PD by 3-5 y (15)(16)(17).…”

Section: Discussionsupporting

confidence: 93%

123I-FP-CIT SPECT Imaging of Dopamine Transporters in Patients with Recurrent Sudden Falls: Are Such Falls a Distinct Entity?

Djaldetti¹,

Treves²,

Ziv³

et al. 2007

Journal of Nuclear Medicine Technology

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Recurrent falls in older people are commonly associated with abnormalities that involve several parts of the central nervous system, especially with basal ganglion pathology. The aim of the present study was to evaluate the integrity of striatal dopamine transporters (DaTs) by use of 123 I-N-3-fluoropropyl-2b-carbomethoxy-3b-(4-iodophenyl)tropane ( 123 I-FP-CIT) SPECT of striatal DaTs in patients with recurrent sudden falls. Methods: Twenty-one patients without a definite neurologic diagnosis for recurrent sudden falls were enrolled in a cross-sectional study. SPECT with a DaT ligand was performed 180 min after injection of 185 MBq of 123 I-FP-CIT with a dual-head g-camera. Results: DaT SPECT findings were normal in 15 of 21 patients (71%). Of those, 73% had abnormal MRI findings suggestive of atherosclerotic lesions. Eleven patients with normal DaT SPECT findings had mild parkinsonian symptoms. There was no correlation of the SPECT results with patient age, duration of occurrence of falls, or frequency of falls, and there was no significant difference in the relative distributions of SPECT findings between patients with and patients without parkinsonian symptoms or vascular risk factors. Conclusion: Recurrent sudden falls are, in most cases, not attributable to the degeneration of the nigrostriatal system.

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Section: Discussionsupporting

confidence: 93%

123I-FP-CIT SPECT Imaging of Dopamine Transporters in Patients with Recurrent Sudden Falls: Are Such Falls a Distinct Entity?

Djaldetti¹,

Treves²,

Ziv³

et al. 2007

Journal of Nuclear Medicine Technology

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“…The reduction is not uniform throughout the striatum, with the smallest reduction in the caudate and an anterior-posterior gradient in the putamen (Morrish et al 1996;Nurmi et al 2001). Additionally, the reduction is asymmetrical, being more pronounced on the brain hemisphere contralateral to the more severe motor signs (Brooks et al 1990;Eidelberg et al 1990;Vingerhoets et al 1997;Benamer et al 2000;Pirker 2003;Filippi et al 2005). Other radiotracers that provide measures of presynaptic dopaminergic function (e.g., DAT and vesicular monoamine transporter [VMAT] ligands), show similar findings, and all decline with dis-ease progression (Vingerhoets et al 1994;Hirano et al 2010).…”

Section: Dopaminergic Dysfunction and Motor Symptomsmentioning

confidence: 99%

Functional Neuroimaging in Parkinson's Disease

Niethammer¹,

Feigin²,

Eidelberg³

2012

Cold Spring Harbor Perspectives in Medicine

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“…Quantitative methods for evaluating the dopaminergic deficit in SPECT scans have been developed (17)(18)(19)(20)(21)(22)(23) and offer an independent second read of the image data. Use of such software tools may also speed training by providing immediate feedback.…”

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confidence: 99%

Receiver-Operating-Characteristic Analysis of an Automated Program for Analyzing Striatal Uptake of 123I-Ioflupane SPECT Images: Calibration Using Visual Reads

Kuo

Avery

Krupiński

et al. 2013

Journal of Nuclear Medicine Technology

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A fully automated objective striatal analysis (OSA) program that quantitates dopamine transporter uptake in subjects with suspected Parkinson's disease was applied to images from clinical 123 I-ioflupane studies. The striatal binding ratios or alternatively the specific binding ratio (SBR) of the lowest putamen uptake was computed, and receiver-operating-characteristic (ROC) analysis was applied to 94 subjects to determine the best discriminator using this quantitative method. Methods: Ninety-four 123 I-ioflupane SPECT scans were analyzed from patients referred to our clinical imaging department and were reconstructed using the manufacturer-supplied reconstruction and filtering parameters for the radiotracer. Three trained readers conducted independent visual interpretations and reported each case as either normal or showing dopaminergic deficit (abnormal). The same images were analyzed using the OSA software, which locates the striatal and occipital structures and places regions of interest on the caudate and putamen. Additionally, the OSA places a region of interest on the occipital region that is used to calculate the background-subtracted SBR. The lower SBR of the 2 putamen regions was taken as the quantitative report. The 33 normal (bilateral comma-shaped striata) and 61 abnormal (unilateral or bilateral dopaminergic deficit) studies were analyzed to generate ROC curves. Results: Twenty-nine of the scans were interpreted as normal and 59 as abnormal by all 3 readers. For 12 scans, the 3 readers did not unanimously agree in their interpretations (discordant). The ROC analysis, which used the visual-majority-consensus interpretation from the readers as the gold standard, yielded an area under the curve of 0.958 when using 1.08 as the threshold SBR for the lowest putamen. The sensitivity and specificity of the automated quantitative analysis were 95% and 89%, respectively. Conclusion: The OSA program delivers SBR quantitative values that have a high sensitivity and specificity, compared with visual interpretations by trained nuclear medicine readers. Such a program could be a helpful aid for readers not yet experienced with 123 I-ioflupane SPECT images and if further adapted and validated may be useful to assess disease progression during pharmaceutical testing of therapies. Parki nson's disease (PD) is the prototypical neurodegenerative disease involving degeneration of nigrostriatal dopaminergic neurons, and its study has led to specific therapeutic interventions using dopamine-replacement therapies. Radiotracer SPECT imaging has played an important role in understanding the underlying mechanism of PD and potential therapy efficacies (1-8). Neuronal cell death in PD is an active, ongoing process. More objective assessment of disease progression in individuals with PD is becoming increasingly important as neuroprotective and neurorestorative strategies for PD are developed and tested.Difficulties in clinically evaluating disease progression in PD patients are multifactorial. The progression of PD is slow and ...

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123I-FP-CIT semi-quantitative SPECT detects preclinical bilateral dopaminergic deficit in early Parkinsonʼs disease with unilateral symptoms

Cited by 78 publications

References 19 publications

123I-FP-CIT SPECT Imaging of Dopamine Transporters in Patients with Recurrent Sudden Falls: Are Such Falls a Distinct Entity?

123I-FP-CIT SPECT Imaging of Dopamine Transporters in Patients with Recurrent Sudden Falls: Are Such Falls a Distinct Entity?

Functional Neuroimaging in Parkinson's Disease

Receiver-Operating-Characteristic Analysis of an Automated Program for Analyzing Striatal Uptake of 123I-Ioflupane SPECT Images: Calibration Using Visual Reads

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