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Differential Diagnosis of Parkinson’s Disease and Vascular Parkinsonism by ^99mTc-TRODAT-1

Departments of Nuclear Medicine and Neurology, Chang Gung Memorial Hospital at Lin-Ko and Keelung, Taipei Medical Center and School of Medicine, Chang Gung University; and Institute of Nuclear Energy Research, Lung-Tan, Taiwan

View larger version (144K): [in a new window]   FIGURE 1. (A) 99mTc-TRODAT-1 brain SPECT and MR images of 62-y-old male VP patient. Symmetric and normal uptake of 99mTc-TRODAT-1 in bilateral basal ganglia is observed (L = left image). Multiple small infarcts are seen bilaterally in basal ganglia and white matter (arrow) on MR image (R = right image). (B) 99mTc-TRODAT-1 brain SPECT and MR images of 62-y-old male Parkinson’s disease patient. Asymmetric and low uptake of 9mTc-TRODAT-1 in right putamen is observed (L = left image). No obvious abnormality is seen bilaterally in basal ganglia and white matter on MR image (R = right image).

View larger version (12K): [in a new window]   FIGURE 2. 99mTc-TRODAT-1 uptake ratios in striatum in age-matched healthy (normal) individuals, VP patients, and Parkinson’s disease (PD) patients. Age-related decline of 99mTc-TRODAT-1 uptake ratios in striatum was observed in healthy individuals and in VP patients. In comparison with VP and Parkinson’s disease patients, 99mTc-TRODAT-1 uptake ratio in striatum is asymmetric and significantly decreased bilaterally in Parkinson’s disease patients. S/O ratio = striatum-to-occipital ratio.

View larger version (12K): [in a new window]   FIGURE 3. Putamen-to-caudate uptake ratio (P/C ratio) for 99mTc-TRODAT-1 in age-matched VP and Parkinson’s disease (PD) patients. 99mTc-TRODAT-1 uptake in Parkinson’s disease patients is significantly decreased compared with that in VP patients, with uptake in contralateral putamen site more obviously decreased in Parkinson’s disease patients.