Kaveh Vejdani MD, Presenter: Nothing to Disclose

Razi Muzaffar DO, Abstract Co-Author: Nothing to Disclose

Pratap Chand MD, Abstract Co-Author: Nothing to Disclose

Medhat M. Osman MD, Abstract Co-Author: Speaker, Koninklijke Philips NV

To correlate the severity of striatal dopaminergic loss with symptom chronicity of Parkinsonism; and to compare clinical symptom laterality with findings on ioflupane imaging.

123I-Ioflupane (DaTscan) brain SPECT images from 44 patients with Parkinsonian movement disorders were analyzed retrospectively. Ioflupane uptake in the right and left corpora striata was quantified using manually drawn regions of interest (ROI). The occipital lobes were used as background for Ioflupane specific binding ratio (SBR) calculation. SBR was defined as striatal counts minus background counts, divided by background counts. SBR was correlated with patient’s symptom duration. Symptom laterality was compared with the visual findings on imaging.

Of 44 patients, 21 were female (age 64.3 ± 10.5, range 47-85) and 23 were male (age 67.5 ± 8.9, range 49-82). Symptom duration ranged from 1 month to 40 years (average 4.7 years). Mean ± SD of striatal SBR was 1.22 ± 0.64. Weak correlation (r2 < 0.3) was observed between the duration of Parkinsonian symptoms and the degree of striatal dopaminergic loss, regardless of gender (r2 = 0.11 in men, and -0.11 in women). Data on symptom laterality was available in 40 patients. Clinical suspicion for Parkinson’s disease was high (HCS) in 20 patients and low (LCS) in the other 20. Ioflupane scan results were normal in 16/20 (80%) of the patients with LCS. In those with HCS, symptoms were unilateral in 3, symmetrically bilateral in 2, and asymmetrically bilateral in 15. Imaging results agreed with clinical symptom laterality in 1/3 (33%) of the unilateral cases, 0/2 (0%) of the symmetrically bilateral cases, and 5/10 (50%) of the asymmetrically bilateral cases.

The degree of striatal dopaminergic loss correlates weakly with symptomatic chronicity of Parkinsonism, regardless of gender. Ioflupane imaging findings agree partially with Parkinsonian symptom laterality.

123I-ioflupane brain SPECT helps in clinical differentiation between Parkinsonian movement disorders with or without a dopaminergic deficit, which require different approaches to therapy. The relationship between striatal dopaminergic density and Parkinsonian symptoms chronicity and laterality is not well understood.

Vejdani, K, Muzaffar, R, Chand, P, Osman, M, Clinical Correlation of 123I-ioflupane Brain SPECT with Symptom Chronicity and Laterality in the Sssessment of Parkinsonian Movement Disorders.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006734.html