唾液腺摄取 F-FP-CIT PET 作为帕金森病患者的新生物标志物。
Salivary Gland Uptake on F-FP-CIT PET as a New Biomarker in Patients With Parkinsonism.
机构信息
Department of Nuclear Medicine, Ewha Womans University College of Medicine, Seoul, Korea.
Department of Neurology, Ewha Womans University College of Medicine, Seoul, Korea.
出版信息
Korean J Radiol. 2023 Jul;24(7):690-697. doi: 10.3348/kjr.2023.0066.
OBJECTIVE
F-FP-CIT positron emission tomography (PET) is known for its high sensitivity and specificity for evaluating striatal dopamine transporter (DAT) binding. Recently, for the early diagnose of Parkinson's disease, many researchers focused on the diagnosis of synucleinopathy in organs involved in non-motor symptoms of Parkinson's disease. We investigated the feasibility of salivary gland uptake on F-FP-CIT PET as a new biomarker in patients with parkinsonism.
MATERIALS AND METHODS
A total of 219 participants with confirmed or presumed parkinsonism, including 54 clinically diagnosed idiopathic Parkinson's disease (IPD), 59 suspected and yet undiagnosed, and 106 with secondary parkinsonism, were enrolled. The standardized uptake value ratio (SUVR) of the salivary glands was measured on both early and delayed F-FP-CIT PET scans using the cerebellum as the reference region. Additionally, the delayed-to-early ratio (DE_ratio) of salivary gland was obtained. The results were compared between patients with different PET patterns.
RESULTS
The SUVR in early F-FP-CIT PET scan was significantly higher in patients with IPD pattern compared that in the non-dopaminergic degradation group (0.5 ± 0.19 vs. 0.6 ± 0.21, < 0.001). Compared with the non-dopaminergic degradation group, the DE_ratio was significantly lower in patients with IPD (5.05 ± 1.7 vs. 4.0 ± 1.31, < 0.001) or atypical parkinsonism patterns (5.05 ± 1.7 vs. 3.76 ± 0.96, < 0.05). The DE_ratio was moderately and positively correlated with striatal DAT availability in both the whole striatum ( = 0.37, < 0.001) and posterior putamen ( = 0.36, < 0.001).
CONCLUSION
Parkinsonism patients with an IPD pattern exhibited a significant increase in uptake on early F-FP-CIT PET and a decrease in the DE_ratio in the salivary gland. Our findings suggest that salivary gland uptake of dual-phase F-FP-CIT PET can provide diagnostic information on DAT availability in patients with Parkinson's disease.
目的
F-FP-CIT 正电子发射断层扫描（PET）以其对评估纹状体多巴胺转运体（DAT）结合的高灵敏度和特异性而闻名。最近，为了对帕金森病进行早期诊断，许多研究人员专注于诊断帕金森病非运动症状相关器官中的突触核蛋白病。我们研究了唾液腺摄取 F-FP-CIT PET 作为帕金森病患者新生物标志物的可行性。
材料和方法
共纳入 219 名确诊或疑似帕金森病患者，包括 54 名临床诊断为特发性帕金森病（IPD）患者、59 名疑似且尚未确诊患者和 106 名继发性帕金森病患者。使用小脑作为参考区域，测量唾液腺的早期和延迟 F-FP-CIT PET 扫描的标准化摄取值比（SUVR）。此外，还获得了唾液腺的延迟至早期比值（DE_ratio）。比较了不同 PET 模式患者之间的结果。
结果
IPD 模式患者的早期 F-FP-CIT PET 扫描 SUVR 明显高于非多巴胺降解组（0.5±0.19 比 0.6±0.21，<0.001）。与非多巴胺降解组相比，IPD 患者的 DE_ratio 明显较低（5.05±1.7 比 4.0±1.31，<0.001）或不典型帕金森病模式（5.05±1.7 比 3.76±0.96，<0.05）。DE_ratio 与整个纹状体（ = 0.37，<0.001）和后壳核（ = 0.36，<0.001）的纹状体 DAT 可用性呈中度正相关。
结论
具有 IPD 模式的帕金森病患者在早期 F-FP-CIT PET 上的摄取增加，唾液腺的 DE_ratio 降低。我们的研究结果表明，双时相 F-FP-CIT PET 唾液腺摄取可提供帕金森病患者 DAT 可用性的诊断信息。
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