A multicenter assessment of dopamine transporter imaging with DOPASCAN/SPECT in parkinsonism. Parkinson Study Group.
BACKGROUND
In vivo imaging of the dopamine transporter (DAT) with SPECT is a quantitative biomarker for PD onset and severity.


OBJECTIVE
To use a multicenter study to evaluate the diagnostic accuracy of DOPASCAN and SPECT in patients with PD, progressive supranuclear palsy (PSP), and essential tremor (ET), and in healthy controls (HC).


METHODS
Ninety-six individuals with known clinical diagnosis were imaged with DOPASCAN at five sites with different multidetector SPECT systems. Both masked visual interpretation and region of interest (ROI) analysis were performed at each site and at a core analysis center.


RESULTS
Visual interpretation of the images by an expert panel demonstrated a sensitivity of 0.98 and specificity of 0.83 comparing parkinsonian (PD + PSP) versus nonparkinsonian (ET + HC) controls. Quantitative analysis of putamen and caudate DOPASCAN uptake for each region in the PD or PSP groups was significantly reduced compared to the ET or HC groups. Comparison of parkinsonian (PD + PSP) versus nonparkinsonian (ET + HC) individuals demonstrated a reduction of 76% in mean putamen and 48% in mean caudate DOPASCAN uptake.


CONCLUSIONS
DOPASCAN and SPECT imaging reliably and effectively distinguish between subjects with Parkinson's syndrome (PD + PSP) and without Parkinson's syndrome (HC + ET). This is the first multicenter assessment of dopamine transporter imaging demonstrating that this tool may be used widely to assess dopaminergic degeneration in patients with parkinsonism.
D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging*; D002352:Carrier Proteins / Q000378:metabolism*; D050483:Dopamine Plasma Membrane Transport Proteins; D006801:Humans; D008297:Male; D008562:Membrane Glycoproteins; D026901:Membrane Transport Proteins; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009419:Nerve Tissue Proteins; D020734:Parkinsonian Disorders / Q000000981:diagnostic imaging*; D015899:Tomography, Emission-Computed, Single-Photon
D002352:Carrier Proteins; D050483:Dopamine Plasma Membrane Transport Proteins; D008562:Membrane Glycoproteins; D026901:Membrane Transport Proteins; D009419:Nerve Tissue Proteins; C493214:SLC6A3 protein, human