帕金森病患者中（99m）Tc - TRODAT - 1单光子发射计算机断层扫描（SPECT）与（18）F - FDOPA正电子发射断层扫描（PET）的交叉研究

Crossover study of (99m)Tc-TRODAT-1 SPECT and (18)F-FDOPA PET in Parkinson's disease patients.

作者信息

Huang Wen-Sheng, Chiang Yung-Hsiao, Lin Jiann-Chyun, Chou Yuan-Hwa, Cheng Cheng-Yi, Liu Ren-Shyan

机构信息

Department of Nuclear Medicine, Tri-Service General Hospital, Taipei, Taiwan.

出版信息

J Nucl Med. 2003 Jul;44(7):999-1005.

PMID:12843212

Abstract

UNLABELLED

99mTc-TRODAT-1 ([2-[[2-[[[3-(4-chlorophenyl)-8-methyl-8-azabicyclo[3,2,1]oct-2-yl]methyl](2-mercaptoethyl)amino]ethyl]amino]ethanethiolato(3-)-N2,N2',S2,S2']oxo-[1R-(exo-exo)]) is a potential agent for dopamine transporter (DAT) SPECT, whereas 6-(18)F-fluoro-L-dopa ((18)F-FDOPA) PET has been used for the quantitative assessment of presynaptic nigrostriatal dopaminergic function. The current study investigated the relationship between the 2 imaging modalities in evaluating patients with Parkinson's disease (PD).

METHODS

Twenty patients in whom PD was diagnosed by generally accepted criteria were recruited. In addition to visual inspection, specific uptake ratios (SURs) of (99m)Tc-TRODAT-1 in the striatum and putamen were measured bilaterally. For PET, all patients received 100 mg of carbidopa 90 min before (18)F-FDOPA (300 MBq) injection. Images were acquired between 120 and 150 min after injection, using a whole-body PET scanner with settings identical to those for the SPECT studies. The SURs for PET were calculated similarly to those for SPECT. Individual SURs of the striatum or putamen from SPECT were correlated with the corresponding PET values using linear regression.

RESULTS

A consistent image pattern between SPECT and PET was achieved by visual inspection except for 3 cases. In 1 case (a patient with Hoehn and Yahr Scale I PD), the SPECT images were more compatible with the patient's clinical findings whereas PET showed nearly normal uptake. In the other 2 cases (both patients with Hoehn and Yahr Scale II PD), PET correlated better with the clinical findings. The caudate and putamen nuclei were more discernable on PET. An acceptable correlation of SUR, however, was found between SPECT and PET in both the striatum and the putamen (P < 0.01 for both).

CONCLUSION

The comparability of (99m)Tc-TRODAT-1 SPECT and (18)F-FDOPA PET suggests that (99m)Tc-TRODAT-1 SPECT may provide a reliable alternative to (18)F-FDOPA PET in the evaluation of clinical PD patients.

摘要

未标记

99mTc-TRODAT-1（[2-[[2-[[[3-(4-氯苯基)-8-甲基-8-氮杂双环[3,2,1]辛-2-基]甲基](2-巯基乙基)氨基]乙基]氨基]乙硫醇盐(3-)-N2,N2',S2,S2']氧代-[1R-(外向-外向)])是一种潜在的多巴胺转运体（DAT）单光子发射计算机断层扫描（SPECT）显像剂，而6-(18)F-氟-L-多巴（(18)F-FDOPA）正电子发射断层扫描（PET）已用于突触前黑质纹状体多巴胺能功能的定量评估。本研究调查了这两种成像方式在评估帕金森病（PD）患者中的关系。

方法

招募20例根据公认标准诊断为PD的患者。除了视觉检查外，双侧测量纹状体和壳核中99mTc-TRODAT-1的特异性摄取率（SURs）。对于PET，所有患者在注射(18)F-FDOPA（300MBq）前90分钟接受100mg卡比多巴。在注射后120至150分钟之间采集图像，使用与SPECT研究设置相同的全身PET扫描仪。PET的SURs计算方法与SPECT类似。使用线性回归将SPECT中纹状体或壳核的个体SURs与相应的PET值进行关联。

结果

除3例患者外，通过视觉检查实现了SPECT和PET之间一致的图像模式。在1例患者（Hoehn和Yahr量表I级PD患者）中，SPECT图像与患者的临床发现更相符，而PET显示摄取几乎正常。在另外2例患者（均为Hoehn和Yahr量表II级PD患者）中，PET与临床发现的相关性更好。尾状核和壳核在PET上更清晰可辨。然而，在纹状体和壳核中均发现SPECT和PET的SUR之间具有可接受的相关性（两者P均<0.01）。