Abstract
Purpose: The density of the neuronal dopamine transporter (DAT) is directly correlated with the presynaptic dopaminergic system injury. In a first study, we evaluated the brain distribution and kinetics of [18F]LBT-999, a DAT PET radioligand, in a group of eight healthy subjects. Taking into account the results obtained in healthy volunteers, we wanted to evaluate whether the loss of presynaptic striatal dopaminergic fibers could be estimated, under routine clinical conditions, using [18F]LBT-999 and a short PET acquisition.Materials and methods: Six patients with Parkinson's disease (PD) were compared with eight controls. Eighty-nine minutes of dynamic PET following an intravenous injection of [18F]LBT-999 were acquired. Using regions of interest for striatal nuclei, substantia nigra (SN), cerebellum, and occipital cortex, defined over each T1 3D MRI, time–activity curves (TACs) were obtained. From TACs, binding potential (BPND) using the simplified reference tissue model and distribution volume ratios (DVRs) using Logan graphical analysis were calculated. Ratios obtained for a 10-min image, acquired between 30 and 40 min post-injection, were also calculated. Cerebellum activity was used as non-specific reference region.Results: In PD patients and as expected, striatal uptake was lower than in controls which is confirmed by BPND, DVR, and ratios calculated for both striatal nuclei and SN, significantly inferior in PD patients compared with controls (p < 0.001).Conclusions: PET with [18F]LBT-999 could be an alternative to assess dopaminergic presynaptic injury in a clinical environment using a single 10 min acquisition.
Highlights
The core symptoms of parkinsonian syndrome may not always be present in a single patient [1]
It has been known for many years that the dopaminergic neurotransmitter system plays a major role in movement disorders, and in Parkinson’s disease (PD), as well as in dementia with Lewy body (DLB) [3,4,5,6,7]
We present mean time–activity curves (TACs) corresponding to caudate nucleus, putamen, and substantia nigra (SN)
Summary
The core symptoms of parkinsonian syndrome (akinetic rigid syndrome, tremor syndrome, etc.) may not always be present in a single patient [1]. The accuracy of clinical diagnosis of PD varies [18F]LBT-999 and DAT in Parkinson’s Disease between 74% (diagnostic performed by non-experts) and 84% (diagnosis performed by movement disorders experts), and it has not significantly improved in the last 25 years [2] It has been known for many years that the dopaminergic neurotransmitter system plays a major role in movement disorders, and in PD, as well as in dementia with Lewy body (DLB) [3,4,5,6,7]. In our nuclear medicine department, as in many others, the evaluation of the pre-synaptic dopaminergic neuron’s degeneration is explored in clinical routine with a SPECT DAT ligand, the FP-CIT labeled with iodine-123 [15, 16]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
