Differential Diagnosis of Patients with Inconclusive Parkinsonian Features Using [18F]FP-CIT PET/CT
- Authors
- Park, E.; Hwang, Y.M.; Lee, C.-N.; Kim, S.; Oh, S.Y.; Kim, Y.C.; Choe, J.G.; Park, K.W.
- Issue Date
- 2014
- Publisher
- Springer Verlag
- Keywords
- Dopamine transporter; Inconclusive parkinsonian features; Parkinsonism; Positron emission tomography
- Citation
- Nuclear Medicine and Molecular Imaging, v.48, no.2, pp.106 - 113
- Indexed
- SCOPUS
KCI
- Journal Title
- Nuclear Medicine and Molecular Imaging
- Volume
- 48
- Number
- 2
- Start Page
- 106
- End Page
- 113
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/100793
- DOI
- 10.1007/s13139-013-0253-1
- ISSN
- 1869-3474
- Abstract
- Purpose: It is often difficult to differentiate parkinsonism, especially when patients show uncertain parkinsonian features. We investigated the usefulness of dopamine transporter (DAT) imaging for the differential diagnosis of inconclusive parkinsonism using [18F]FP-CIT PET. Methods: Twenty-four patients with inconclusive parkinsonian features at initial clinical evaluation and nine healthy controls were studied. Patients consisted of three subgroups: nine patients whose diagnoses were unclear concerning whether they had idiopathic Parkinson's disease or drug-induced parkinsonism ('PD/DIP'), nine patients who fulfilled neither the diagnostic criteria of PD nor of essential tremor ('PD/ET'), and six patients who were alleged to have either PD or atypical parkinsonian syndrome ('PD/APS'). Brain PET images were obtained 120 min after injection of 185 MBq [18F]FP-CIT. Imaging results were quantified and compared with follow-up clinical diagnoses. Results: Overall, 11 of 24 patients demonstrated abnormally decreased DAT availability on the PET scans, whereas 13 were normal. PET results could diagnose PD/DIP and PD/ET patients as having PD in six patients, DIP in seven, and ET in five; however, the diagnoses of all six PD/APS patients remained inconclusive. Among 15 patients who obtained a final follow-up diagnosis, the image-based diagnosis was congruent with the follow-up diagnosis in 11 patients. Four unsolved cases had normal DAT availability, but clinically progressed to PD during the follow-up period. Conclusion: [18F]FP-CIT PET imaging is useful in the differential diagnosis of patients with inconclusive parkinsonian features, except in patients who show atypical features or who eventually progress to PD. © 2013 Korean Society of Nuclear Medicine.
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