2007 issue 1

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Volume 16, issue 1

Original article

The role of DaTSCAN SPET examination in the diagnosis of the extrapyramidal system diseases - original observations

Wanda Lipczyńska-Łojkowska1, Tomasz Jędrzejczak2, Włodzimierz Kuran1, Jerzy Kulczycki1, Izabella Kozłowicz-Gudzińska2, Halina Sienkiewicz-Jarosz1, Anna Bochyńska1, Agata Sackiewicz-Słaby2, Danuta Ryglewicz1
1. I Klinika Neurologiczna Instytutu Psychiatrii i Neurologii w Warszawie
2. Zakład Medycyny Nuklearnej Centrum Onkologii w Warszawie
Postępy Psychiatrii i Neurologii 2007; 16 (1): 23-29
Keywords: Parkinson’s disease, parkinsonism, SPET, DaTSCAN, 123I FP-CIT

Abstract

Objectives. An attempt was made to find out whether SPET examination using the 123I FP-CIT (DaTSCAN) may contribute to an improvement in the diagnostics of diseases presenting with the extrapyramidal syndrome symptoms.
Method. Participants in the study were 9 patients with symptoms of the extrapyramidal system impairment diagnosed on the neurological examination at the onset of the disease. Six patients were diagnosed with Parkinson's disease, and the remaining three were single cases of: multisystem atrophy (MSA), a sporadic form of the Creutzfeldt-Jakob disease, and the Gerstmann-Straussler-Scheinker disease. In all the patients SPET of the brain was conducted with the use of 123I FP-CIT. SPET scans were evaluated using optical and semi-quantitative methods. In the semi-quantitative method of the DaTSCAN uptake assessment regions of interest (ROI) were identified for the striatum and occipital cortex. The index of DaTSCAN uptake by DAT in the striatum was determined.
Results. In 6 persons with different degrees of Parkinson's disease advancement lowered 123I FP-CIT uptake indexes were found in the striatum. The results correlated with the degree of the disease advancement. In patients with the hemi-parkinsonian syndrome changes in the opposing striatum were found in SPET scans. In the female patient with MSA a lowered radio-marker uptake index was observed bilaterally in the striatum. In the remaining two cases of the Creutzfeldt-Jakob disease the DaTSCAN SPET scans were normal.
Conclusions. SPET examination with the use of 123I is helpful in diagnosing Parkinson's disease and other, so-called "presynaptic", forms of Parkinsonism, as well as in the evaluation of the disease advancement.

Address for correspondence:
Dr Wanda Lipczyńska-Łojkowska
I Klinika Neurologiczna Instytutu Psychiatrii i Neurologii,
ul. Sobieskiego 9, 02-957 Warszawa
e-mail: wlojkowska@poczta.onet.pl