Dopamine transporter SPECT using fast kinetic ligands: 123I-FP-β-CIT versus 99mTc-TRODAT-1

  • K. Van Laere
  • L. De Ceuninck
  • R. Dom
  • J. Van den Eynden
  • H. Vanbilloen
  • J. Cleynhens
  • P. Dupont
  • G. Bormans
  • A. Verbruggen
  • L. Mortelmans
Original Article

DOI: 10.1007/s00259-004-1480-6

Cite this article as:
Van Laere, K., De Ceuninck, L., Dom, R. et al. Eur J Nucl Med Mol Imaging (2004) 31: 1119. doi:10.1007/s00259-004-1480-6

Abstract

A comparative study was carried out on two promising presynaptic dopamine transporter single-photon emission tomography (SPECT) radioligands with a fast pharmacokinetic profile, 123I-FP-β-CIT (FP) and 99mTc-TRODAT-1 (TR), in order to assess their differential diagnostic power in early parkinsonism and their sensitivity for detection of disease progression. This cross-sectional study was conducted on 96 patients with early-stage parkinsonism referred in a tertiary clinical setting. Mean disease duration was 2.0±1.3 years, and patients had a modified Hoehn and Yahr (H&Y) stage of 1–2 (average 1.2). Forty-seven patients received TR, and 49 received FP. In both groups, ten patients with normal presynaptic function were included as a control population; all other patients were clinically diagnosed as having idiopathic Parkinson’s disease. Groups were matched for gender, age, disease duration and modified H&Y stage. Triple-head gamma camera SPECT was analysed using a semiquantitative index of transporter binding (BI). Discriminant analysis with cross-validation resulted in a maximal classification accuracy for FP of 93% (sensitivity 95% and specificity 86%) for the contralateral putamen BI. For TR, the corresponding values were 87% accuracy, 92% sensitivity and 70% specificity. For FP, disease duration was correlated with both the putamen BI (−8.8%/year, ρ=−0.41, P=0.025) and the putamen/caudate ratio (−7.4%/year, ρ=−0.51, P=0.004), but for TR no significant correlation was found (all P values >0.5). In conclusion, both FP and TR show high sensitivity in a clinically relevant setting, but FP has superior accuracy for early differential diagnosis of idiopathic parkinsonism and non-degenerative extrapyramidal disorders, as well as better sensitivity for disease follow-up.

Keywords

FP-β-CIT TRODAT-1 Idiopathic parkinsonism Parkinson’s disease Differential diagnosis 

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • K. Van Laere
    • 1
  • L. De Ceuninck
    • 1
  • R. Dom
    • 2
  • J. Van den Eynden
    • 1
  • H. Vanbilloen
    • 3
  • J. Cleynhens
    • 3
  • P. Dupont
    • 1
  • G. Bormans
    • 3
  • A. Verbruggen
    • 3
  • L. Mortelmans
    • 1
  1. 1.Division of Nuclear MedicineLeuven University Hospital and K.U. LeuvenLeuvenBelgium
  2. 2.Department of NeurologyLeuven University Hospital and K.U. LeuvenLeuvenBelgium
  3. 3.Department of Radiopharmaceutical ChemistryLeuven University Hospital and K.U. LeuvenLeuvenBelgium

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