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Establishing On-Site Reference Values for 123I-FP-CIT SPECT (DaTSCAN®) Using a Cohort of Individuals with Non-Degenerative Conditions

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To overcome the issue of reference values for DaTSCAN® requiring healthy controls, we propose an original approach using scans from individuals with non-degenerative conditions performed at one single center following the same acquisition protocol.


From a cohort of 970 consecutive patients, we identified 182 patients with a clinical diagnosis of non-degenerative parkinsonism or tremor and a visually normal DATSCAN®. Caudate nucleus (C), putamen (P), and striatum (S) uptake values, C/P ratios, and asymmetry indexes (AI) were calculated using semi-quantitative methods. Outcomes were assessed according to age and gender, and reference limits were established using the percentile approach.


A significant negative linear effect of age was found upon striatal nuclei uptake of 0.21–0.22 per decade (6.8 %/decade for striatum), whereas a potential gender influence proved unclear. Inferior reference limits were established at the 5th percentile. C/P ratios and AIs were not influenced by age or gender, and superior reference limits were set at the 95th percentile.


We here propose a convenient approach to calculate site-specific reference limits for DaTSCAN® outcomes not requiring scanning healthy controls. The method appears to yield robust values that range within nearly identical limits as those obtained in healthy subjects.

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Conflict of Interest

The authors state that they have no conflict of interest.

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Correspondence to Pierre R. Burkhard.

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Nicastro, N., Garibotto, V., Poncet, A. et al. Establishing On-Site Reference Values for 123I-FP-CIT SPECT (DaTSCAN®) Using a Cohort of Individuals with Non-Degenerative Conditions. Mol Imaging Biol 18, 302–312 (2016). https://doi.org/10.1007/s11307-015-0889-6

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Key words

  • Reference values
  • Dopaminergic uptake
  • Gender
  • Age