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Clinical routine use of dopamine transporter imaging in 516 consecutive patients

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Abstract

[123I]-FP-CIT is a single photon emission computed tomography (SPECT) ligand showing in vivo the loss of dopaminergic terminals in the brain and is now available in the market. Despite several systematic studies in clinically inconclusive cases, the use of such imaging in clinical routine is scarcely reported. We analyzed 516 files of subjects with movement disorders who were consecutively examined using [123I]-FP-CIT scan and determined whether the use of imaging was appropriate and if it improved clinical diagnosis or care of the patient. In addition, we determined if appropriate use was related to subspecialties in Neurology, e.g., movement disorders’ specialists vs. general neurologists, and if appropriate use was increasing over time. Among the 516 scans, 18 % were in agreement with the license, 62 % were classified as appropriate and 37 % were considered inappropriate. A change of management was obvious in 60 % of patients, but in 92 % of those with an appropriate request vs. 13 % of patients with an inappropriate request. Movement disorders’ specialists had more appropriate requests than other practitioners. Eventually, comparing the first 100 vs. the last 100 quantified SPECT, performed more than 2.5 years apart, we found no difference for the appropriateness of the examination. The use of [123I]-FP-CIT imaging in clinical routine does not fit a restrictive license. An inappropriate use is seen in nearly 40 % of cases, which reduces the real cost-effectiveness of the technique suggesting a need for continuing medical education on the topic.

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Conflict of interest

The authors declare that they have no conflict of interest which could influence the content of the manuscript submitted. However, Emmanuel Itti declares a partnership between GE HealthCare and a non-profit association the 14/01/14. Claire Thiriez declares grants from Boston Scientific for another study, and congress funding from Orkyn, novartis, and Lundbeck-Teva. Gilles Fenelon declares speaker honoraria from Teva Pharma and Lundbeck SAS, and travel funding from Teva Pharma and Lundbeck SAS. Eva Evangelista and Michel Meignan reported no financial disclosure. Pierre Cesaro deceased before giving his financial disclosure. Philippe Remy declares consultancies from Lundbeck, and advisory Boards from Novartis.

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Authors and Affiliations

  1. Centre Expert Parkinson, Service de neurologie, Hôpital Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94010, Creteil Cedex, France

    Claire Thiriez, Gilles Fénelon, Pierre Cesaro & Philippe Remy

  2. MIRCen, URA CEA-CNRS 2210, Equipe 2, Fontenay aux Roses et Orsay, France

    Claire Thiriez & Philippe Remy

  3. Faculté de Médecine, Université Paris Est-Créteil, 94010, Creteil Cedex, France

    Emmanuel Itti, Michel Meignan, Pierre Cesaro & Philippe Remy

  4. Service de médecine nucléaire, AP-HP, Groupe Hospitalier Henri Mondor, 94010, Creteil Cedex, France

    Emmanuel Itti, Eva Evangelista & Michel Meignan

Authors
  1. Claire Thiriez
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  2. Emmanuel Itti
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  3. Gilles Fénelon
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  4. Eva Evangelista
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  5. Michel Meignan
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  6. Pierre Cesaro
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  7. Philippe Remy
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Correspondence to Claire Thiriez.

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Thiriez, C., Itti, E., Fénelon, G. et al. Clinical routine use of dopamine transporter imaging in 516 consecutive patients. J Neurol 262, 909–915 (2015). https://doi.org/10.1007/s00415-014-7634-y

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  • DOI: https://doi.org/10.1007/s00415-014-7634-y

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