EANM practice guideline/SNMMI procedure standard for dopaminergic imaging in Parkinsonian syndromes 1.0

Silvia Morbelli,Iván Peñuelas,Giuseppe Esposito,David Douglas,Henryk Barthel,David J Brooks ,John Dickson ,Alexander Drzezga,Ronald Boellaard,Adriaan A Lammertsma ,Peter Herscovitch,Jacques Darcourt,Livia Tossici-Bolt,Michele Wanner,Özgül Ekmekçioğlu ,John Seibyl,Jacob Dubroff,Franck Semah,Koen Van Laere,Andrea Varrone,Sabina Pappatà ,George Zubal,Javier Arbizu,Valentina Garibotto,Nicolaas I Bohnen ,Elsmarieke Van De Giessen,Phillip H Kuo ,Ian Law

doi:10.1007/s00259-020-04817-8

Abstract

PurposeThis joint practice guideline or procedure standard was developed collaboratively by the European Association of Nuclear Medicine (EANM) and the Society of Nuclear Medicine and Molecular Imaging (SNMMI). The goal of this guideline is to assist nuclear medicine practitioners in recommending, performing, interpreting, and reporting the results of dopaminergic imaging in parkinsonian syndromes.MethodsCurrently nuclear medicine investigations can assess both presynaptic and postsynaptic function of dopaminergic synapses. To date both EANM and SNMMI have published procedural guidelines for dopamine transporter imaging with single photon emission computed tomography (SPECT) (in 2009 and 2011, respectively). An EANM guideline for D2 SPECT imaging is also available (2009). Since the publication of these previous guidelines, new lines of evidence have been made available on semiquantification, harmonization, comparison with normal datasets, and longitudinal analyses of dopamine transporter imaging with SPECT. Similarly, details on acquisition protocols and simplified quantification methods are now available for dopamine transporter imaging with PET, including recently developed fluorinated tracers. Finally, [18F]fluorodopa PET is now used in some centers for the differential diagnosis of parkinsonism, although procedural guidelines aiming to define standard procedures for [18F]fluorodopa imaging in this setting are still lacking.ConclusionAll these emerging issues are addressed in the present procedural guidelines for dopaminergic imaging in parkinsonian syndromes.

Highlights

Parkinsonian syndromes are a group of diseases characterized by signs of parkinsonism, such as bradykinesia, rigidity, tremor, and postural instability
Parkinsonism can be present in all alpha synucleinopathies, which include Lewy body diseases (LBDs), a subset of disorders associated with the accumulation of Lewy bodies (LB) and neurites, i.e., intracytoplasmic inclusions composed of aggregated alpha-synuclein and other proteins such as ubiquitin [1]
The tauopathies corticobasal degeneration (CBD) and progressive supranuclear palsy (PSP) are movement disorders belonging to the spectrum of frontotemporal degeneration [3, 4]

Summary

Introduction

Parkinsonian syndromes are a group of diseases characterized by signs of parkinsonism, such as bradykinesia, rigidity, tremor, and postural instability. Parkinsonism can be present in all alpha synucleinopathies, which include Lewy body diseases (LBDs), a subset of disorders associated with the accumulation of Lewy bodies (LB) and neurites, i.e., intracytoplasmic inclusions composed of aggregated alpha-synuclein and other proteins such as ubiquitin [1]. Alpha synucleinopathies include multiple system atrophy (MSA), an atypical parkinsonism characterized by the presence of glial and neural silver staining aggregates of alphasynuclein [2]. Resting tremor and cogwheel rigidity or other isolated parkinsonian characteristics can be present in a subgroup of patients with ET, making the clinical diagnosis more challenging [5]

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