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Quantitative simultaneous 99mTc-ECD/123I-FP-CIT SPECT in Parkinson’s disease and multiple system atrophy

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Abstract

Purpose

The purpose of this study was to investigate the feasibility and utility of dual-isotope SPECT for differential diagnosis of idiopathic Parkinson’s disease (IPD) and multiple system atrophy (MSA).

Methods

Simultaneous 99mTc-ECD/123I-FP-CIT studies were performed in nine normal controls, five IPD patients, and five MSA patients. Projections were corrected for scatter, cross-talk, and high-energy penetration, and iteratively reconstructed while correcting for patient-specific attenuation and variable collimator response. Perfusion and dopamine transporter (DAT) function were assessed using voxel-based statistical parametric mapping (SPM2) and volume of interest quantitation. DAT binding potential (BP) and asymmetry index (AI) were estimated in the putamen and caudate nucleus.

Results

Striatal BP was lower in IPD (55%) and MSA (23%) compared to normal controls (p<0.01) , and in IPD compared to MSA (p<0.05). AI was greater for IPD than for MSA and controls in both the caudate nucleus and the putamen (p<0.05). There was significantly decreased perfusion in the left and right nucleus lentiformis in MSA compared to IPD and controls (p<0.05).

Conclusion

Dual-isotope studies are both feasible in and promising for the diagnosis of parkinsonian syndromes.

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Acknowledgements

This work was supported in part by grants from the French Ministry of Health: FUSPARK project (Réseau National Technologie Santé), Partners Collaborative Research (grant 137561), and the National Institutes of Health (grants RO1-EB000802 and RO1-EB001989).

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Authors and Affiliations

  1. Division of Nuclear Medicine, Department of Radiology, Harvard Medical School and Brigham and Women’s Hospital, Boston, MA, USA

    Georges El Fakhri & Marie Foley Kijewski

  2. U678 INSERM - UPMC, CHU Pitié-Salpêtrière, Paris, France

    Marie-Odile Habert, Philippe Maksud & Zoulikha Malek

  3. Department of Nuclear Medicine, CHU Pitié-Salpêtrière, Paris, France

    Marie-Odile Habert, Philippe Maksud, Aurélie Kas & Zoulikha Malek

  4. Fédération des Maladies du Système Nerveux, CHU Pitié-Salpêtrière, Paris, France

    Lucette Lacomblez

  5. Department of Pharmacology, CHU Pitié-Salpêtrière, Paris, France

    Lucette Lacomblez

Authors
  1. Georges El Fakhri
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  2. Marie-Odile Habert
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  3. Philippe Maksud
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  4. Aurélie Kas
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  5. Zoulikha Malek
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  6. Marie Foley Kijewski
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  7. Lucette Lacomblez
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Corresponding author

Correspondence to Georges El Fakhri.

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El Fakhri, G., Habert, MO., Maksud, P. et al. Quantitative simultaneous 99mTc-ECD/123I-FP-CIT SPECT in Parkinson’s disease and multiple system atrophy. Eur J Nucl Med Mol Imaging 33, 87–92 (2006). https://doi.org/10.1007/s00259-005-1920-y

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  • DOI: https://doi.org/10.1007/s00259-005-1920-y

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