Session Information
Date: Monday, October 8, 2018
Session Title: Parkinson's Disease: Neuroimaging And Neurophysiology
Session Time: 1:15pm-2:45pm
Location: Hall 3FG
Objective: To assess the clear indication for which DaT scan was requested, its specificity and sensitivity and factors that might be considered for future clinical use.
Background: The diagnosis of Parkinson disease (PD) and related syndromes is merely clinical. The availability of DaT scan is limited both by cost and lack of expert interpreter. There are no clear criteria when to use and how to implement the outcome into clinical decision. Here we reflect on the use of DaT scan outcome as requested by neurology team.
Methods: Retrospective check for all consecutive patients attending neurology outpatient clinics in HEFT, requested for DaT scan between August 2014 and December 2017.
Results: 299 patients were identified, 3 were not able to tolerate the test. Among the rest (296; 148 M & 148 F), 52(17.6%) were requested to exclude iatrogenic parkinsonism, 117(39.5%) to assess clinically isolated atypical tremor syndrome, 26(8.8%) for new parkinsonian features on top of chronic neurological condition, 8(2.7%) for PD in patients <45 years old, and 69(23.3%) for no clear reason. All were followed up till diagnosis is confirmed with treatment response, 8 lost to follow up. Mismatch between first DaT scan report and clinical outcome was found in 14 patients (1 false positive and 13 false negative; 6.4%). Second reporting identified mild positive features in 6 out of the 13 false negative reports. In properly indicated cases, specificity of DaT scan was found to be 98.6% and sensitivity 92%. Among the 13 false negative cases, 11 cases were proven as PD, one PSP and one MSA. For all the 11 patients with PD but one, DaT scan was performed within 12 months from the start of the symptoms.
Conclusions: Clinical assessment of PD is still the main diagnostic tool, with proper interpretation of DaT scans results especially if too early in the disease course.
To cite this abstract in AMA style:
M. Awadh, G. Ferris, K. Alam. The use of DaT scan for diagnosis of Idiopathic Parkinson’s disease and Parkinson’s Plus syndromes in clinical practice (HEFT experience) [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/the-use-of-dat-scan-for-diagnosis-of-idiopathic-parkinsons-disease-and-parkinsons-plus-syndromes-in-clinical-practice-heft-experience/. Accessed November 21, 2024.« Back to 2018 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/the-use-of-dat-scan-for-diagnosis-of-idiopathic-parkinsons-disease-and-parkinsons-plus-syndromes-in-clinical-practice-heft-experience/