Imaging of dopamine transporters in Parkinson disease: a meta-analysis of 18 F/123 I-FP-CIT studies.

Abstract

Objective 18F‐FP‐CIT and 123I‐FP‐CIT are widely used radiotracers in molecular imaging for Parkinson’s disease (PD) diagnosis. Compared with 123I‐FP‐CIT, 18F‐FP‐CIT has superior tracer kinetics. We aimed to conduct a meta‐analysis to assess the efficacy of using 18F‐FP‐CIT positron emission tomography (PET) and 123I‐FP‐CIT single‐photon emission computed tomography (SPECT) of dopamine transporters in patients with PD in order to provide evidence for clinical decision‐making.MethodsWe searched the PubMed, Embase, Wanfang Data, and China National Knowledge Infrastructure databases to identify the relevant studies from the time of inception of the databases to 30 April 2020. We identified six PET studies, including 779 patients with PD and 124 healthy controls, which met the inclusion criteria. Twenty‐seven SPECT studies with 1244 PD patients and 859 controls were also included in this meta‐analysis.ResultsOverall effect‐size analysis indicated that patients with PD showed significantly reduced 18F‐FP‐CIT uptake in three brain regions [caudate nucleus: standardized mean difference (SMD) = −1.71, Z = −3.31, P = 0.0009; anterior putamen: SMD = −3.71, Z = −6.26, P < 0.0001; and posterior putamen: SMD = −5.49, Z = −5.97, P < 0.0001]. Significant decreases of 123I‐FP‐CIT uptake were also observed in the caudate (SMD = −2.31, Z = −11.49, P < 0.0001) and putamen (SMD = −3.25, Z = −14.79, P < 0.0001).InterpretationIn conclusion, our findings indicate that both 18F‐FP‐CIT PET and 123I‐FP‐CIT SPECT imaging of dopamine transporters can provide viable biomarkers for early PD diagnosis.