Premium
Accuracy of Visual Assessment of Dopamine Transporter Imaging in Early Parkinsonism
Author(s) -
Jakobson Mo Susanna,
Linder Jan,
Forsgren Lars,
Riklund Katrine
Publication year - 2015
Publication title -
movement disorders clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.754
H-Index - 18
ISSN - 2330-1619
DOI - 10.1002/mdc3.12089
Subject(s) - dopamine transporter , parkinsonism , medicine , putamen , spect imaging , dopaminergic , nuclear medicine , dopamine , psychology , disease
Dopamine transporter (DaT) imaging may be supportive in the initial clinical diagnostic workup in patients with suspected parkinsonian diseases, given that the method has the potential to detect dopaminergic degeneration. We investigated the diagnostic accuracy of visual assessment of the initial DaT single‐photon emission CT (DaT‐ SPECT ) with 123 I‐ FP ‐ CIT in a large group of early‐stage parkinsonian patients. After inclusion in a long‐term multidisciplinary population‐based prospective study, a baseline DaT‐ SPECT was done in 171 incidental, L‐dopa‐naïve, parkinsonian patients (102 men and 69 women) and 37 healthy controls (19 men and 18 women). The results of the DaT‐ SPECT s were linked to criteria‐based clinical diagnoses, which were set after a mean follow‐up of 4.6 (±1.7) years. The outcome of the visual assessment was also compared with that of a semiquantitative evaluation method using regions of interest to measure uptake ratios in the caudate and putamen. We found that visual assessment of DaT‐ SPECT in clinically diagnosed incidental Parkinson's disease patients had a sensitivity of 94% and a specificity of 92%, rendering a positive likelihood ratio of 11.75 and a negative likelihood ratio of 0.07. The proportion of false positives was 1.4% and false negatives 4.8% at baseline. These figures were comparable to those of the semiquantitative method. This study demonstrates that visual interpretation of presynaptic dopamine imaging with 123 I‐ FP ‐ CIT offers reliable support in the diagnostic procedure of early parkinsonian diseases.