title: Is There a Role for DAT-SPECT Imaging in a Specialty Movement Disorders Practice?
abstract: OBJECTIVE
  Analyze indications for ordering DAT-SPECT scans and the clinical impact of scan results on patients evaluated in a movement disorders practice.
  
  
  BACKGROUND
  DAT-SPECT is FDA approved to evaluate cases of suspected presynaptic dopaminergic deficiency. Little data is available on clinical use and impact of these scans among movement disorders neurologists.
  
  
  METHODS
  DAT-SPECT scans ordered at the Northwestern University Parkinson's disease (PD) and movement disorders center from 2011-2013 were reviewed. Clinic notes were reviewed for information regarding the indication for ordering each scan, and to assess for any changes in clinical impression or management choices that followed the scan.
  
  
  RESULTS
  83 scans were ordered by four specialists. Scans were commonly ordered to differentiate PD from Essential Tremor (21.7%, n = 18) or from drug-induced parkinsonism (21.7%, n = 18). In 59% (n = 49) of cases, a change in clinical diagnosis or medication regimen occurred within one visit after the scan. The strongest impact was seen for the indication of ET vs. PD in which 72.2% (n = 13) had a change in diagnosis, management, or both.
  
  
  CONCLUSIONS
  Diagnostic uncertainty in cases of parkinsonism exists even in a tertiary referral center. DAT-SPECT has significant impact on clinical diagnosis and management even in the hands of movement disorders specialists.
authors.affiliation: Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Ill., USA.
authors.forename: Danny
authors.initials: D
authors.lastname: Bega
authors.forename: Paulina
authors.initials: P
authors.lastname: Gonzalez-Latapi
authors.forename: Cindy
authors.initials: C
authors.lastname: Zadikoff
authors.forename: William
authors.initials: W
authors.lastname: Spies
authors.forename: Tanya
authors.initials: T
authors.lastname: Simuni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism*; D050483:Dopamine Plasma Membrane Transport Proteins / Q000378:metabolism*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009069:Movement Disorders / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D050483:Dopamine Plasma Membrane Transport Proteins