非专家核医学医师视觉评估的可靠性以及神经科医生对初治早期帕金森病患者进行[I]FP-CIT SPECT成像的适应症适宜性。
Reliability of visual assessment by non-expert nuclear medicine physicians and appropriateness of indications of [I]FP-CIT SPECT imaging by neurologists in patients with early drug-naive Parkinson's disease.
作者信息
Suwijn Sven R, Verschuur Constant V M, Slim Marleen A, Booij Jan, de Bie Rob M A
机构信息
Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
Department of Neurology, Albert Schweitzer Hospital, PO BOX 444, 3300 AK, Dordrecht, The Netherlands.
出版信息
EJNMMI Res. 2019 Jul 24;9(1):63. doi: 10.1186/s13550-019-0537-2.
PURPOSE
To determine the reliability of visual assessment of [I]FP-CIT SPECT imaging by non-experts in dopamine transporter (DAT) SPECT imaging in patients with early drug-naive Parkinson's disease (PD). Also, we explored the indications of DAT SPECT imaging in clinical practice by neurologists.
METHODS
We collected [I]FP-CIT SPECT scans of the Levodopa in EArly Parkinson's disease (LEAP) trial participants that were made prior to recruitment, as part of routine clinical work-up. All scans were reassessed by an expert in DAT imaging. A survey on the use of DAT SPECT imaging was sent to all referring neurologists.
RESULTS
The concordance of the initial local assessment and the expert reassessment was 98.7%. The survey showed that neurologists requested DAT SPECT imaging in only 73.6% of patients to differentiate between a neurodegenerative disease and non-neurodegenerative parkinsonism.
CONCLUSIONS
Visual assessment of [I]FP-CIT SPECT imaging by community nuclear medicine physicians in patients with early PD is reliable. Neurologists who request DAT SPECT scans are not always aware that the high accuracy is limited only to the differentiation between neurodegenerative and non-neurodegenerative parkinsonism. A significant portion of neurologists who request DAT SPECT scans is not always aware that the high accuracy is limited to the differentiation between neurodegenerative and non-neurodegenerative parkinsonism as DAT SPECT cannot reliably distinguish the various Parkinsonian syndromes.
目的
确定在早期未接受过药物治疗的帕金森病（PD）患者中，非多巴胺转运体（DAT）单光子发射计算机断层扫描（SPECT）成像专家对[I]FP-CIT SPECT成像进行视觉评估的可靠性。此外，我们还探讨了神经科医生在临床实践中使用DAT SPECT成像的指征。
方法
我们收集了左旋多巴治疗早期帕金森病（LEAP）试验参与者在入组前作为常规临床检查一部分所进行的[I]FP-CIT SPECT扫描。所有扫描均由DAT成像专家重新评估。我们向所有转诊的神经科医生发送了一份关于DAT SPECT成像使用情况的调查问卷。
结果
初始局部评估与专家重新评估的一致性为98.7%。调查显示，神经科医生仅在73.6%的患者中要求进行DAT SPECT成像，以区分神经退行性疾病和非神经退行性帕金森综合征。
结论
社区核医学医生对早期PD患者进行[I]FP-CIT SPECT成像的视觉评估是可靠的。要求进行DAT SPECT扫描的神经科医生并不总是意识到，其高准确性仅局限于区分神经退行性和非神经退行性帕金森综合征。相当一部分要求进行DAT SPECT扫描的神经科医生并不总是意识到，由于DAT SPECT无法可靠地区分各种帕金森综合征，其高准确性仅限于区分神经退行性和非神经退行性帕金森综合征。
Zotero 插件