Der Nuklearmediziner 2015; 38(01): 40-47
DOI: 10.1055/s-0034-1398585
Normalbefunde Konventioneller NUK-Diagnostik (non-PET)
© Georg Thieme Verlag KG Stuttgart · New York

Dopamintransporter-SPECT mit [123I]FP-CIT: Empfehlungen für die visuelle Beurteilung

Dopamine Transporter SPECT with [123I]FP-CIT: Recommendations for Visual Interpretation
R. Buchert
1   Klinik für Nuklearmedizin, Charité – Universitätsmedizin Berlin
,
C. Lange
1   Klinik für Nuklearmedizin, Charité – Universitätsmedizin Berlin
,
I. Apostolova
2   Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R.
,
P. T. Meyer
3   Klinik für Nuklearmedizin, Universitätsklinikum Freiburg
› Author Affiliations
Further Information

Publication History

Publication Date:
10 March 2015 (online)

Zusammenfassung

SPECT mit dem Kokain-Analogon [123I]FP-CIT wird für den Nachweis oder Ausschluss der Degeneration nigrostriataler Neurone bei Patienten mit klinisch unklarem Parkinson-Syndrom eingesetzt. Die Beurteilung der Untersuchung basiert auf der visuellen Interpretation der SPECT-Bilder, die durch semiquantitative Analysen unterstützt werden kann. Wesentlicher Nachteil der visuellen Bildbeurteilung gegenüber der semiquantitativen Analyse ist, dass sie prinzipiell subjektiv und insbesondere von der Erfahrung des Befunders abhängig ist. Im vorliegenden Artikel sind daher einfach anzuwendende Empfehlungen zusammengestellt, die den Arzt in der täglichen Routine bei der visuellen Differenzierung zwischen normaler und reduzierter striataler [123I]FP-CIT-Aufnahme im Sinne nigrostriataler Degeneration unterstützen sollen. Anwendung der Empfehlungen sollte die Befunder-Abhängigkeit der visuellen Bildinterpretation bei der [123I]FP-CIT-SPECT reduzieren.

Abstract

SPECT with the cocaine analog [123I]FP-CIT is widely used for the detection or exclusion of nigrostriatal degeneration in patients with clinically uncertain parkinsonian syndrome. The interpretation of [123I]FP-CIT SPECT is based on visual assessment of the SPECT images, which can be supported by semi-quantitative analysis of [123I]FP-CIT uptake in the striatum and its substructures. The main limitation of visual interpretation of [123I]FP-CIT SPECT images is its inter-rater variability. The present paper compiles easily applicable recommendations for visual interpretation of [123I]FP-CIT SPECT that are intended to support the physician in the differentiation between normal and reduced striatal uptake of [123I]FP-CIT in everyday clinical routine. Application of these recommendations is expected to reduce inter-rater variability.

 
    • Literatur

    • 1 Amtage F, Hellwig S, Meyer PT. Klinische Differentialdiagnose des Parkinson-Syndroms. Der Nuklearmediziner 2012; 35: 93-101
    • 2 Antonini A, Benti R, De Notaris R et al. 123I-Ioflupane/SPECT binding to striatal dopamine transporter (DAT) uptake in patients with Parkinson‘s disease, multiple system atrophy, and progressive supranuclear palsy. Neurol Sci 2003; 24: 149-150
    • 3 Badiavas K, Molyvda E, Iakovou I et al. SPECT imaging evaluation in movement disorders: far beyond visual assessment. Eur J Nucl Med Mol Imaging 2011; 38: 764-773
    • 4 Bajaj N, Hauser RA, Seibyl J et al. Association between Hoehn and Yahr, Mini-Mental State Examination, age, and clinical syndrome predominance and diagnostic effectiveness of ioflupane I 123 injection (DaTSCAN) in subjects with clinically uncertain parkinsonian syndromes. Alzheimers Res Ther 2014; 6: 67
    • 5 Benamer TS, Patterson J, Grosset DG et al. Accurate differentiation of parkinsonism and essential tremor using visual assessment of [123I]-FP-CIT SPECT imaging: the [123I]-FP-CIT study group. Mov Disord 2000; 15: 503-510
    • 6 Benito-Leon J. Essential tremor: a neurodegenerative disease?. Tremor Other Hyperkinet Mov (N Y) 2014; 4: 252
    • 7 Booij J, Kemp P. Dopamine transporter imaging with [(123)I]FP-CIT SPECT: potential effects of drugs. Eur J Nucl Med Mol Imaging 2008; 35: 424-438
    • 8 Borghammer P, Knudsen K, Danielsen E et al. False-positive 123I-FP-CIT scintigraphy and suggested dopamine transporter upregulation due to chronic modafinil treatment. Clin Nucl Med 2014; 39: e87-e88
    • 9 Brooks DJ, Pavese N. Imaging biomarkers in Parkinson’s disease. Prog Neurobiol 2011; 95: 614-628
    • 10 Catafau AM, Tolosa E, Da TCUPSSG. Impact of dopamine transporter SPECT using 123I-Ioflupane on diagnosis and management of patients with clinically uncertain Parkinsonian syndromes. Mov Disord 2004; 19: 1175-1182
    • 11 Ceravolo R, Rossi C, Cilia R et al. Evidence of delayed nigrostriatal dysfunction in corticobasal syndrome: a SPECT follow-up study. Parkinsonism Relat Disord 2013; 19: 557-559
    • 12 Colloby SJ, McParland S, O‘Brien JT et al. Neuropathological correlates of dopaminergic imaging in Alzheimer‘s disease and Lewy body dementias. Brain 2012; 135: 2798-2808
    • 13 Darcourt J, Booij J, Tatsch K et al. EANM procedure guidelines for brain neurotransmission SPECT using (123)I-labelled dopamine transporter ligands, version 2. Eur J Nucl Med Mol Imaging 2010; 37: 443-450
    • 14 de la Fuente-Fernandez R, Schulzer M, Kuramoto L et al. Age-specific progression of nigrostriatal dysfunction in Parkinson‘s disease. Ann Neurol 2011; 69: 803-810
    • 15 Djang DS, Janssen MJ, Bohnen N et al. SNM practice guideline for dopamine transporter imaging with 123I-ioflupane SPECT 1.0. J Nucl Med 2012; 53: 154-163
    • 16 Eshuis SA, Jager PL, Maguire RP et al. Direct comparison of FP-CIT SPECT and F-DOPA PET in patients with Parkinson‘s disease and healthy controls. Eur J Nucl Med Mol Imaging 2009; 36: 454-462
    • 17 Fearnley JM, Lees AJ. Ageing and Parkinson‘s disease: substantia nigra regional selectivity. Brain 1991; 114 (Pt 5) 2283-2301
    • 18 Healthcare G. DaTSCAN(TM) 74 MBq/ml IOFLUPANE (123I) Injektionlösung. Information für den Arzt & Information für den Anwender (DEU/AUT) 2013;
    • 19 Hesse S, Barthel H, Seese A et al. Dopamin-Transporter- und Dopamin-D2-Rezeptor-SPECT bei Erkrankungen der Basalganglien. Der Nuklearmediziner 2007; 30: 195-203
    • 20 Innis RB, Cunningham VJ, Delforge J et al. Consensus nomenclature for in vivo imaging of reversibly binding radioligands. J Cereb Blood Flow Metab 2007; 27: 1533-1539
    • 21 Kaasinen V, Gardberg M, Roytta M et al. Normal dopamine transporter SPECT in neuropathologically confirmed corticobasal degeneration. J Neurol 2013; 260: 1410-1411
    • 22 Koch W, Bartenstein P, la Fougere C. Radius dependence of FP-CIT quantification: a Monte Carlo-based simulation study. Ann Nucl Med 2014; 28: 103-111
    • 23 Kupitz D, Apostolova I, Lange C et al. Global scaling for semi-quantitative analysis in FP-CIT SPECT. Nuklearmedizin 2014; 53: 234-241
    • 24 Lange C, Seese A, Schwarzenbock S et al. CT-based attenuation correction in I-123-ioflupane SPECT. PLoS One 2014; 9: e108328
    • 25 Lee CS, Samii A, Sossi V et al. In vivo positron emission tomographic evidence for compensatory changes in presynaptic dopaminergic nerve terminals in Parkinson‘s disease. Ann Neurol 2000; 47: 493-503
    • 26 Marshall VL, Reininger CB, Marquardt M et al. Parkinson‘s disease is overdiagnosed clinically at baseline in diagnostically uncertain cases: a 3-year European multicenter study with repeat [123I]FP-CIT SPECT. Mov Disord 2009; 24: 500-508
    • 27 Meyer PT, Hellwig S, Amtage F. Differentialdiagnostik des neurodegenerativen Parkinson-Syndroms mit nuklearmedizinischen Verfahren. Der Nuklearmediziner 2012; 35: 109-123
    • 28 Meyer PT, Sattler B, Lincke T et al. Investigating dopaminergic neurotransmission with 123I-FP-CIT SPECT: comparability of modern SPECT systems. J Nucl Med 2003; 44: 839-845
    • 29 Meyer PT, Winz OH, Dafotakis M et al. Improved visual [(123)I]FP-CIT SPECT interpretation for evaluation of parkinsonism by visual rating of parametric distribution volume ratio images. Q J Nucl Med Mol Imaging 2011; 55: 301-309
    • 30 Munoz E, Iranzo A, Rauek S et al. Subclinical nigrostriatal dopaminergic denervation in the cerebellar subtype of multiple system atrophy (MSA-C). J Neurol 2011; 258: 2248-2253
    • 31 Neurologie LdDGf. Parkinson-Syndrome - Diagnostik und Therapie. 2012, Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften 2012;
    • 32 Nuklearmedizin LdDGf. SPECT-Untersuchungen mit dem 123I-markierten Dopamintransporter Liganden FP-CIT (DaTSCAN). 2007. Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften 2007;
    • 33 O‘Brien JT, Oertel WH, McKeith IG et al. Is ioflupane I123 injection diagnostically effective in patients with movement disorders and dementia? Pooled analysis of four clinical trials. BMJ Open 2014; 4: e005122
    • 34 Oh M, Kim JS, Kim JY et al. Subregional patterns of preferential striatal dopamine transporter loss differ in Parkinson disease, progressive supranuclear palsy, and multiple-system atrophy. J Nucl Med 2012; 53: 399-406
    • 35 Pena E, Fernandez C. Abnormal DAT SCAN in a patient with parkinsonism after a midbrain ischemic lesion. Mov Disord 2012; 27: 205
    • 36 Petyt G, Kreisler A, Demailly F et al. Undetectable specific striatal [(1)(2)(3)I]-ioflupane binding in patients with parkinsonism. J Neurol Sci 2014; 341: 167-171
    • 37 Sawle GV, Playford ED, Brooks DJ et al. Asymmetrical pre-synaptic and post-synpatic changes in the striatal dopamine projection in dopa naive parkinsonism. Diagnostic implications of the D2 receptor status. Brain 1993; 116 (Pt 4) 853-867
    • 38 Schwarz J, Storch A, Koch W et al. Loss of dopamine transporter binding in Parkinson‘s disease follows a single exponential rather than linear decline. J Nucl Med 2004; 45: 1694-1697
    • 39 Spehl TS, Frings L, Hellwig S et al. Role of Semiquantitative Assessment of Regional Binding Potential in 123I-FP-CIT SPECT for the Differentiation of Frontotemporal Dementia, Dementia With Lewy Bodies, and Alzheimer‘s Dementia. Clin Nucl Med 2015; 40: e27-e33
    • 40 Tatsch K. Diagnostik des Parkinson-Syndroms mit [123I]FP-CIT und SPECT. Der Nuklearmediziner 2012; 35: 102-108
    • 41 Tatsch K, Poepperl G. Quantitative approaches to dopaminergic brain imaging. Q J Nucl Med Mol Imaging 2012; 56: 27-38
    • 42 Thomsen G, Knudsen GM, Jensen PS et al. No difference in striatal dopamine transporter availability between active smokers, ex-smokers and non-smokers using [123I]FP-CIT (DaTSCAN) and SPECT. EJNMMI Res 2013; 3: 39
    • 43 Tissingh G, Booij J, Bergmans P et al. Iodine-123-N-omega-fluoropropyl-2beta-carbomethoxy-3beta-(4-iod ophenyl)tropane SPECT in healthy controls and early-stage, drug-naive Parkinson‘s disease. J Nucl Med 1998; 39: 1143-1148
    • 44 van de Giessen E, Hesse S, Caan MW et al. No association between striatal dopamine transporter binding and body mass index: a multi-center European study in healthy volunteers. Neuroimage 2013; 64: 61-67
    • 45 Varrone A, Dickson JC, Tossici-Bolt L et al. European multicentre database of healthy controls for [123I]FP-CIT SPECT (ENC-DAT): age-related effects, gender differences and evaluation of different methods of analysis. Eur J Nucl Med Mol Imaging 2013; 40: 213-227
    • 46 Winz OH, Hellwig S, Mix M et al. Image quality and data quantification in dopamine transporter SPECT: advantage of 3-dimensional OSEM reconstruction?. Clin Nucl Med 2012; 37: 866-871
    • 47 Ziebell M, Holm-Hansen S, Thomsen G et al. Serotonin transporters in dopamine transporter imaging: a head-to-head comparison of dopamine transporter SPECT radioligands 123I-FP-CIT and 123I-PE2I. J Nucl Med 2010; 51: 1885-1891