title: Comparison of 99mTc-TRODAT-1 SPECT and 18 F-AV-133 PET imaging in healthy controls and Parkinson's disease patients.
abstract: (99m)Tc-TRODAT-1 is the first clinical routine (99m)Tc radiopharmaceutical to evaluate dopamine neurons loss in Parkinson's disease (PD). (18)F-AV-133 is a novel PET radiotracer targeting the vesicular monoamine transporter type 2 (VMAT2) to detect monoaminergic terminal reduction in PD patients. The aim of this study is to compare both images in the same health control (HC) and PD subjects.
  
  
  METHODS
  Eighteen subjects (8 HC and 10 PD) were recruited for (99m)Tc-TRODAT-1 SPECT, (18)F-AV-133 PET and MRI scans within two weeks. The SPECT images were performed at 4-h post-injection for 45 min, and the PET images were performed at 90 min post-injection for 10 min. Each PET and SPECT image was normalized into Montreal Neurological Institute template aided from individual MRI for comparison. For regional analysis, volume of interest (VOIs) of bilateral caudate nuclei, anterior, posterior putamen and occipital cortex (as reference region) were delineated from the normalized MRI. The specific uptake ratio (SUR) was calculated as (regional mean counts/reference mean counts-1). The nonparametric Mann-Whitney U test was used to evaluate the power of differentiating control from PD subjects for both image modalities. The correlations of the SURs to the clinical parameters were examined. For voxelwise analysis, two-sample t-test for group comparison between HC and PD was computed in both image modalities.
  
  
  RESULTS
  The SURs of caudate nucleus and putamen correlated well between two image modalities (r = 0.81, p<0.001), and showed significant different between HC and PD subjects. Of note, the (18)F-AV-133 SUR displayed a better correlation to PD clinical laterality index as compared to (99m)Tc-TRODAT-1 (r = 0.73 vs. r = 0.33). Voxelwise analysis showed more lesions for PD subjects from (18)F-AV-133 image as compared to (99m)Tc-TRODAT-1 especially at the substantia nigra region.
  
  
  CONCLUSIONS
  (18)F-AV-133 PET demonstrated similar performance in differentiation PD from control, and a better correlation to clinical characteristics than that of (99m)Tc-TRODAT-1 SPECT. (18)F-AV-133 PET also showed additional information in substantia nigra integrity in PD subjects by voxelwise analysis. Collectively, (18)F-AV-133 could be a promising and better tracer for clinical use to detect monoaminergic terminal reduction in PD patients.
authors: Healthy Aging Research Center, and Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Molecular Imaging Center and Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors: Ing-Tsung
authors: IT
authors: Hsiao
authors: Healthy Aging Research Center, and Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Neuroscience Research Center and Section of Movement Disorder, Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors: Yi-Hsin
authors: YH
authors: Weng
authors: Neuroscience Research Center and Section of Movement Disorder, Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors: Wey-Yil
authors: WY
authors: Lin
authors: Healthy Aging Research Center, and Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors: Chia-Ju
authors: CJ
authors: Hsieh
authors: Healthy Aging Research Center, and Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Molecular Imaging Center and Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors: Shiaw-Pyng
authors: SP
authors: Wey
authors: Healthy Aging Research Center, and Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Molecular Imaging Center and Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors: Tzu-Chen
authors: TC
authors: Yen
authors: Radiology, University of Pennsylvania, Philadelphia, PA, USA.
authors: Mei-Ping
authors: MP
authors: Kung
authors: Healthy Aging Research Center, and Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Neuroscience Research Center and Section of Movement Disorder, Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors: Chin-Song
authors: CS
authors: Lu
authors: Healthy Aging Research Center, and Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Molecular Imaging Center and Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan. Electronic address: kunjulin@gmail.com.
authors: Kun-Ju
authors: KJ
authors: Lin
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005462:Fluorine Radioisotopes; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010300:Parkinson Disease / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000379:methods*; D013747:Tetrabenazine / Q000031:analogs & derivatives*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014326:Tropanes
chemical_list: D005462:Fluorine Radioisotopes; D015609:Organotechnetium Compounds; D014326:Tropanes; C104196:technetium Tc 99m TRODAT-1; C549477:florbenazine F 18; D013747:Tetrabenazine
keywords: (18)F-AV-133; (99m)Tc-TRODAT-1; DAT; Parkinson's disease; VMAT2