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Effects of medication on dopamine transporter imaging using [123I]I-FP-CIT SPECT in routine practice

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Abstract

Purpose

Dopamine transporter (DAT) imaging is used to support the diagnosis of neurodegenerative parkinsonian disorders. Specific medications have been reported to confound the interpretation of [123I]I-FP-CIT SPECT scans, but there is limited data. The aim of the current study is to identify potential medication effects on the interpretation of [123I]I-FP-CIT SPECT scans in routine practice.

Materials and methods

Consecutive patients undergoing a [123I]I-FP-CIT SPECT/CT scan on a 360° CZT camera between September 2019 and December 2022 were included. An exhaustive review of patient medications (antidepressants, antipsychotics, anti-epileptics, anti-parkinsonians, benzodiazepines, lithium, opioids, and stimulants) was performed. Two experienced nuclear physicians, blinded to the medication reports, interpreted the [123I]I-FP-CIT SPECT scans visually and a semi-quantitative analysis was performed using a local normal database.

Results

The study included 305 patients (71.0 ± 10.4, 135 women) and 145 (47.5%) visually interpreted normal scans. In normal scans, the striatum/occiput radioligand uptake ratio was decreased by noradrenergic and specific serotonergic antidepressants (NASSAs) (n = 15, z-score of − 0.93) and opioid medication (tramadol, n = 6, z-score of − 0.85) and was associated with a younger age in the multivariate analysis. In the overall population, the striatum/occiput ratio was influenced by NASSAs and associated with consensual visual analysis, age, sex, and anti-parkinsonian medications related to the status of the disease.

Conclusion

Our study confirms the potential impact of antidepressant (NASSA) and opioid (tramadol) medications on the semi-quantitative analysis of [123I]I-FP-CIT SPECT scans. However, when performing a visual analysis, only NASSAs significantly impacted the interpretation of [123I]I-FP-CIT SPECT scans.

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Data availability

Data that support the findings of this study may be requested from the corresponding author (AV).

Code availability

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Author information

Authors and Affiliations

  1. Department of Nuclear Medicine and Nancyclotep Imaging Platform, Université de Lorraine, CHRU Nancy, F-54000, Nancy, France

    Yuliya Piatkova, Sébastien Heyer, Ayaz Tahmazov, Laetitia Imbert & Antoine Verger

  2. IADI, INSERM U1254, Université de Lorraine, F-54000, Nancy, France

    Matthieu Doyen, Laetitia Imbert & Antoine Verger

  3. Department of Neurology, Université de Lorraine, CHRU de Nancy, F-54000, Nancy, France

    Solene Frismand & Lucie Hopes

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  1. Yuliya Piatkova
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  2. Matthieu Doyen
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Contributions

All authors contributed significantly to the collection, analysis, and interpretation of the data (YP, MD, SH, LI, AV), to the writing of the manuscript (YP, AV) and to the revision of the manuscript (MD, AT, SF, LH, AV).

Corresponding author

Correspondence to Antoine Verger.

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Ethics approval and consent to participate

The institutional ethics committee (Comité d’Ethique du CHRU de Nancy) approved the evaluation of retrospective patient data and the trial was registered at ClinicalTrials.gov (NCT 05683665). This research complied with the principles of the Declaration of Helsinki. Informed consent was obtained from all individuals included in the study.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Piatkova, Y., Doyen, M., Heyer, S. et al. Effects of medication on dopamine transporter imaging using [123I]I-FP-CIT SPECT in routine practice. Eur J Nucl Med Mol Imaging 51, 1323–1332 (2024). https://doi.org/10.1007/s00259-023-06565-x

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