Download PDF
Der Nuklearmediziner 2012; 35(02): 102-108
DOI: 10.1055/s-0032-1314852
Neurodegenerative Erkrankungen
© Georg Thieme Verlag KG Stuttgart · New York

Diagnostik des Parkinson-Syndroms mit [123I]FP-CIT und SPECT

Diagnosis of Parkinsonism with [123I]FP-CIT and SPECT
K. Tatsch
1   Klinik für Nuklearmedizin, Städtisches Klinikum Karlsruhe gGmbH
› Author Affiliations
Further Information

Publication History

Publication Date:
12 July 2012 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Die Arbeit gibt einen Überblick über den Einsatz der SPECT-Bildgebung des präsynaptischen Dopamintransporters mit [123I]FP-CIT bei der Abklärung von Parkinson-Syndromen. Abgehandelt wird der Stellenwert dieser Methodik beim Nachweis neurodegenerativer Parkinson-Syndrome, für deren Früh- und präklinische Diagnostik sowie für die Beurteilung der Krankheitsprogression. In der Abgrenzung der symptomatischen PS und wichtiger Tremorsyndrome von den neurodegenerativen PS wird die Bedeutung normaler FP-CIT-SPECT-Befunde eingehend erläutert. Schließlich wird der Stellenwert der Methode bei der Diagnostik der Lewy-Body-Demenz und deren Abgrenzung von der Alzheimer-Demenz beleuchtet. Kurze Betrachtungen zur ökonomischen Seite von [123I]FP-CIT-Untersuchungen runden die Ausführungen ab.

Summary

This paper gives an overview on the use of presynaptic dopamine transporter imaging with [123I]FP-CIT and SPECT in the diagnostic work-up of parkinsonism. The role of this method for diagnosing the various forms of neurodegenerative parkinsonism, for their early and preclinical diagnosis, and for assessment of disease progression is highlighted. The clinical impact of normal results of DAT-binding in the assessment of symptomatic parkinsonism including relevant tremor syndromes in contrast to the pathologic imaging results in neurodegenerative parkinsonism is critically addressed. Further, the role of [123I]FP-CIT imaging in establishing the diagnosis of dementia with Lewy bodies and its powerful differentiation from Alzheimer dementia is noted. Finally some concluding remarks follow on economic aspects of the application of [123I]FP-CIT SPECT in the respective indications.

Schlüsselwörter

Single-Photon-Emissions-Computertomografie - Parkinson-Syndrome - dopaminerges System - Dopamintransporter

Key words

single photon emission tomography - parkinsonism - dopaminergic system - dopamine transporter
 

  • Literatur

  • 1 Adams JR, van Netten H, Schulzer M et al. PET in LRRK2 mutations: comparison to sporadic Parkinson’s disease and evidence for presymptomatic compensation. Brain 2005; 128: 2777-2785
    CrossrefPubMedGoogle Scholar
  • 2 Antonini A, Berto P, Lopatriello S et al. Cost-effectiveness of 123I-FP-CIT SPECT in the differential diagnosis of essential tremor and Parkinson’s disease in Italy. Mov Disord 2008; 23: 2202-2209
    CrossrefPubMedGoogle Scholar
  • 3 Bajaj NP, Gontu V, Birchall J et al. Accuracy of clinical diagnosis in tremulous parkinsonian patients: a blinded video study. J Neurol Neurosurg Psychiatry 81: 1223-1228
    PubMedGoogle Scholar
  • 4 Benamer HT, Oertel WH, Patterson J et al. Prospective study of presynaptic dopaminergic imaging in patients with mild parkinsonism and tremor disorders: part 1. Baseline and 3-month observations. Mov Disord 2003; 18: 977-984
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 6 Booij J, Speelman JD, Horstink MW et al. The clinical benefit of imaging striatal dopamine transporters with [123I]FP-CIT SPET in differentiating patients with presynaptic parkinsonism from those with other forms of parkinsonism. Eur J Nucl Med 2001; 28: 266-272
    CrossrefPubMedGoogle Scholar
  • 7 Booij J, Teune LK, Verberne HJ. The role of molecular imaging in the differential diagnosis of parkinsonism. Q J Nucl Med Mol Imaging 2012; 56: 17-26
    PubMedGoogle Scholar
  • 8 Booij J, Tissingh G, Winogrodzka A et al. Imaging of the dopaminergic neurotransmission system using single-photon emission tomography and positron emission tomography in patients with parkinsonism. Eur J Nucl Med 1999; 26: 171-182
    CrossrefPubMedGoogle Scholar
  • 9 Catafau AM, Tolosa E. 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
    CrossrefPubMedGoogle Scholar
  • 10 Contrafatto D, Mostile G, Nicoletti A et al. [(123) I]FP-CIT-SPECT asymmetry index to differentiate Parkinson’s disease from vascular parkinsonism. Acta Neurol Scand 2011; Epub ahead of print
    PubMedGoogle Scholar
  • 11 Coria F, Gimenez-Garcia M, Samaranch L et al. Nigrostriatal dopaminergic function in subjects with isolated action tremor. Parkinsonism Relat Disord 2012; 18: 49-53
    CrossrefPubMedGoogle Scholar
  • 12 Cuberas-Borros G, Lorenzo-Bosquet C, Aguade-Bruix S et al. Quantitative evaluation of striatal I-123-FP-CIT uptake in essential tremor and parkinsonism. Clin Nucl Med 2012; 36: 991-996
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 14 Diaz-Corrales FJ, Sanz-Viedma S, Garcia-Solis D et al. Clinical features and 123I-FP-CIT SPECT imaging in drug-induced parkinsonism and Parkinson’s disease. Eur J Nucl Med Mol Imaging 37: 556-564
    PubMedGoogle Scholar
  • 15 Gaig C, Marti MJ, Tolosa E et al. 123I-Ioflupane SPECT in the diagnosis of suspected psychogenic Parkinsonism. Mov Disord 2006; 21: 1994-1998
    CrossrefPubMedGoogle Scholar
  • 16 Gerasimou G, Costa DC, Papanastasiou E et al. SPECT study with I-123-Ioflupane (DaTSCAN) in patients with essential tremor. Is there any correlation with Parkinson’s disease?. Ann Nucl Med 2012; Epub ahead of print
    PubMedGoogle Scholar
  • 17 Gerschlager W, Bencsits G, Pirker W et al. [123I]beta-CIT SPECT distinguishes vascular parkinsonism from Parkinson’s disease. Mov Disord 2002; 17: 518-523
    CrossrefPubMedGoogle Scholar
  • 18 Hauser RA, Grosset DG. [(123) I]FP-CIT (DaTscan) SPECT Brain Imaging in Patients with Suspected Parkinsonian Syndromes. J Neuroimaging 2011; Epub ahead of print
    PubMedGoogle Scholar
  • 19 Hesse S, Oehlwein C, Barthel H et al. Possible impact of dopamine SPECT on decision-making for drug treatment in Parkinsonian syndrome. J Neural Transm 2006; 113: 1177-1190
    CrossrefPubMedGoogle Scholar
  • 20 Hughes AJ, Daniel SE, Ben-Shlomo Y et al. The accuracy of diagnosis of parkinsonian syndromes in a specialist movement disorder service. Brain 2002; 125: 861-870
    CrossrefPubMedGoogle Scholar
  • 21 Hughes AJ, Daniel SE, Kilford L et al. Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 1992; 55: 181-184
    CrossrefPubMedGoogle Scholar
  • 22 Jeon BS, Jeong JM, Park SS et al. Dopamine transporter density measured by [123I]beta-CIT single-photon emission computed tomography is normal in dopa-responsive dystonia. Ann Neurol 1998; 43: 792-800
    CrossrefPubMedGoogle Scholar
  • 23 Katzenschlager R, Costa D, Gerschlager W et al. [123I]-FP-CIT-SPECT demonstrates dopaminergic deficit in orthostatic tremor. Ann Neurol 2003; 53: 489-496
    CrossrefPubMedGoogle Scholar
  • 24 Khan NL, Brooks DJ, Pavese N et al. Progression of nigrostriatal dysfunction in a parkin kindred: an [18F]dopa PET and clinical study. Brain 2002; 125: 2248-2256
    CrossrefPubMedGoogle Scholar
  • 25 Laihinen A, Ruottinen H, Rinne JO et al. Risk for Parkinson’s disease: twin studies for the detection of asymptomatic subjects using [18F]6-fluorodopa PET. J Neurol 2000; 247 (Suppl. 02) II110-II113
    PubMedGoogle Scholar
  • 26 Lorberboym M, Treves TA, Melamed E et al. [123I]-FP/CIT SPECT imaging for distinguishing drug-induced parkinsonism from Parkinson’s disease. Mov Disord 2006; 21: 510-514
    CrossrefPubMedGoogle Scholar
  • 27 Marek KL, Seibyl JP, Zoghbi SS et al. [123I] beta-CIT/SPECT imaging demonstrates bilateral loss of dopamine transporters in hemi-Parkinson’s disease. Neurology 1996; 46: 231-237
    CrossrefPubMedGoogle Scholar
  • 28 Marshall V, Grosset D. Role of dopamine transporter imaging in routine clinical practice. Mov Disord 2003; 18: 1415-1423
    CrossrefPubMedGoogle Scholar
  • 29 Marshall V, Grosset DG. Role of dopamine transporter imaging in the diagnosis of atypical tremor disorders. Mov Disord 2003; 18 (Suppl. 07) S22-S27
    CrossrefPubMedGoogle Scholar
  • 30 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
    CrossrefPubMedGoogle Scholar
  • 31 McKeith I, Mintzer J, Aarsland D et al. Dementia with Lewy bodies. Lancet Neurol 2004; 3: 19-28
    CrossrefPubMedGoogle Scholar
  • 32 McKeith I, O’Brien J, Walker Z et al. Sensitivity and specificity of dopamine transporter imaging with 123I-FP-CIT SPECT in dementia with Lewy bodies: a phase III, multicentre study. Lancet Neurol 2007; 6: 305-313
    CrossrefPubMedGoogle Scholar
  • 33 Meara J, Bhowmick BK, Hobson P. Accuracy of diagnosis in patients with presumed Parkinson’s disease. Age Ageing 1999; 28: 99-102
    CrossrefPubMedGoogle Scholar
  • 34 Mian OS, Schneider SA, Schwingenschuh P et al. Gait in SWEDDs patients: comparison with Parkinson’s disease patients and healthy controls. Mov Disord 26: 1266-1273
    PubMedGoogle Scholar
  • 35 Naumann M, Pirker W, Reiners K et al. [123I]beta-CIT single-photon emission tomography in DOPA-responsive dystonia. Mov Disord 1997; 12: 448-451
    CrossrefPubMedGoogle Scholar
  • 36 Newman EJ, Breen K, Patterson J et al. Accuracy of Parkinson’s disease diagnosis in 610 general practice patients in the West of Scotland. Mov Disord 2009; 24: 2379-2385
    PubMedGoogle Scholar
  • 37 O’Brien JT, Colloby S, Fenwick J et al. Dopamine transporter loss visualized with FP-CIT SPECT in the differential diagnosis of dementia with Lewy bodies. Arch Neurol 2004; 61: 919-925
    CrossrefPubMedGoogle Scholar
  • 38 O’Brien JT, McKeith IG, Walker Z et al. Diagnostic accuracy of 123I-FP-CIT SPECT in possible dementia with Lewy bodies. Br J Psychiatry 2009; 194: 34-39
    CrossrefPubMedGoogle Scholar
  • 39 Ouchi Y, Nakayama T, Kanno T et al. In vivo presynaptic and postsynaptic striatal dopamine functions in idiopathic normal pressure hydrocephalus. J Cereb Blood Flow Metab 2007; 27: 803-810
    CrossrefPubMedGoogle Scholar
  • 40 Pal PK, Wszolek ZK, Uitti R et al. Positron emission tomography of dopamine pathways in familial Parkinsonian syndromes. Parkinsonism Relat Disord 2001; 8: 51-56
    CrossrefPubMedGoogle Scholar
  • 41 Papathanasiou ND, Boutsiadis A, Dickson J et al. Diagnostic accuracy of (1)(2)(3)I-FP-CIT (DaTSCAN) in dementia with Lewy bodies: a meta-analysis of published studies. Parkinsonism Relat Disord 2012; 18: 225-229
    CrossrefPubMedGoogle Scholar
  • 42 Pavese N, Brooks DJ. Imaging neurodegeneration in Parkinson’s disease. Biochim Biophys Acta 2009; 1792: 722-729
    CrossrefPubMedGoogle Scholar
  • 43 Pavese N, Khan NL, Scherfler C et al. Nigrostriatal dysfunction in homozygous and heterozygous parkin gene carriers: an 18F-dopa PET progression study. Mov Disord 2009; 24: 2260-2266
    CrossrefPubMedGoogle Scholar
  • 44 Piccini P, Morrish PK, Turjanski N et al. Dopaminergic function in familial Parkinson’s disease: a clinical and 18F-dopa positron emission tomography study. Ann Neurol 1997; 41: 222-229
    CrossrefPubMedGoogle Scholar
  • 45 Pirker W, Djamshidian S, Asenbaum S et al. Progression of dopaminergic degeneration in Parkinson’s disease and atypical parkinsonism: a longitudinal beta-CIT SPECT study. Mov Disord 2002; 17: 45-53
    CrossrefPubMedGoogle Scholar
  • 46 Ribeiro MJ, Thobois S, Lohmann E et al. A multitracer dopaminergic PET study of young-onset parkinsonian patients with and without parkin gene mutations. J Nucl Med 2009; 50: 1244-1250
    CrossrefPubMedGoogle Scholar
  • 47 Rinne JO, Ruottinen H, Bergman J et al. Usefulness of a dopamine transporter PET ligand [(18)F]beta-CFT in assessing disability in Parkinson’s disease. J Neurol Neurosurg Psychiatry 1999; 67: 737-741
    CrossrefPubMedGoogle Scholar
  • 48 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
    PubMedGoogle Scholar
  • 49 Schwingenschuh P, Ruge D, Edwards MJ et al. Distinguishing SWEDDs patients with asymmetric resting tremor from Parkinson’s disease: a clinical and electrophysiological study. Mov Disord 25: 560-569
    PubMedGoogle Scholar
  • 50 Seibyl J, Russell D, Jennings D et al. The molecular basis of dopaminergic brain imaging in Parkinson’s disease. Q J Nucl Med Mol Imaging 2012; 56: 4-16
    PubMedGoogle Scholar
  • 51 Sixel-Doring F, Liepe K, Mollenhauer B et al. The role of 123I-FP-CIT-SPECT in the differential diagnosis of Parkinson and tremor syndromes: a critical assessment of 125 cases. J Neurol 2012; 258: 2147-2154
    PubMedGoogle Scholar
  • 52 Stoessl AJ. Positron emission tomography in premotor Parkinson’s disease. Parkinsonism Relat Disord 2007; 13 (Suppl. 03) S421-S424
    CrossrefPubMedGoogle Scholar
  • 53 Stoffers D, Booij J, Bosscher L et al. Early-stage [123I]beta-CIT SPECT and long-term clinical follow-up in patients with an initial diagnosis of Parkinson’s disease. Eur J Nucl Med Mol Imaging 2005; 32: 689-695
    CrossrefPubMedGoogle Scholar
  • 54 Suzuki M, Desmond TJ, Albin RL et al. Striatal monoaminergic terminals in Lewy body and Alzheimer’s dementias. Ann Neurol 2002; 51: 767-771
    CrossrefPubMedGoogle Scholar
  • 55 Tatsch K. Imaging of the dopaminergic system in differential diagnosis of dementia. Eur J Nucl Med Mol Imaging 2008; 35 (Suppl. 01) S51-S57
    CrossrefPubMedGoogle Scholar
  • 56 Tatsch K. Extrapyramidal syndromes: PET and SPECT. Neuroimaging Clin N Am 2010; 20: 57-68
    CrossrefPubMedGoogle Scholar
  • 57 Tatsch K, Schwarz J, Mozley PD et al. Relationship between clinical features of Parkinson’s disease and presynaptic dopamine transporter binding assessed with [123I]IPT and single-photon emission tomography. Eur J Nucl Med 1997; 24: 415-421
    PubMedGoogle Scholar
  • 58 Tinazzi M, Antonini A, Bovi T et al. Clinical and [123I]FP-CIT SPET imaging follow-up in patients with drug-induced parkinsonism. J Neurol 2009; 256: 910-915
    CrossrefPubMedGoogle Scholar
  • 59 Tinazzi M, Ottaviani S, Isaias IU et al. [123I]FP-CIT SPET imaging in drug-induced Parkinsonism. Mov Disord 2008; 23: 1825-1829
    CrossrefPubMedGoogle Scholar
  • 60 Trocello JM, Zanotti-Fregonara P, Roze E et al. Dopaminergic deficit is not the rule in orthostatic tremor. Mov Disord 2008; 23: 1733-1738
    CrossrefPubMedGoogle Scholar
  • 61 Tzen KY, Lu CS, Yen TC et al. Differential diagnosis of Parkinson’s disease and vascular parkinsonism by (99m)Tc-TRODAT-1. J Nucl Med 2001; 42: 408-413
    PubMedGoogle Scholar
  • 62 Vaamonde J, Garcia A, Flores JM et al. Study of presynaptic nigrostriatal pathway by 123-I-FD-CIT-SPECT (DatSCAN SPECT) in primary orthostatic tremor. Neurologia 2006; 21: 37-39
    PubMedGoogle Scholar
  • 63 Varrone A, Halldin C. New developments of dopaminergic imaging in Parkinson’s disease. Q J Nucl Med Mol Imaging 2012; 56: 68-82
    PubMedGoogle Scholar
  • 64 Varrone A, Pellecchia MT, Amboni M et al. Imaging of dopaminergic dysfunction with [123I]FP-CIT SPECT in early-onset parkin disease. Neurology 2004; 63: 2097-2103
    CrossrefPubMedGoogle Scholar
  • 65 Walker Z, Costa DC, Walker RW et al. Differentiation of dementia with Lewy bodies from Alzheimer’s disease using a dopaminergic presynaptic ligand. J Neurol Neurosurg Psychiatry 2002; 73: 134-140
    CrossrefPubMedGoogle Scholar
  • 66 Walker Z, Jaros E, Walker RW et al. Dementia with Lewy bodies: a comparison of clinical diagnosis, FP-CIT single photon emission computed tomography imaging and autopsy. J Neurol Neurosurg Psychiatry 2007; 78: 1176-1181
    CrossrefPubMedGoogle Scholar
  • 67 Warr L, Walker Z. Identification of biomarkers in Lewy-body disorders. Q J Nucl Med Mol Imaging 2012; 56: 39-54
    PubMedGoogle Scholar
  • 68 Zijlmans J, Evans A, Fontes F et al. [123I] FP-CIT spect study in vascular parkinsonism and Parkinson’s disease. Mov Disord 2007; 22: 1278-1285
    CrossrefPubMedGoogle Scholar