Werner Rudolf A, Lapa Constantin, Sheikhbahaei Sara, Marcus Charles, Solnes Lilja B, Du Yong, Leal Jeffrey P, Buck Andreas K, Higuchi Takahiro, Rowe Steven P, Javadi Mehrbod S
Division of Nuclear Medicine and Molecular Imaging, The Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Nuclear Medicine, Hannover Medical School, Hannover.
Nucl Med Commun. 2019 Oct;40(10):1001-1004. doi: 10.1097/MNM.0000000000001061.
Studies investigating the age-related impact on dopamine transporter binding have previously omitted the use of attenuation correction by computed tomography (CT). We aimed to explore the impact of age and gender on dopamine transporter binding on [I]Ioflupane single photon emission CT (SPECT) imaging with simultaneously acquired CT.
Three hundred forty-two patients with clinically uncertain parkinsonian syndrome underwent [I]-Ioflupane SPECT/CT with CT-based attenuation correction. Two nuclear medicine physicians independently performed a visual evaluation of all scans and only visibly normal scans were included for further analysis. Moreover, the results of a fully automatic semiquantitative evaluation method were recorded. Thereafter, the obtained [I]Ioflupane binding ratio and the hemispheric asymmetry index were correlated with age and sex.
Patient age range was 41-80 years with a balanced distribution over decades. Of 342 patients, 133 (38.9%, 66 females, median age, 64 years) were considered visually normal by both observers on the SPECT/CT images. A significant inverse correlation between age and [I]Ioflupane binding ratios in the striata (R = -0.38; P < 0.001), putamina (R = -0.39; P < 0.001) and caudate nuclei (R = -0.3; P < 0.001) was demonstrated. Linear regression of all included subjects demonstrated an average decrease of 0.19 per decade in the striatal binding ratio (6.6%). No significant sex differences were found in striatal binding ratios (P = 0.86). Moreover, no significant correlation was observed between age and striatal asymmetry index (r = 0.12; P = 0.16).
In the present largest single-center analysis investigating [I]Ioflupane SPECT/CT in patients with clinical uncertain parkinsonian syndrome, a dopamine transporter loss of 6.6% per decade in visually normal scans was recorded.
以往研究年龄对多巴胺转运体结合的影响时，未采用计算机断层扫描（CT）进行衰减校正。我们旨在探讨年龄和性别对[I]碘氟烷单光子发射计算机断层扫描（SPECT）成像中多巴胺转运体结合的影响，同时进行CT扫描。
342例临床帕金森综合征诊断不明确的患者接受了基于CT衰减校正的[I]碘氟烷SPECT/CT检查。两名核医学医师独立对所有扫描进行视觉评估，仅纳入视觉上正常的扫描进行进一步分析。此外，记录全自动半定量评估方法的结果。之后，将获得的[I]碘氟烷结合率和半球不对称指数与年龄和性别进行相关性分析。
患者年龄范围为41 - 80岁，各年龄段分布均衡。在342例患者中，两位观察者均认为133例（38.9%，66名女性，中位年龄64岁）的SPECT/CT图像视觉上正常。纹状体（R = -0.38；P < 0.001）、壳核（R = -0.39；P < 0.001）和尾状核（R = -0.3；P < 0.001）的年龄与[I]碘氟烷结合率之间存在显著负相关。对所有纳入受试者的线性回归分析显示，纹状体结合率每十年平均下降0.19（6.6%）。纹状体结合率未发现显著性别差异（P = 0.86）。此外，年龄与纹状体不对称指数之间未观察到显著相关性（r = 0.12；P = 0.16）。
在目前对临床帕金森综合征诊断不明确患者进行的[I]碘氟烷SPECT/CT的最大规模单中心分析中，视觉上正常的扫描显示多巴胺转运体每十年损失6.6%。
