Objective: This study is aimed at introducing a new method to get Dopamine transporter (DAT) imaging simultaneously with regional cerebral flow (CBF) imaging.

Background: DAT imaging by Ioflupane 123I is a sensitive method to detect loss of striatal dopamine transporter and can assist to diagnose neurodegenerative parkinsonism (PS). PS patients have been reported not to develop cognitive dysfunction, but cognitive dysfunction is considered to be a crucial symptoms among PS patients. Thus, early and accurate diagnosis of movement disorders and dementia is critical to ensuring optimal clinical management and information of CBF is useful for diagnoses PS. However, to conduct DAT imaging simultaneously with CBF imaging is a time and cost consumed procedure.

Methods: Eight patients with PS were out-patiently recruited. The first study was single photon emission computed tomography images to measure CBF were performed by using N-isopropyl-p-123I-iodoamphetamine (123I-IMP). A series of slices was reconstructed to be parallel to the orbito-meatal line. The second study was surface brain perfusions images, “dynamic DAT”, and conventional DAT images that initiated soon and three hours after the intravenous injection of 180MBq of 123I-N-w-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl) nortropane (123I-FP-CIT) respectively. We analyzed 123I-IMP imaging and DAT imaging data and used statistical image using statistical parametric mapping (SPM) and three-dimensional stereotactic surface projections (3D-SSP).

Results: Based on the neurological examination and MRI, patients were diagnosed as four PD, one CBD, one MSA and two DLB. All patients had reduced DAT uptakes in the striatum and showed four cerebral perfusion (CBF) patterns in 123I-IMP SPECT images that well correlated with CBF patterns in dynamic DAT images. The first pattern was normal regional CBF patterns comparing with those of normal controls. The second pattern was reduced frontal cortex regional CBF patterns comparing with those of normal controls. The third pattern was reduced parietoposterior cortex regional CBF patterns comparing with those of normal controls. The fourth pattern was reduced occipital cortex regional CBF patterns comparing with those of normal controls.

Conclusions: Early diagnosis of PS with dementia is critical to predict clinical course and to ensuring optimal clinical management. Dynamic DAT imaging may be helpful for such clinical situations.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/dynamic-dopamine-transporter-images-are-helpful-for-diagnosing-parkinsonism/