Xiromerisiou Georgia, Boura Iro, Barmpounaki Eleni, Georgoulias Panagiotis, Dardiotis Efthimios, Spanaki Cleanthe, Valotassiou Varvara
School of Medicine, University of Thessaly, 41500 Larisa, Greece.
School of Medicine, University of Crete, 70013 Heraklion, Greece.
Biomedicines. 2025 Apr 16;13(4):970. doi: 10.3390/biomedicines13040970.
: The introduction of dopamine transporter scan (DaTscan) in clinical diagnostics has revolutionized the way clinicians approach movement disorders, offering valuable insights into presynaptic striatal dopaminergic deficits and revealing subjacent neurodegeneration. The aim of our study was to evaluate the impact of DaTscan on diagnostic decisions regarding movement disorders, particularly Parkinson's disease (PD) and atypical parkinsonian syndromes, under real-world circumstances in Greece. : We retrospectively analyzed data from 360 patients who underwent a DaTscan examination between 2018 and 2023 at a tertiary hospital in Greece, including referrals from both movement disorder specialists and general neurologists, either hospital-based or in private practice. Demographics, primary referral symptoms, and both pre-scan and post-scan diagnoses were collected and analyzed. : The mean age in our cohort was 60 ± 13.5 years, and tremor was the leading referral symptom (40.8%). The initial diagnosis changed in nearly half of the cases (48.3%) following DaTscan. Significant shifts included transitions from an "Unclear" or "Dystonia" diagnosis to "Parkinson's disease" in 78.1% and 72.7% of patients, respectively. However, the particularly high concordance rates between pre-scan and post-scan diagnosis for "Vascular parkinsonism" (100%), "Parkinson's disease" (89.3%), and "Essential/Dystonic Tremor" (86%) suggest that the test may have been over-utilized or ordered beyond its intended indications. : DaTscan markedly enhances diagnostic accuracy for movement disorders, particularly for general neurologists, addressing the complexities of overlapping clinical presentations. Continuous medical training is essential to ensure the cost-effective utilization of DaTscan in routine clinical practice; ongoing technological advancements will further refine and expand their applications, benefiting both patients and the broader medical community.
多巴胺转运体扫描(DaTscan)引入临床诊断领域,彻底改变了临床医生诊断运动障碍的方式,为突触前纹状体多巴胺能缺陷提供了有价值的见解,并揭示了潜在的神经退行性变。我们研究的目的是在希腊的实际情况下,评估DaTscan对运动障碍,特别是帕金森病(PD)和非典型帕金森综合征诊断决策的影响。
我们回顾性分析了2018年至2023年期间在希腊一家三级医院接受DaTscan检查的360例患者的数据,包括来自运动障碍专科医生和普通神经科医生的转诊患者,这些医生既有医院的,也有私人诊所的。收集并分析了人口统计学数据、主要转诊症状以及扫描前和扫描后的诊断结果。
我们队列的平均年龄为60±13.5岁,震颤是主要的转诊症状(40.8%)。在DaTscan检查后,近一半的病例(48.3%)初始诊断发生了变化。显著的转变包括分别有78.1%和72.7%的患者从“不明”或“肌张力障碍”诊断转变为“帕金森病”。然而,“血管性帕金森综合征”(100%)、“帕金森病”(89.3%)和“特发性/肌张力障碍性震颤”(86%)在扫描前和扫描后诊断之间特别高的一致性率表明,该检查可能被过度使用或超出其预期适应症进行了开具。
DaTscan显著提高了运动障碍的诊断准确性,特别是对普通神经科医生而言,解决了重叠临床表现的复杂性。持续的医学培训对于确保在常规临床实践中经济有效地使用DaTscan至关重要;不断的技术进步将进一步完善和扩展其应用,使患者和更广泛的医疗界都受益。