Clinical impact of correlative [123I]-FP-CIT brain imaging and neurological findings in suspect Parkinson's disease

• Published in: Radiologia medica Vol. 108; no. 4; p. 417
• Main Authors: Covelli, Eugenio Maria, Brunetti, Arturo, Di Lauro, Andrea, Sullo, Pasquale, Mazzarella, Giancarlo, Tedeschi, Enrico, Belfiore, Giuseppe
• Format: Journal Article
• Language: English; Italian
• Published: Italy 01.10.2004
• Subjects: Aged; Brain - diagnostic imaging; Brain - metabolism; Brain - pathology; Dopamine - metabolism; Dopamine Plasma Membrane Transport Proteins; Female; Humans; Iodine Radioisotopes; Magnetic Resonance Imaging; Male; Membrane Glycoproteins - metabolism; Membrane Transport Proteins - metabolism; Middle Aged; Nerve Tissue Proteins - metabolism; Neurologic Examination; Parkinson Disease - diagnosis; Parkinson Disease - diagnostic imaging; Parkinson Disease - metabolism; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon; Tropanes
• ISSN: 0033-8362

Here we report our experience in a general hospital setting using [(123)I]-FP-CIT SPECT to diagnose patients with suspect Parkinson's disease (PD). Thirty consecutive patients (19M, 11W, mean age: 61+/-13 years) were prospectively studied. Patients underwent MRI (27) at 1.5T or CT (3) when MRI was contraindicated, to rule out focal brain abnormalities. Motor and cognitive function were evaluated by neurologists with UPDRS and Hoehn e Yahr Scale. [(123)I]-FP-CIT striatal uptake, assessed with SPECT, was classified as normal, non-diagnostic, abnormal (unilateral or bilateral). Imaging results (SPECT+MRI) were correlated with the neurological findings. In 5 patients the [(123)I]-FP-CIT brain SPECT was normal, suggesting that their symptoms could be related to a benign disorder such as essential tremor. Two patients had non-diagnostic [(123)I]-FP-CIT brain SPECT, with MRI/CT findings compatible with subcortical cerebrovascular disease. In the remaining 23 patients abnormal striatal [(123)I]-FP-CIT uptake correlated with neurological findings, significantly increasing the probability of Parkinson's disease. In these patients MRI/CT scans were normal, or showed a mild BA, or mild cerebral vascular disease (mild CVD). Our results suggest that [(123)I]-FP-CIT scan could be used routinely in clinical practice to support the diagnosis of PD and to differentiate between other conditions. Moreover, FP-CIT could significantly impact treatment selection and follow-up of these patients.