Pearls and pitfalls of I-123 Ioflupane (DATscan) SPECT imaging

Learning Objectives 1. Review the anatomy, pathophysiology, and imaging findings including SPECT imaging (DATscan), CT, and MRI of various movement disorders including Parkinson’s disease and supranuclear palsy. 2. Review pearls and pitfalls of SPECT Imaging.

After dementia, movement disorders are the most frequent neurodegenerative disorder encountered in clinical practice. Movement disorders have various etiologies and sometimes they are difficult to distinguish clinically. I-123 Ioflupane (DATscan) SPECT imaging is one of the unique diagnostic test being used to measure degeneration of dopamine presynaptic terminal. I-123 Ioflupane nigrostriaum imaging is a valuable functional imaging modality in evaluation of various movement disorders including Parkinsons disease, essential tremor, pseudoparkinsonism, and progressive supranuclear palsy. As the incidence of these movement disorder increases with increase in aging population, DATscan usage is likely to increase. It is critical for interpreting physician to familiarize him/herself with various aspects of DATscan. This educational exhibit will review nigrostriatum I-123 Ioflupane imaging highlighting study technique, detailed discussion of physiologic and pharmacologic principals of I-123, clinical indications for DATscan, review approach to SPECT study interpretation, case-based review of imaging findings (SPECT, CT and/or MRI) for various movement disorders and their respective differential diagnoses. Addtionally, there will be extensive case-based discussion of various radiological pitfalls and emphasize key points which can help in avoiding these pitfalls. Clinical and radiological pearls that can help narrow the differential diagnosis will be discussed as well.