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Comparison between visual assessment of dopaminergic degeneration pattern and semi-quantitative ratio calculations in patients with Parkinson's disease and Atypical Parkinsonian syndromes using DaTSCAN® SPECT

Davidsson, Anette ; Georgiopoulos, Charalampos LU orcid ; Dizdar, Nil ; Granerus, Göran and Zachrisson, Helene (2014) In Annals of Nuclear Medicine 28(9). p.9-851
Abstract

OBJECTIVE: To verify if (123)I-FP-CIT, DaTSCAN(®) can differentiate early stages of Parkinson's disease (PD) as well as patients with Atypical Parkinsonian syndromes (APS) from manifest Parkinson's disease.

METHODS: 128 consecutive patients were investigated with (123)I-FP-CIT SPECT during a 4-year period. All patients were diagnosed according to the established consensus criteria for diagnosis of PD (n = 53) and APS (n = 19). Remaining patients were grouped early PD (before onset of L-DOPA medication), (n = 20), vascular PD (n = 6), and non-PD syndromes (n = 30) and SWEDD (n = 1). SPECT images were analyzed visually according to a predefined ranking scale of dopaminergic nerve cell degeneration, distinguishing a... (More)

OBJECTIVE: To verify if (123)I-FP-CIT, DaTSCAN(®) can differentiate early stages of Parkinson's disease (PD) as well as patients with Atypical Parkinsonian syndromes (APS) from manifest Parkinson's disease.

METHODS: 128 consecutive patients were investigated with (123)I-FP-CIT SPECT during a 4-year period. All patients were diagnosed according to the established consensus criteria for diagnosis of PD (n = 53) and APS (n = 19). Remaining patients were grouped early PD (before onset of L-DOPA medication), (n = 20), vascular PD (n = 6), and non-PD syndromes (n = 30) and SWEDD (n = 1). SPECT images were analyzed visually according to a predefined ranking scale of dopaminergic nerve cell degeneration, distinguishing a posterior-anterior degeneration pattern (egg shape) from a more global and severe degeneration pattern (burst striatum). Striatum uptake ratios were quantitatively analyzed with the 3D software, EXINI.

RESULTS: In the group of APS patients, the burst striatum pattern was most frequent and found in 61 % (11/18 patients). In PD patients, the egg shape pattern was dominating, especially in early PD where it was present in 95 % (19/20 patients). The positive predictive value for the egg shape pattern to diagnose PD was 92 % in this material (APS and all PD patients) and the specificity 90 % for the burst striatum pattern to exclude APS. The uptake ratios were reduced in both PD and APS patients and closely related to the image ranking.

CONCLUSION: In this study, we found that in more than half of the patients it was possible to differentiate between PD and APS by visual interpretation only. Similar results were obtained using semi-quantitative uptake ratios. Combining visual assessment with uptake ratios did not add to the discriminating power of DaTSCAN(®) SPECT in this material.

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author
; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adult, Aged, Aged, 80 and over, Dopaminergic Neurons/diagnostic imaging, Female, Humans, Imaging, Three-Dimensional, Male, Middle Aged, Nerve Degeneration/diagnosis, Parkinson Disease/diagnosis, Radiopharmaceuticals, Severity of Illness Index, Software, Tomography, Emission-Computed, Single-Photon/methods, Tropanes
in
Annals of Nuclear Medicine
volume
28
issue
9
pages
9 - 851
publisher
Springer
external identifiers
  • pmid:24997753
  • scopus:84919579833
ISSN
1864-6433
DOI
10.1007/s12149-014-0878-x
language
English
LU publication?
no
id
8e167b26-e24d-4b57-a26e-f34cafb9ef83
date added to LUP
2023-02-09 11:22:35
date last changed
2024-12-14 21:18:21
@article{8e167b26-e24d-4b57-a26e-f34cafb9ef83,
  abstract     = {{<p>OBJECTIVE: To verify if (123)I-FP-CIT, DaTSCAN(®) can differentiate early stages of Parkinson's disease (PD) as well as patients with Atypical Parkinsonian syndromes (APS) from manifest Parkinson's disease.</p><p>METHODS: 128 consecutive patients were investigated with (123)I-FP-CIT SPECT during a 4-year period. All patients were diagnosed according to the established consensus criteria for diagnosis of PD (n = 53) and APS (n = 19). Remaining patients were grouped early PD (before onset of L-DOPA medication), (n = 20), vascular PD (n = 6), and non-PD syndromes (n = 30) and SWEDD (n = 1). SPECT images were analyzed visually according to a predefined ranking scale of dopaminergic nerve cell degeneration, distinguishing a posterior-anterior degeneration pattern (egg shape) from a more global and severe degeneration pattern (burst striatum). Striatum uptake ratios were quantitatively analyzed with the 3D software, EXINI.</p><p>RESULTS: In the group of APS patients, the burst striatum pattern was most frequent and found in 61 % (11/18 patients). In PD patients, the egg shape pattern was dominating, especially in early PD where it was present in 95 % (19/20 patients). The positive predictive value for the egg shape pattern to diagnose PD was 92 % in this material (APS and all PD patients) and the specificity 90 % for the burst striatum pattern to exclude APS. The uptake ratios were reduced in both PD and APS patients and closely related to the image ranking.</p><p>CONCLUSION: In this study, we found that in more than half of the patients it was possible to differentiate between PD and APS by visual interpretation only. Similar results were obtained using semi-quantitative uptake ratios. Combining visual assessment with uptake ratios did not add to the discriminating power of DaTSCAN(®) SPECT in this material.</p>}},
  author       = {{Davidsson, Anette and Georgiopoulos, Charalampos and Dizdar, Nil and Granerus, Göran and Zachrisson, Helene}},
  issn         = {{1864-6433}},
  keywords     = {{Adult; Aged; Aged, 80 and over; Dopaminergic Neurons/diagnostic imaging; Female; Humans; Imaging, Three-Dimensional; Male; Middle Aged; Nerve Degeneration/diagnosis; Parkinson Disease/diagnosis; Radiopharmaceuticals; Severity of Illness Index; Software; Tomography, Emission-Computed, Single-Photon/methods; Tropanes}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{9--851}},
  publisher    = {{Springer}},
  series       = {{Annals of Nuclear Medicine}},
  title        = {{Comparison between visual assessment of dopaminergic degeneration pattern and semi-quantitative ratio calculations in patients with Parkinson's disease and Atypical Parkinsonian syndromes using DaTSCAN® SPECT}},
  url          = {{http://dx.doi.org/10.1007/s12149-014-0878-x}},
  doi          = {{10.1007/s12149-014-0878-x}},
  volume       = {{28}},
  year         = {{2014}},
}