The majority of the studies did not report intra- and inter-observer variation. The Index test was generally well described and there were no major concerns for introducing bias. cMRI of the 3 cases (T 2 , coronal plane, including hippocampal area). The impact of DaTscan on the diagnosis and management of movement disorders: A retrospective study. Google Scholar. -, Ballard C, Grace J, McKeith I, Holmes C. Neuroleptic sensitivity in dementia with Lewy bodies and Alzheimer's disease. performed the literature search. [Spanish]. DaTscan is a test that can help in the diagnosis of PD, although in most situations a clinical exam done by a neurologist offers the same information. Clinical impact of 123I-ioflupane SPECT (DaTscan) in a Movement Disorder Center. Despite these results, clinicians often rely on clinical judgement and follow-up alone to establish a diagnosis. As a neurologist, over the years I’ve heard comments like: I understand how some patients and care partners can feel this way so I want to address this concern and discuss the role and limitations of a test that is available, known as DaTscan. Imaging 29, 1623–1629 (2002). Antonini, A. et al. Disord. This finding could be due to the different treatment management options for different subgroups. This drug was approved by the FDA in 2011. It may help distinguish the diagnosis of essential tremor from Parkinson's syndromes, like Parkinson's disease or Parkinson's disease dementia. Unauthorized use of these marks is strictly prohibited. Northwestern University Feinberg School of Medicine, Chicago, IL, USA, Departments of Medical Imaging Medicine, and Biomedical Engineering, University of Arizona, Tucson, AZ, USA, King’s Technology Evaluation Centre, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK, Anastasia Chalkidou, Mariusz T. Grzeda & Thomas Macmillan, GE Healthcare, Pollards Wood, Nightingales Ln, Chalfont Saint Giles, UK, Department of Neuroscience, University of Padua, Padua, Italy, You can also search for this author in SPECT imaging with DaTscanTM (Ioflupane 123-I SPECT), can provide evidence of pre-synaptic dopaminergic deficits in vivo4. Unable to load your collection due to an error, Unable to load your delegates due to an error. The American Parkinson Disease Association (APDA) is the largest grassroots network dedicated to fighting Parkinson’s disease (PD) and works tirelessly to help the approximately one million with PD in the United States live life to the fullest in the face of this chronic, neurological disorder. Carter LP, Henningfield JE, Wang YG, Lu Y, Kelsh D, Vince B, Sellers E. J Psychopharmacol. Case studies and small case series (<10 patients). In conclusion, our systematic review and meta-analysis showed that the results of imaging with DaTscan were associated with a change in management in approximately half the patients tested and altered the diagnosis in one third even in patients with longer symptom duration. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). apda@apdaparkinson.org. Article Any medical information provided is solely for the purpose of providing information and is not intended as medical advice. 2023 Jun;50(7):1974-1987. doi: 10.1007/s00259-023-06171-x. 2004 Jun;61(6):919-25. doi: 10.1001/archneur.61.6.919. You will likely be asked to lie quietly on your back for about 20 minutes during the SPECT scan. Our systematic review and meta-analysis show that imaging with DaTscan was associated with a change . Nuclear medicine procedures capture images of radiation that comes from inside your body. Would you like email updates of new search results? Federal government websites often end in .gov or .mil. Usually it is quite straightforward for a neurologist to distinguish between the tremors of ET and the tremors of PD. Nucl. Get the most important science stories of the day, free in your inbox. and JavaScript. The RCT by Kupsch et al.7 showed significantly more changes in management and diagnosis in the group undergoing DaT SPECT compared to the clinical assessment control group, however, quality of life was not significantly different. Change in management was reported by 13 studies6,7,9,10,11,12,18,20,21,23,24,25 including 950 patients. In addition, study design varied between studies contributing to a high degree of heterogeneity for the pooled effect. The DaTscan injection and accompanying SPECT scan will usually take place in the nuclear medicine, or radiology, department of a hospital or in an outpatient clinic. The effect of symptom duration on cognitive and motor perfomname in parkinsonism. PMC Unauthorized use of these marks is strictly prohibited. J. 27, 933–937 (2006). A positive response to the therapy is a sign of the proper diagnosis. This is to show how a body system is functioning. Pathological confirmation was also included in the revised consensus criteria for the diagnosis of DLB. The purpose of this systematic review and meta-analysis is to examine the available evidence on the clinical utility of DaTscan image results in changing diagnoses and subsequent management of patients. Results of any medical test that is performed, must therefore be considered within the entire clinical context. See this image and copyright information in PMC. %PDF-1.6
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A DaTscan is an imaging drug, also called Ioflupane I 123 or phenyltropane, that acts as a radioactive tracer for dopamine transporters within the brain. PubMed Google Scholar. All the analyses were performed in the R programme (v 3.6.1) using ‘metafor’ and ‘meta’. However, these neurological exam findings can sometimes be unclear. Mirpour, S., Turkbey, E. B., Marashdeh, W., El Khouli, R. & Subramaniam, R. M. Impact of DAT-SPECT on management of patients suspected of Parkinsonism. Commun. Assoc. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Change in diagnosis was reported by 13 studies6,7,8,9,10,13,16,17,20,21,22,23,24 including 779 patients. The patient then undergoes a SPECT scan which will produce an image of the dopaminergic neuron terminals that remain available in the striatum. the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in DaTscan is a radioactive drug that is injected into your bloodstream to highlight areas of your brain so that images can be taken with a special camera (called a single-photon emission computed tomography [SPECT] camera). and A.A. contributed to the risk of bias assessment. Bairactaris, C. et al. Several hours after the tracer has been injected, special imaging equipment scans the head to detect the presence of DaTscan. Other atypical parkinsonian conditions, such as vascular parkinsonism however, can have abnormalities on MRI, so the test may be done to rule out other diagnoses. L�j� �!&`n�$P��zP'�֮�lh Neurology 29, 951–951 (1979). Med. Lokkegaard, A., Werdelin, L. M. & Friberg, L. Clinical impact of diagnostic SPET investigations with a dopamine re-uptake ligand. The searches retrieved 3916 unique records and 20 studies were included in quantitative synthesis6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25. Matthews, C. G. & Haaland, K. Y. Expand section Collapse section Studies including patients with higher mean age and higher female to male ratio resulted in a larger change in diagnosis. Disord. He serves as a consultant for Boehringer–Ingelheim for legal cases on pathological gambling. Please enable it to take advantage of the complete set of features! J Neurol Neurosurg Psychiatry. Administration of a thyroid blocking agent is recommended before the use of DaTscan in a pregnant woman. GE Healthcare. When will I get my results? The tracer attaches itself to a molecule found on dopamine neurons in the striatum called the dopamine transporter (or DAT). Bhattacharjee, S., Paramanandam, V. & Bhattacharya, A. The authors of the IDEAS study, meanwhile, identified a 30% threshold as being consistent with previous studies of coverage, with evidence examining the association between diagnostic imaging and changes in management27. In the Flow and Timing domain, with the exception of 4 studies, the rest of the studies lacked clarity in the time interval between clinical diagnosis and DaTscan. Accurate differentiation of parkinsonism and essential tremor using visual assessment of [123I]-FP-CIT SPECT imaging: the [123I]-FP-CIT study group. Accessibility 2015 Oct;11(10):1153-62. doi: 10.1016/j.jalz.2014.10.011. 4. Watch webinars, download our latest publications, and read articles — all filterable by the topic you would like to learn more about. Anastasia Chalkidou. J. Neurol. and transmitted securely. The time since onset of symptoms to DaTscan imaging was reported in 11 studies: the means ranged from 2.4 to 6.7 years (median 3.8 years). Studies that combined DaT SPECT with other imaging tests to establish the diagnosis. Shimizu S, Hirao K, Kanetaka H, Namioka N, Hatanaka H, Hirose D, Fukasawa R, Umahara T, Sakurai H, Hanyu H. Eur J Nucl Med Mol Imaging. knowledge of other test results)), and baseline characteristics of studied patients were extracted (disease duration, age at imaging, criteria used for diagnosing PD). and A.C. screened the articles for eligibility and tabulated relevant information. Front. GE is a trademark of General Electric Company. Imaging of dopam … I want a test to prove whether I do or do not have Parkinson’s disease!”, small handwriting, that decreases in size as the writing continues. Regardless of time from symptom onset to scan results, these changes were consistent and suggest that earlier execution of DaTscan may shorten time to diagnosis in uncertain cases. Used under trademark license. The use of DaTscan imaging resulted in a change in management in 54% (95% CI: 47-61%) of patients. To obtain Founded in 1961, APDA has raised and invested more than $226 million to provide outstanding patient services and educational programs, elevate public awareness about the disease, and support research designed to unlock the mysteries of PD and ultimately put an end to this disease. Some of the variables considered important for clinical utility, such as diagnostic uncertainty, were inconsistently reported in the primary studies, limiting a comprehensive evaluation of their impact on heterogeneity. This scanning technique gathers images of a particular area in the brain called the striatum, a cluster of neurons (nerve cells) in the subcortical basal ganglia of the forebrain. 24, 392–403 (2005). 258, 2147–2154 (2011). Bethesda, MD 20894, Web Policies The results of the meta-analyses presented here must be interpreted with caution due to the significant heterogeneity in the investigated population. sharing sensitive information, make sure you’re on a federal A replication study, systematic review and meta-analysis of automated image-based diagnosis in parkinsonism, Differential diagnosis of parkinsonism: a head-to-head comparison of FDG PET and MIBG scintigraphy, Safinamide in the treatment pathway of Parkinson’s Disease: a European Delphi Consensus, A nationwide study of the incidence, prevalence and mortality of Parkinson’s disease in the Norwegian population, A systematic review of brain morphometry related to deep brain stimulation outcome in Parkinson’s disease, Clinical factors and dopamine transporter availability for the prediction of outcomes after globus pallidus deep brain stimulation in Parkinson’s disease, Factors associated with mortality in early stages of parkinsonism, A meta-analysis of the diagnostic utility of biomarkers in cerebrospinal fluid in Parkinson’s disease, Change in the incidence of Parkinson’s disease in a large UK primary care database, https://doi.org/10.1016/j.parkreldis.2012.03.017, https://doi.org/10.1002/9780470743386.ch13, http://creativecommons.org/licenses/by/4.0/, Stereotactical normalization with multiple templates representative of normal and Parkinson-typical reduction of striatal uptake improves the discriminative power of automatic semi-quantitative analysis in dopamine transporter SPECT, A systematic review of the potential effects of medications and drugs of abuse on dopamine transporter imaging using [123I]I-FP-CIT SPECT in routine practice, Dopamine transporter single photon emission computed tomography (DaT-SPECT) use in the diagnosis and clinical management of parkinsonism: an 8-year retrospective study, Multiple-pinhole collimators improve intra- and between-rater agreement and the certainty of the visual interpretation in dopamine transporter SPECT, Mining imaging and clinical data with machine learning approaches for the diagnosis and early detection of Parkinson’s disease. .ge-cdx-header-redesign__authentication-menu-container__register-btn :hover {color: #410588;border: 1px solid #410588;} volume 7, Article number: 43 (2021) Google Scholar. A DaTscan may be helpful in complex cases. All radiopharmaceuticals have potential to cause fetal harm. The two pooled analyses were characterised by high levels of heterogeneity. However, DaTscan has the potential to direct both you and your healthcare provider in the right direction, optimizing the selection of treatment options. • The risks of overdose relate predominantly to increased radiation exposure, with the long-term risks for neoplasia. Careers. Please enable it to take advantage of the complete set of features! By Brandon Peters, MD PD tremors occur at rest and are accompanied by slowness and stiffness of the limb, whereas ET tremors occur with action and are not accompanied by slowness and stiffness of the limb. O'Brien JT, Colloby S, Fenwick J, Williams ED, Firbank M, Burn D, Aarsland D, McKeith IG. ���(�$"
INTRODUCTION OF THE CLINICAL DILEMMA. führen zu falsch-negativen oder falsch-positiven Befunden und sind daher abzusetzen. Hum Psychopharmacol. Both false positive DAT scan results (1.4%) and false negative (4.8%) are uncommon. ISSN 2373-8057 (online). Espanola de. Longitudinal follow-up of SWEDD subjects in the PRECEPT Study. J. Neural Transm. performed the statistical analyses. Yomtoob, J., Koloms, K. & Bega, D. DAT-SPECT imaging in cases of drug-induced parkinsonism in a specialty movement disorders practice. The combination of an elderly population with potentially cognitive impairment and no benefit from levodopa reduce treatment options in these patients and therefore, determine an overall low rate of change in management. 15, 503–510 (2000). The .gov means it’s official. Elderly patients frequently suffer from concomitant cognitive deficits and the presence of cerebrovascular brain pathology potentially limits the benefit from levodopa treatment regardless of the imaging results. A DaTscan is a nuclear medicine imaging procedure. Imaging of dopamine transporter with FP-CIT SPECT is one possibility to increase sensitivity. 48, 1901–1908 (2007). Typically, medications used as dopaminergic therapies can continue to be used. DaTscan will appear abnormal in any disease in which there is a loss of dopamine nerve endings in the striatum. Although DaTscan cannot distinguish PSP, CBGD, and MSA from PD, studies suggest that it may be able to distinguish drug-induced parkinsonism and vascular parkinsonism from PD. Marshall, V. L., Patterson, J., Hadley, D. M., Grosset, K. A. It is important to note, that a person who displays some of these features on exam may be unaware of them, while a trained neurologist can easily identify them. Parkinsonism Relat. Clinical routine use of dopamine transporter imaging in 516 consecutive patients. Keep in mind that like in any medical test, DaTscans can result in false positives and false negatives. The SPECT machine is large and circular and will capture the scans of your brain from above you while rotating around your head. It may seem like a brief exam, but all of the above can be assessed quickly. The use of DaTscan imaging resulted in a change in management in 54% (95% CI: 47–61%) of patients. Die Falsch-Positiv-Rate wird von der Spezifität eines Testes bestimmt und hängt direkt mit der Mess- größe des positiven prädiktiven Wertes (PPV) zusammen, wie Prof. Alexander Katalinic, Direktor des Instituts für Sozialmedizin und Epidemiologie der Universität Lübeck, rekapitulierte. Seifert KD, Wiener JI. Studies’ authors were contacted, where necessary, to confirm or clarify key study details. It turns out that the clinical features of PD are unique to PD and often very easy to see via a neurologic exam in a doctor’s office. This site needs JavaScript to work properly. An x-ray produces images using radiation outside your body to create images of dense interior structures. Dopamine transporter SPECT imaging (DaTscan) with 123-Iodine Ioflupane, a cocaine derivative, is used to differentiate nonneurodegenerative parkinsonism from neurodegenerative parkinsonism through radiotracer binding to the presynaptic dopamine transporter (DAT) in the striatum. Days prior to this testing, your healthcare provider may ask you to stop taking certain medications that might interfere with the DaTscan results. PubMed Essential tremor (ET), drug-induced Parkinsonism (DIP) and other forms of non-DDA may present clinical features—bradykinesia, atypical tremor, rigidity, postural instability/gait impairment-resembling PS or PD without evidence of dopaminergic deficit3. Epub 2023 Feb 27. Bega, D., Gonzalez-Latapi, P., Zadikoff, C., Spies, W. & Simuni, T. Is there a role for DAT-SPECT imaging in a specialty movement disorders practice? DaTscans do not yield any quantitative findings and SPECT scans can only be assessed by eye. 8, https://doi.org/10.3389/fneur.2017.00481 (2017). Change in management can impact patients’ outcomes in a number of ways including affecting their quality of life by avoiding unnecessary medications and their side-effects and by providing people with clearer expectations related to prognosis. California Transparency in Supply Chain Act, https://www.linkedin.com/company/gehealthcare/, https://www.youtube.com/user/gehealthcare, • DaTscan is contraindicated in patients with known serious hypersensitivity to ioflupane I 123. Can I bring someone with me? The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). ��:��9�./&̐�|L� �r%� �U-Q�\���BT-����! The DaTscan is typically an outpatient procedure, so you will likely be free to go home afterward. Marek, K. et al. Our systematic review and meta-analysis show that imaging with DaTscan was associated with a change in management in approximately half the patients tested and the diagnosis was modified in one third.