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

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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.

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Fig. 1A–D
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Acknowledgements

This study was supported by a research grant from the Leuven University Research Foundation (BOF). The authors thank Prof. H. Kung (Penn University, Philadelphia) for his kind co-operation in the synthesis of 99mTc-TRODAT-1.

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Authors and Affiliations

  1. Division of Nuclear Medicine, Leuven University Hospital and K.U. Leuven, Herestraat 49, 3000, Leuven, Belgium

    K. Van Laere, L. De Ceuninck, J. Van den Eynden, P. Dupont & L. Mortelmans

  2. Department of Neurology, Leuven University Hospital and K.U. Leuven, Leuven, Belgium

    R. Dom

  3. Department of Radiopharmaceutical Chemistry, Leuven University Hospital and K.U. Leuven, Leuven, Belgium

    H. Vanbilloen, J. Cleynhens, G. Bormans & A. Verbruggen

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  1. K. Van Laere
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  2. L. De Ceuninck
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Correspondence to K. Van Laere.

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Van Laere, K., De Ceuninck, L., Dom, R. et al. Dopamine transporter SPECT using fast kinetic ligands: 123I-FP-β-CIT versus 99mTc-TRODAT-1. Eur J Nucl Med Mol Imaging 31, 1119–1127 (2004). https://doi.org/10.1007/s00259-004-1480-6

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  • DOI: https://doi.org/10.1007/s00259-004-1480-6

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