Parkinson Disease: Maes A

Vander Borght T, Laloux P, Maes A, Salmon E, Goethals I, Goldman S, Anonymous00187. · Nuclear Medicine Division, Mont-Godinne Medical Center, Université Catholique de Louvain, B-5530 Yvoir, Belgium. · Acta Neurol Belg. · Pubmed #11851026 No free full text.

Abstract: The purpose of these guidelines is to assist nuclear medicine practitioners in recommending, performing, interpreting, and reporting the results of brain perfusion SPECT studies using Tc-99m radiopharmaceuticals and brain metabolism PET studies using F-18 fluorodeoxyglucose (FDG). These guidelines have been adapted and extended from those produced by the Society of Nuclear Medicine (Juni et al., 1998) and the European Association of Nuclear Medicine by a Belgian group of experts in the field trained in neurology and/or nuclear medicine. Some indications are not universally approved (e.g. brain death), but largely supported by the literature. They have been included in these guidelines in order to provide recommendations and a standardised protocol.

Maes A, Vanbilloen H, Cleynhens B, Mortelmans L, Bormans G, Verbruggen A. · No affiliation provided · Eur J Nucl Med Mol Imaging. · Pubmed #12618905 No free full text.

This publication has no abstract.

Van Laere K, Casteels C, De Ceuninck L, Vanbilloen B, Maes A, Mortelmans L, Vandenberghe W, Verbruggen A, Dom R. · Division of Nuclear Medicine, University Hospital Gasthuisberg and K.U. Leuven, Leuven, Belgium. · J Nucl Med. · Pubmed #16513606 links to  free full text

Abstract: Clinical differential diagnosis in parkinsonism can be difficult especially at early stages. We investigated whether combined perfusion and dopamine transporter (DAT) imaging can aid in the differential diagnosis of parkinsonian disorders: idiopathic Parkinson's disease (IPD), progressive supranuclear palsy (PSP), multiple system atrophy (MSA), dementia with Lewy bodies (LBD), and essential tremor (ET). METHODS: One hundred twenty-nine patients were studied, retrospectively (69 males; 24 MSA, 12 PSP, 8 LBD, 27 ET, and 58 IPD; mean disease duration, 3.5 +/- 3.7 y). Diagnosis was based on established clinical criteria after follow-up of 5.5 +/- 3.8 y in a university specialist movement disorders clinic. Group characterization was done using a categoric voxel-based design and, second, a predefined volume-of-interest approach along Brodmann areas (BA) and subcortical structures, including striatal asymmetry and anteroposterior indices. Stepwise forward discriminant analysis was performed with cross-validation (CV) using the leave-one-out technique. RESULTS: Characteristic patterns for perfusion and DAT were found for all pathologies. In the parkinson-plus group, MSA, PSP, and LBD could be discriminated in 100% (+CV) of the cases. When including IPD, discrimination accuracy was 82.4% (99% without CV). 2beta-Carbomethoxy-3beta-(4-iodophenyl)nortropane imaging as a single technique was able to discriminate between ET and neurodegenerative forms with an accuracy of 93.0% (+CV); inclusion of perfusion information augmented this slightly to 97.4% (+CV). CONCLUSION: Dual-tracer DAT and perfusion SPECT in combination with discrimination analysis allows an automated, accurate differentiation between the most common forms of parkinsonism in a clinically relevant setting.