[Utility of dopamine transporter imaging (123-I Ioflupane SPECT) in the assessment of movement disorders].
OBJECTIVE
The aim of our work was to assess the diagnostic impact of 123-I Ioflupane SPECT in patients with tremor and some other sign of Parkinsonisms in regards to its categorization in Parkinsonisms with involvement/indemnity of presynaptic dopaminergic neurons as well as to establish a differential diagnosis between essential tremor (ET) and degenerative Parkinsonism.


METHODS
105 patients were included, 45 for differential diagnosis between Parkinsonism and ET, 52 to determine the origin of their Parkinsonism (degenerative vs secondary) and 8 with an established diagnosis, 5 Parkinson's disease and 3 ET. A dose of 185 MBq of Ioflupane 1-123 was administered and tomographic study acquired at 5 hours. After reconstruction, transaxial views were assessed by three observers. In all the patients, the diagnosis was established by a neurologist specialized in movement disorders, according to the symptoms, course, response to treatment and result of Ioflupane I-123.


RESULTS
42 patients were diagnosed of degenerative Parkinsonism (PD or Parkinsonism plus) and 63 of ET or secondary Parkinsonism. We obtained a values of sensitivity, specificity, PPV, NPV and accuracy of 93 %, 100 %, 100 %, 97 % and 97 % respectively. 123-I Ioflupane SPECT changed the treatment in 18 % of our patients.


CONCLUSIONS
123-I Ioflupane SPECT is a test of great value to establish the differential diagnosis between Parkinsonism vs ET and secondary vs degenerative Parkinsonism.
García Vicente
A M
AM
Servicio de Medicina Nuclear, Complejo Hospitalario Nuestra Sra. de Alarcos, Ciudad Real. amgarcia@sescam.jccm.es
Vaamonde Cano
J
J
Poblete García
V M
VM
Rodado Marina
S
S
Cortés Romera
M
M
Ruiz Solís
S
S
Ibáñez Alonso
R
R
Soriano Castrejón
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050483:Dopamine Plasma Membrane Transport Proteins; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D008562:Membrane Glycoproteins; D026901:Membrane Transport Proteins; D008875:Middle Aged; D009069:Movement Disorders / Q000000981:diagnostic imaging*; D009419:Nerve Tissue Proteins; D012189:Retrospective Studies; D015899:Tomography, Emission-Computed, Single-Photon; D014326:Tropanes
D050483:Dopamine Plasma Membrane Transport Proteins; D007457:Iodine Radioisotopes; D008562:Membrane Glycoproteins; D026901:Membrane Transport Proteins; D009419:Nerve Tissue Proteins; D014326:Tropanes; C087552:2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane