Puñal-Riobóo J, Serena-Puig A, Varela-Lema L, Alvarez-Páez A M, Ruano-Ravina A
Agencia de Evaluación de Tecnologías Sanitarias de Galicia (avalia-t), Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, La Coruña, España.
Rev Esp Med Nucl. 2009 May-Jun;28(3):106-13.
(18)F-fluorodopa ((18)F-DOPA) is a functional tracer of presynaptic dopaminergic neuron terminations in the nigrostriatal system. This review is aimed to assess the efficacy of (18)F-DOPA-PET in the diagnosis and evaluation of the progression of Parkinson's Disease (PD) and in the differential diagnosis with other Parkinsonism Syndromes.
A review was made of the literature by searching six databases and selecting the most relevant articles according to strict inclusion and exclusion criteria. The study data were systematically extracted and included in evidence tables.
Of the 1478 registries recovered through the search of the literature, 48 studies were extracted. Of these, only 13 were included in the systematic review. It was observed in all of them that PD is manifested by a lower striatal uptake of (18)F-DOPA, especially in the putamen with posterior predominance. Prospective studies have shown that there is loss of uptake with disease progression. One article described regional differences in (18)F-DOPA striatal pattern between PD, multisystem atrophy (MSA) and progressive supranuclear palsy (PSP). Cognitive impairment in PD seems to be related with (18)F-DOPA abnormal uptake in some regions of frontal cortex and caudate nucleus.
(18)F-DOPA-PET seems to be useful for the diagnosis and evaluation of PD progression. However, the evidence is not conclusive regarding its utility in the differential diagnosis with other Parkinsonism Syndromes and in the differentiation between ex novo and advanced PD.
（18）F - 氟多巴（（18）F - DOPA）是黑质纹状体系统中突触前多巴胺能神经元终末的功能性示踪剂。本综述旨在评估（18）F - DOPA - PET在帕金森病（PD）诊断、病情进展评估以及与其他帕金森综合征鉴别诊断中的疗效。
通过检索六个数据库对文献进行综述，并根据严格的纳入和排除标准选择最相关的文章。对研究数据进行系统提取并纳入证据表。
通过文献检索共获得1478个记录，提取出48项研究。其中，仅13项被纳入系统评价。在所有这些研究中均观察到，PD表现为纹状体对（18）F - DOPA的摄取降低，尤其是壳核后部更为明显。前瞻性研究表明，随着疾病进展摄取会减少。一篇文章描述了PD、多系统萎缩（MSA）和进行性核上性麻痹（PSP）之间（18）F - DOPA纹状体模式的区域差异。PD中的认知障碍似乎与额叶皮质和尾状核某些区域的（18）F - DOPA异常摄取有关。
（18）F - DOPA - PET似乎对PD的诊断和病情进展评估有用。然而，关于其在与其他帕金森综合征鉴别诊断以及新发PD和晚期PD鉴别方面的效用，证据并不确凿。
