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Differential diagnosis of parkinsonian syndromes using F-18 fluorodeoxyglucose positron emission tomography.
MedLine Citation:
PMID:  23314836     Owner:  NLM     Status:  Publisher    
INTRODUCTION: Positron emission tomography (PET) imaging with F-18 fluorodeoxyglucose (FDG) has been used to identify characteristic patterns of regional glucose metabolism in patients with idiopathic Parkinson's disease (IPD) and the atypical parkinsonian syndromes of progressive supranuclear palsy (PSP), multiple system atrophy (MSA), and corticobasal syndrome (CBS). We undertook this study to assess the utility of fluorodeoxyglucose-PET in the differential diagnosis of individual patients with clinical parkinsonism. "Visual" and "computer-supported" reading of the fluorodeoxyglucose-PET scans were used for image interpretation and compared with each other. METHODS: One hundred thirty-six parkinsonian patients were referred from movement disorder clinics in specialty neurology centers for the fluorodeoxyglucose-PET study. Imaging-based diagnosis was obtained by visual assessment of individual scans by a PET physician blinded to the clinical diagnosis and also by computer-assisted interpretation using statistical parametric mapping (SPM) analysis. The results were compared with a 2-year follow-up clinical assessment made by a movement disorder specialist. RESULTS: Concordance of visual evaluation of fluorodeoxyglucose-PET with clinical diagnosis was achieved in 91.7 % of patients scanned, 97.6 % IPD, 80 % MSA, 76.6 % PSP, and 100 % CBS. Blinded computer assessment using SPM was concordant with the clinical diagnosis in 91 % of cases evaluated (90.4 % IPD, 80 % MSA, 93.3 % PSP, and 100 % CBS). CONCLUSIONS: Fluorodeoxyglucose-PET performed at the time of initial referral for parkinsonism is useful for the differential diagnosis of IPD, PSP, MSA, and CBS. Computer-assisted methods can be used for objective evaluation especially when expert readers are not available.
Madhavi Tripathi; Vijay Dhawan; Shichun Peng; Suman Kushwaha; Amit Batla; Abhinav Jaimini; Maria M D'Souza; Rajnish Sharma; Sanjiv Saw; Anupam Mondal
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-13
Journal Detail:
Title:  Neuroradiology     Volume:  -     ISSN:  1432-1920     ISO Abbreviation:  Neuroradiology     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1302751     Medline TA:  Neuroradiology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Nuclear Medicine & PET, All India Institute of Medical Sciences, New Delhi, 110029, India,
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