Predictive value of dopamine transporter SPECT imaging with [123I]PE2I in patients with subtle parkinsonian symptoms
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To examine the diagnostic sensitivity and specificity of dopamine transporter SPECT imaging with a highly dopamine transporter selective radioligand. The study included consecutively enrolled, drug-naive patients with an average short history of parkinsonian motor symptoms, referred for diagnostic scanning.
The study group comprised 288 patients naive to antiparkinson treatment who were enrolled as they were admitted for a diagnostic SPECT scan with the radioligand [123I]-N-(3-iodoprop-2E-enyl)-2-β-carbomethoxy-3β-(4-methylphenyl)nortropane (123I-PE2I). After the diagnostic scanning, patients were followed clinically with an average follow-up of 19.7 ± 12.5 months.
A diagnosis could be clinically settled in 189 patients and among these patients, a dopamine transporter scan had a sensitivity of 88% and a specificity of 91% for discrimination between patients with and without striatal neurodegeneration. In cognitively impaired patients (Mini Mental State Examination <27) the specificity was 75% and the sensitivity 95%. A striatal anterior–posterior ratio (APR) of >2 differentiated between idiopathic Parkinson’s disease and atypical parkinsonian syndromes with a specificity of 84% and a sensitivity of 63%.
In drug-naive patients with subtle clinical parkinsonian motor symptoms, dopamine transporter scan using 123I-PE21 has a high sensitivity and specificity in distinguishing between patients with and without striatal neurodegeneration. The specificity is lower in patients who are also cognitively impaired. Calculation of the striatal APR can assist in differentiating between idiopathic Parkinson’s disease and atypical parkinsonian syndromes.
- Benamer HT, Oertel WH, Patterson J, Hadley DM, Pogarell O, Hoffken H, 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;18:977–84. CrossRef
- McKeith I, O’Brien J, Walker Z, Tatsch K, Booij J, Darcourt J, 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;6:305–13. CrossRef
- Vlaar AM, van Kroonenburgh MJ, Kessels AG, Weber WE. Meta-analysis of the literature on diagnostic accuracy of SPECT in parkinsonian syndromes. BMC Neurol. 2007;7:27. CrossRef
- Guttman M, Stewart D, Hussey D, Wilson A, Houle S, Kish S. Influence of L-dopa and pramipexole on striatal dopamine transporter in early PD. Neurology. 2001;56:1559–64.
- McKeith IG, Dickson DW, Lowe J, Emre M, O’Brien JT, Feldman H, et al. Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology. 2005;65:1863–72. CrossRef
- Tatsch K. Imaging of the dopaminergic system in differential diagnosis of dementia. Eur J Nucl Med Mol Imaging. 2008;35 Suppl 1:S51–7. CrossRef
- Emond P, Garreau L, Chalon S, Boazi M, Caillet M, Bricard J, et al. Synthesis and ligand binding of nortropane derivatives: N-substituted 2beta-carbomethoxy-3beta-(4'-iodophenyl)nortropane and N-(3-iodoprop-(2E)-enyl)-2beta-carbomethoxy-3beta-(3',4'-disubstituted phenyl)nortropane. New high-affinity and selective compounds for the dopamine transporter. J Med Chem. 1997;40:1366–72. CrossRef
- Ziebell M, Holm-Hansen S, Thomsen G, Wagner A, Jensen P, Pinborg LH, 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;51:1885–91. CrossRef
- Booij J, de Jong J, de Bruin K, Knol R, de Win MM, van Eck-Smit BL. Quantification of striatal dopamine transporters with 123I-FP-CIT SPECT is influenced by the selective serotonin reuptake inhibitor paroxetine: a double-blind, placebo-controlled, crossover study in healthy control subjects. J Nucl Med. 2007;48:359–66.
- Ziebell M, Pinborg LH, Thomsen G, de Nijs R, Svarer C, Wagner A, et al. MRI-guided region-of-interest delineation is comparable to manual delineation in dopamine transporter SPECT quantification in patients: a reproducibility study. J Nucl Med Technol. 2010;38:61–8. CrossRef
- Ziebell M, Thomsen G, Knudsen GM, de Nijs R, Svarer C, Wagner A, et al. Reproducibility of [123I]PE2I binding to dopamine transporters with SPECT. Eur J Nucl Med Mol Imaging. 2007;34:101–9. CrossRef
- Pinborg LH, Ziebell M, Frokjaer VG, de Nijs R, Svarer C, Haugbol S, et al. Quantification of 123I-PE2I binding to dopamine transporter with SPECT after bolus and bolus/infusion. J Nucl Med. 2005;46:1119–27.
- Innis RB, Cunningham VJ, Delforge J, Fujita M, Gjedde A, Gunn RN, et al. Consensus nomenclature for in vivo imaging of reversibly binding radioligands. J Cereb Blood Flow Metab. 2007;27:1533–9. CrossRef
- Gilman S, Wenning GK, Low PA, Brooks DJ, Mathias CJ, Trojanowski JQ, et al. Second consensus statement on the diagnosis of multiple system atrophy. Neurology. 2008;71:670–6. CrossRef
- Gelb DJ, Oliver E, Gilman S. Diagnostic criteria for Parkinson disease. Arch Neurol. 1999;56:33–9. CrossRef
- Bain P, Brin M, Deuschl G, Elble R, Jankovic J, Findley L, et al. Criteria for the diagnosis of essential tremor. Neurology. 2000;54:S7.
- Josephs KA, Dickson DW. Diagnostic accuracy of progressive supranuclear palsy in the Society for Progressive Supranuclear Palsy brain bank. Mov Disord. 2003;18:1018–26. CrossRef
- Lantos PL. Diagnostic criteria for corticobasal degeneration. J Neurol Neurosurg Psychiatry. 2000;69:705–6. CrossRef
- Harbo HF, Finsterer J, Baets J, Van Broeckhoven C, Di Donato S, Fontaine B, et al. EFNS guidelines on the molecular diagnosis of neurogenetic disorders: general issues, Huntington’s disease, Parkinson’s disease and dystonias. Eur J Neurol. 2009;16:777–85. CrossRef
- Dubois B, Feldman HH, Jacova C, Dekosky ST, Barberger-Gateau P, Cummings J, et al. Research criteria for the diagnosis of Alzheimer’s disease: revising the NINCDS-ADRDA criteria. Lancet Neurol. 2007;6:734–46. CrossRef
- Kalra S, Grosset DG, Benamer HT. Differentiating vascular parkinsonism from idiopathic Parkinson’s disease: a systematic review. Mov Disord. 2010;25:149–156. CrossRef
- Jasinska-Myga B, Putzke JD, Wider C, Wszolek ZK, Uitti RJ. Depression in Parkinson’s disease. Can J Neurol Sci. 2010;37:61–6.
- Aarsland D, Andersen K, Larsen JP, Lolk A, Kragh-Sorensen P. Prevalence and characteristics of dementia in Parkinson disease: an 8-year prospective study. Arch Neurol. 2003;60:387–92. CrossRef
- Ballard C, Holmes C, McKeith I, Neill D, O’Brien J, Cairns N, et al. Psychiatric morbidity in dementia with Lewy bodies: a prospective clinical and neuropathological comparative study with Alzheimer’s disease. Am J Psychiatry. 1999;156:1039–45.
- O’Brien JT, McKeith IG, Walker Z, Tatsch K, Booij J, Darcourt J, et al. Diagnostic accuracy of 123I-FP-CIT SPECT in possible dementia with Lewy bodies. Br J Psychiatry. 2009;194:34–9. CrossRef
- Marek K, Seibyl J. b-CIT scans without evidence of dopaminergic deficit (SWEDD) in the ELLDOPA-CIT and CALM-CIT study: long-term imaging assessment. Neurology. 2003;60:abstract 298.
- Marshall VL, Reininger CB, Marquardt M, Patterson J, Hadley DM, Oertel WH, 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;24:500–8. CrossRef
- Eerola J, Tienari PJ, Kaakkola S, Nikkinen P, Launes J. How useful is [123I]beta-CIT SPECT in clinical practice? J Neurol Neurosurg Psychiatry. 2005;76:1211–6. CrossRef
- Vlaar AM, de Nijs T, Kessels AG, Vreeling FW, Winogrodzka A, Mess WH, et al. Diagnostic value of 123I-ioflupane and 123I-iodobenzamide SPECT scans in 248 patients with parkinsonian syndromes. Eur Neurol. 2008;59:258–66. CrossRef
- Knudsen GM, Karlsborg M, Thomsen G, Krabbe K, Regeur L, Nygaard T, et al. Imaging of dopamine transporters and D2 receptors in patients with Parkinson’s disease and multiple system atrophy. Eur J Nucl Med Mol Imaging. 2004;31:1631–8. CrossRef
- Stoffers D, Booij J, Bosscher L, Winogrodzka A, Wolters EC, Berendse HW. 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;32:689–95. CrossRef
- Litvan I, MacIntyre A, Goetz CG, Wenning GK, Jellinger K, Verny M, et al. Accuracy of the clinical diagnoses of Lewy body disease, Parkinson disease, and dementia with Lewy bodies: a clinicopathologic study. Arch Neurol. 1998;55:969–78. CrossRef
- Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992;55:181–4. CrossRef
- Olanow CW, Rascol O, Hauser R, Feigin PD, Jankovic J, Lang A, et al. A double-blind, delayed-start trial of rasagiline in Parkinson’s disease. N Engl J Med. 2009;361:1268–78. CrossRef
- Predictive value of dopamine transporter SPECT imaging with [123I]PE2I in patients with subtle parkinsonian symptoms
European Journal of Nuclear Medicine and Molecular Imaging
Volume 39, Issue 2 , pp 242-250
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- Predictive value
- Dopamine transporter
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- Author Affiliations
- 1. Neurobiology Research Unit & Cimbi, Rigshospitalet and University of Copenhagen, N9201, 9 Blegdamsvej, Copenhagen, DK-2100, Denmark
- 2. Memory Disorders Research Group, Department of Neurology, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
- 3. Epilepsy Clinic, Department of Neurology, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
- 4. Clinic for Movement Disorders, Department of Neurology, Bispebjerg Hospital, Copenhagen, Denmark