Entacapone improves the diagnostic efficiency of 18F-DOPA PET/CT in patients with Parkinson′s disease

Abstract

Objective To investigate the application and value of entacapone in 6-18F-fluoro-L-dopa (18F-DOPA) PET/CT imaging on Parkinson′s disease (PD). Methods From July 2016 to September 2017, 44 PD patients (24 males, 20 females, age: (51.3±11.0) years) and 14 healthy volunteers (7 males, 7 females, age: (57.6±14.4) years) who underwent 18F-DOPA PET/CT imaging were enrolled. They were divided into 4 groups: PD1 group with entacapone treatment (n=24); PD2 group without entacapone treatment (n=20); healthy control group with entacapone treatment (HC1, n=6); healthy control group without entacapone treatment (HC2, n=8). The striatal-to-occipital ratio (SOR) was calculated. Two-sample t test and receiver operating characteristic (ROC) curve analysis were used to analyze the data. Results The striatum was more clear and the uptake of cerebral cortex decreased significantly in PD1 and HC1 groups. The SOR of contralateral anterior putamen, posterior putamen and caudate nucleus in PD1 group were 15%, 14% and 15% higher (t values: 2.92, 3.11, 2.49, all P<0.05) than those in PD2 group, and SOR of ipsilateral anterior putamen, posterior putamen and caudate nucleus in PD1 were 17%, 21% and 17% higher (t values: 2.90, 3.56, 3.00, all P<0.05). SOR of left anterior putamen, posterior putamen and caudate nucleus in HC1 group were improved 29%, 35% and 27% (t values: 3.64, 3.48, 4.48, all P<0.05) compared to those in HC2 group, and SOR of right anterior putamen, posterior putamen and caudate nucleus in HC1 group were improved 29%, 28% and 29% (t values: 2.92, 2.73, 3.61, all P<0.05). The area under curve (AUC) for SOR of the left anterior and posterior putamen and the right posterior putamen in subjects with entacapone treatment were 0.999, 0.999 and 0.972, which were far greater than 0.865, 0.889 and 0.848 (z values: 3.24, 3.03, 2.77, all P<0.01) in those without entacapone treatment. The AUC for SOR of the right anterior putamen, the left caudate nucleus and the right caudate nucleus subjects with entacapone treatment were 0.927, 0.941 and 0.906, respectively, which were also significantly greater than 0.754, 0.766 and 0.696 (z values: 2.01, 2.36, 2.17, all P<0.05) in subjects without entacapone treatment. Conclusion Entacapone can increase the uptake of 18F-DOPA in the striatum of patients with PD, and it can improve the efficiency of 18F-DOPA to distinguish patients with PD from normal people. Key words: Parkinson disease; Positron-emission tomography; Tomography, X-ray computed; Levodopa; Fluorine radioisotopes; Catechols