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Evaluation of 99mTc-TRODAT-1 SPECT in the diagnosis of Parkinson’s disease versus other progressive movement disorders

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Abstract

Objective

Parkinson disease (PD), parkinsonian syndromes (PS) and essential tremor (ET) are different types of movement disorders which share some symptoms resulting in a difficulty of certain diagnosis. This study was conducted to determine the value of 99mTc-TRODAT-1 scan to differentiate PD from ET and other PS cases.

Methods

Totally, 75 patients were studied including 29 PD, 6 possible PD, 22 ET and 18 PS cases. A dual-head SPECT-CT was used to perform basal ganglia (BG) imaging following administration of 99mTc-TRODAT-1. The BG uptake values were normalized to whole brain and occipital activity. All patients were followed for 2–22 months to reach a certain diagnosis.

Results

Patients with ET and drug-induced parkinsonism show significantly higher normalized BG uptake as compared to the other subgroups; however, no significant difference was noted between PD and PS patients. The sensitivity and specificity of the findings for the differentiation between patients with the disease associated versus not associated with BG dysfunction were 80 and 83.3 %, respectively. A predictive positive value of 82.6 % was obtained using an additive scaling index defined as asymmetry and unevenness of uptake in putamen and/or caudate contralateral to the dominant side of current symptoms.

Conclusions

99mTc-TRODAT-1 scan is an appropriate method to differentiate PD or PS versus ET. A combination of scan pattern including asymmetry of BG uptake and unevenness of activity in caudate and putamen along with the side of dominant symptoms may be valuable for the differentiation of Parkinson’s disease from the other parkinsonian syndromes.

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Acknowledgments

This research has been part of a nuclear medicine specialty thesis and supported by Tehran University of Medical Sciences, Tehran, Iran; grant no. 22020. The authors would also like to thank Mrs Mansooreh Darvishha for her technical assistance.

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Authors and Affiliations

  1. Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, North Kargar Ave., Tehran, 1411713135, Iran

    Babak Fallahi, Atefe Esmaeili, Davood Beiki, Armaghan Fard-Esfahani, Alireza Emami-Ardekani, Parham Geramifar & Mohammad Eftekhari

  2. Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Shahram Oveisgharan & Hamid Noorollahi-Moghaddam

  3. Radiation Application Research School, Nuclear Science and Technology Research Institute, Tehran, Iran

    Mostafa Erfani

  4. Department of Neurology, School of Medicine, Imam Khomeini Hospital and Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran

    Abbas Tafakhori

  5. Department of Neurology, School of Medicine, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran

    Mohammad Rohani

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  1. Babak Fallahi
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  2. Atefe Esmaeili
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Correspondence to Davood Beiki.

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Fallahi, B., Esmaeili, A., Beiki, D. et al. Evaluation of 99mTc-TRODAT-1 SPECT in the diagnosis of Parkinson’s disease versus other progressive movement disorders. Ann Nucl Med 30, 153–162 (2016). https://doi.org/10.1007/s12149-015-1042-y

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  • DOI: https://doi.org/10.1007/s12149-015-1042-y

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