title: Additional Value of Early-Phase 18F-FP-CIT PET Image for Differential Diagnosis of Atypical Parkinsonism.
abstract: OBJECTIVE
  Regional cerebral perfusion is coupled to metabolism in general. Early perfusion dominant imaging using F-FP-CIT PET (pCIT) may provide complementary information to delayed dopamine transporter dominant images. We investigated the ability of pCIT to differentiate atypical Parkinson disorder from Parkinson disease (PD) compared to FDG and the image quality for optimizing the acquisition time.
  
  
  METHODS
  Sixty-seven subjects [PD, 23 subjects; multiple system atrophy-cerebellar type (MSA-C), 27 subjects; MSA-Parkinson type (MSA-P), 12 subjects; and progressive supranuclear palsy (PSP), 5 subjects] underwent F-FP-CIT and FDG PET. Using dynamic PET data acquired during the first 10 minutes after F-FP-CIT administration, we generated potential perfusion images of 0 to 5 (pCIT-5m), 0 to 7 (pCIT-7m), and 0 to 10 (pCIT-10m) minutes. We compared regional uptake between groups in pCIT and FDG images and image quality among pCIT images using visual, quantitative, or statistical parametric mapping analyses.
  
  
  RESULTS
  Regional cerebral uptake of pCITs correlated well to that of the FDG images (R > 0.5, all). Multiple system atrophy-cerebellar type and MSA-P groups show different regional uptake patterns compared with PD group on pCITs in quantitative and statistical parametric mapping analyses, analogous to FDG images, but not in the PSP group. In visual analysis, concordance rates between each pCIT and FDG image were high (92.3%-96.0%, regional; 86.2%-93.1%, diagnostic), and there was no significant difference among pCITs. However, pCIT-10m discriminated PSP better than others and showed higher signal-to-noise ratio (P = 0.001).
  
  
  CONCLUSIONS
  F-FP-CIT PETs with the first 10 minutes could be useful for the differential diagnosis of atypical Parkinson disorder by providing complementary FDG-like information to the dopamine transporter binding on late-phase FP-CIT images.
authors.affiliation: From the *Department of Nuclear Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Korea; and Departments of †Nuclear Medicine, and ‡Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Soyoung
authors.initials: S
authors.lastname: Jin
authors.forename: Minyoung
authors.initials: M
authors.lastname: Oh
authors.forename: Seung Jun
authors.initials: SJ
authors.lastname: Oh
authors.forename: Jungsu S
authors.initials: JS
authors.lastname: Oh
authors.forename: Sang Ju
authors.initials: SJ
authors.lastname: Lee
authors.forename: Sun Ju
authors.initials: SJ
authors.lastname: Chung
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014326:Tropanes
chemical_list: D019275:Radiopharmaceuticals; D014326:Tropanes; C087552:2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane