Clinical utility of DaTscan™ imaging in the evaluation of patients with parkinsonism: a US perspective

Isaacson, Stuart; Fisher, Stanley E.; Gupta, Fiona; Hermanowicz, Neal; Kremens, Daniel; Lew, Mark F.; Marek, Kenneth; Pahwa, Rajesh; Russell, David; Seibyl, John

doi:10.1080/14737175.2017.1256205

Cited by 25 publications

(20 citation statements)

References 47 publications

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“…A possible impediment to using the MDS research criteria is that they utilize likelihood ratios based on certain genetic, clinical motor and nonmotor, environmental, and imaging factors; many of these have not been validated in an autopsy cohort, and the needed data and/or statistical modeling expertise may not always be available. It has been suggested that the combination of earlier‐onset (<55), typical clinical features (focal onset, resting tremor), and focal and asymmetrical posterior putamen dopaminergic depletion makes false‐positive diagnosis much lower, but review of DA imaging studies indicates that striatal uptake patterns, though statistically helpful, are not likely to be useful in individual subjects …”

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confidence: 99%

Importance of low diagnostic Accuracy for early Parkinson's disease

Beach

Adler

2018

Movement Disorders

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confidence: 99%

Importance of low diagnostic Accuracy for early Parkinson's disease

Beach

Adler

2018

Movement Disorders

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“…DaTSCAN is currently approved in Europe and the USA for use in the differential diagnosis between PD tremor and essential tremor as well as for differentiation between AD and LBD. However, in clinical practice, SPECT-DaTSCAN is used much more widely and may be useful whenever there is a need to distinguish between neurodegenerative parkinsonism (PD, MSA, PSP, CBS) and parkinsonian syndromes not resulting from damage to the dopaminergic system in subjects with equivocal signs and symptoms (DIP, PP, VP) [18].…”

Section: Discussionmentioning

confidence: 99%

Should non-movement specialists refer patients for SPECT-DaTSCAN?

Gajos

Dąbrowski

Bieńkiewicz

et al. 2019

Neurol Neurochir Pol.

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Background. SPECT with radioligand DaTSCAN (SPECT-DaTSCAN) is a sensitive tool used for assessing the functional integrity of the presynaptic part of the nigrostriatal dopaminergic system. The procedure is useful whenever there is a need to distinguish between neurodegenerative parkinsonism and other parkinsonian syndromes in subjects with equivocal signs and symptoms. It can be assumed that the neurologist's decision to perform SPECT-DaTSCAN depends on his or her experience and skill in the diagnosis of parkinsonian and tremor syndromes. Aims. To assess the accuracy of referrals to SPECT-DATSCAN made by non-movement disorders specialists. Material and methods. Sixty seven patients referred for SPECT-DaTSCAN by a general neurologist were studied. In all subjects, a movement disorder specialist performed the neurological examination, collected medical history, and analysed previous treatments and the results of diagnostic tests. Results. Evaluation carried out by a movement disorder specialist did not confirm an indication for SPECT-DaTSCAN in 31 patients (46.3%). General neurologists needed support for clinical diagnosis with SPECT-DaTSCAN most frequently in subjects with parkinsonism even though they were presenting a full-blown disease manifestation and even though the patients met the diagnostic criteria for Parkinson's disease or one of the atypical parkinsonian syndromes. Conclusions. Our presented results probably reflect the limited experience of general neurologists in the evaluation of parkinsonian syndromes and tremor. The use of SPECT-DaTSCAN by non-movement disorders specialists is associated with a significant risk of overuse of this tool. To minimise this risk, the skills of general neurologists in diagnosing parkinsonian and tremor syndromes should be improved. Moreover, patients should be provided with access to movement disorders specialists.

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“…DA: dopamine agonist, LEDD: levodopa equivalent daily dose up to 92% of those patients with an appropriate request in comparison to only 13% of patients with an inappropriate request 18 . As a consequence, it has been recommended that the major utility of DAT SPECT imaging is in distinguishing between nigrostriatal dopaminergic degeneration and non-nigrostriatal degeneration in patients displaying parkinsonism with diagnostic uncertainty 19 . [ 11 C]DTBZ PET scans have been less studied; nevertheless, reduction in striatal binding of this radiotracer has proven to correlate with disease duration and clinical asymmetry [24][25][26] .…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Utility of [11C]DTBZ Positron Emission Tomography In Clinically Uncertain Parkinsonism: Experience of a Single Tertiary Center

Perez‐Lohman

Kerik

Díaz-Meneses

et al. 2018

RIC

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Background: The use of single-photon emission computed tomography and positron emission tomography (PET) has proven to be helpful in differentiating Parkinson's disease (PD) from other movement disorders with a sensitivity of up to 95%. Objective: The objective of this study was to determine the accuracy of [ 11 C]DTBZ PET imaging in patients with clinically uncertain parkinsonism from a tertiary referral center in Mexico City. Materials and Methods: Patients who underwent [ 11 C]DTBZ PET brain scan due to clinically uncertain parkinsonism where divided into two groups: PD or non-PD. A scan was considered positive when visual assessment revealed a decrease in [ 11 C]DTBZ uptake typical for PD; a scan was considered negative when visual assessment showed no decrease in [ 11 C]DTBZ uptake or showed a decrease in tracer uptake in a non-PD pattern. Sensitivity, specificity, and positive and negative predictive values were calculated using a 2 × 2 table, with a 95% confidence interval. Results: A total of 39 patients were included in the study. 14 PET studies were deemed positive and 25 PET studies were deemed negative; 12 true positives and 23 true negatives were found. This yielded a sensitivity of 92.9% (95% CI, 66.1-99.8),

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Clinical utility of DaTscan™ imaging in the evaluation of patients with parkinsonism: a US perspective

Cited by 25 publications

References 47 publications

Importance of low diagnostic Accuracy for early Parkinson's disease

Importance of low diagnostic Accuracy for early Parkinson's disease

Should non-movement specialists refer patients for SPECT-DaTSCAN?

Diagnostic Utility of [11C]DTBZ Positron Emission Tomography In Clinically Uncertain Parkinsonism: Experience of a Single Tertiary Center

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