A multicenter assessment of dopamine transporter imaging with DOPASCAN/SPECT in parkinsonism

^*See Appendix 3 on page 1546 for a complete list of investigators.

Supported by Guilford Pharmaceutical, Inc., and a National Parkinson's Foundation Center of Excellence grant at Yale University.

Received May 4, 1999. Accepted in final form July 21, 2000.

Address correspondence and reprint requests to Dr. Kenneth Marek, Department of Neurology, Yale University School of Medicine, 40 Temple St/Suite 6C, New Haven, CT 06510; e-mail: [email protected]

Neurology 57(10):p S52-S59, November 2001.

Article abstract

Background:

In vivo imaging of the dopamine transporter (DAT) with SPECT is a quantitative biomarker for PD onset and severity.

Objective:

To use a multicenter study to evaluate the diagnostic accuracy of DOPASCAN and SPECT in patients with PD, progressive supranuclear palsy (PSP), and essential tremor (ET), and in healthy controls (HC).

Methods:

Ninety-six individuals with known clinical diagnosis were imaged with DOPASCAN at five sites with different multidetector SPECT systems. Both masked visual interpretation and region of interest (ROI) analysis were performed at each site and at a core analysis center.

Results:

Visual interpretation of the images by an expert panel demonstrated a sensitivity of 0.98 and specificity of 0.83 comparing parkinsonian (PD + PSP) versus nonparkinsonian (ET + HC) controls. Quantitative analysis of putamen and caudate DOPASCAN uptake for each region in the PD or PSP groups was significantly reduced compared to the ET or HC groups. Comparison of parkinsonian (PD + PSP) versus nonparkinsonian (ET + HC) individuals demonstrated a reduction of 76% in mean putamen and 48% in mean caudate DOPASCAN uptake.

Conclusions:

DOPASCAN and SPECT imaging reliably and effectively distinguish between subjects with Parkinson's syndrome (PD + PSP) and without Parkinson's syndrome (HC + ET). This is the first multicenter assessment of dopamine transporter imaging demonstrating that this tool may be used widely to assess dopaminergic degeneration in patients with parkinsonism.