Abstract
Aim of the studyFunctional assessment of the nigrostriatal dopaminergic pathway (NSDP) is still largely dominated by SPECT imaging of presynaptic dopamine transporters. Because of greater performance characteristics and a potential medico-economic added value, 18F-DOPA PET may advantageously replace SPECT procedures. Clinical analysis of 18F-DOPA PET images is mainly based on visual assessment, a parameter which may be empirically affected by a low reproducibility. We assessed several reproducible semi-quantitative parameters applicable in clinical routine. Material and methodsSeventy-two patients (18 control subjects, 55.2±13.4years; 54 patients without confirmed Parkinson's disease (no-PD patients): 74.0±9.9years) were prospectively referred for a 18F-DOPA PET brain study. 18F-DOPA striatal uptake, which reflects the activity level of L-DOPA decarboxylase (DDC), was quantified using calculation methods of SUV in several striatal VOI. Background activity in occipital VOI (non specific uptake) was taken into consideration to assess specific uptake. ResultsDespite the absence of standard of truth regarding the medical status of no-PD patients, the most effective quantitative parameter to assess specific striatal dopaminergic activity was the putamen-to-occipital ratio. According to our data, activity level of DCC might decrease with age. ConclusionAn accurate and early in-vivo detection of NSDP alteration is a critical issue at the earliest stages of PD. Despite limits of this preliminary study, simple semi-quantitative parameters appear to be valuable tools to address problems of classification reproducibility in clinical practice.
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