| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
|
|
|||||||||
|
|
Neurosciences: NeurologyMovement Disorders |
1 Nuclear Medicine, CHRU Bretonneau, Tours, France; 2 Inserm U930, University François Rabelais, Tours, France; 3 Neurology, CHRU Bretonneau, Tours, France
24
Objectives: SPET with IBZM, specific D2 receptors radioligand, discriminate Parkinson’s disease (PD) and Parkinson-plus syndromes (PPS) with high specificity but low sensitivity. Low spatial resolution of SPET camera is responsible of lower quantification because of PVE on caudate (C) and putamen (P). We studied diagnostic value of IBZM SPET with two methods of quantification without and with PVEc in prospective study of 100 patients with parkinsonian syndrome (PS).
Methods: 100 patients with initial isolated PS had SPET one hour post-injection of 185 MBq 123I-IBZM. UKPDSBRC criteria classified patients in probable PD, possible PD and possible PPS. Prospective follow up of patients was at least 2 years. Two specialised neurologists reviewed all data of patients. Patients were reclassified after two years in PD (n=66) and PPS (n=34). SPET images of patients were coregistered on MRI template and C, P and occipital lobes (O) were segmented by an anatomist. Quantification of BP was done at equilibrium with C-O/O, P-O/O and S–O/O ratios. PVEc was done according to Rousset methodology. ROC curves determine cut-off values for each ratio.
Results: IBZM SPET was statistically different between PD and PPS. In possible PD, sensitivity and specificity to disciminate PD from PPS of IBZM SPET were respectively without PVEc 86% and 89% whereas with PVEc 77% and 100%. In initial possible PPS, sensitivity and specificity were without PVEc 94% and 52% whereas with PVEc 82% and 52%.
Conclusions: PVEc allow better quantification of BP ratios. In possible PD PVEc increase specificity and improve treatment for patients.
| ||||||||||||||||||||||||||||||||||||||
