RT Journal Article
SR Electronic
T1 Management Impact of Imaging Brain Vesicular Monoamine Transporter Type 2 in Clinically Uncertain Parkinsonian Syndrome with <sup>18</sup>F-AV133 and PET
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1815
OP 1820
DO 10.2967/jnumed.116.189019
VO 58
IS 11
A1 Paschal K. Alexander
A1 Yenni Lie
A1 Gareth Jones
A1 Chomalaven Sivaratnam
A1 Svetlana Bozinvski
A1 Rachel S. Mulligan
A1 Kenneth Young
A1 Victor L. Villemagne
A1 Christopher C. Rowe
YR 2017
UL http://jnm.snmjournals.org/content/58/11/1815.abstract
AB Idiopathic Parkinson disease is a common neurodegenerative disorder for which misdiagnosis occurs in up to 30% of patients after initial assessment and in 10%–15% even after long-term follow-up. Vesicular monoamine transporter type 2 (VMAT2) imaging with PET allows assessment of the integrity of the presynaptic dopaminergic pathway. We investigated the management impact of VMAT2 imaging in patients with clinically uncertain Parkinsonian syndromes. Methods: Forty-seven patients with clinically uncertain Parkinsonian syndromes (mean age ± SD, 56.9 ± 14.9 y; age range, 21–80 y) were referred from movement disorder specialists. All participants underwent a 20-min PET acquisition 2 h after injection of 250 MBq of 18F-AV-133, and the resulting images were quantitatively assessed. Clinical impact was recorded as high, moderate, or low based on diagnosis and management questionnaires completed by the referring specialists before and after release of the PET results. Management impact was high if there was a change in diagnostic category, moderate if there was a change in medication, and low if there was no change. Results: VMAT2 PET changed the diagnosis in 11 (23%) and medication in 25 (53%) participants. Management impact was high in 23%, moderate in 38%, and low in 39% of the participants. High diagnostic confidence increased from 11% of patients to 80% after the release of the scan results. Conclusion: 18F-AV-133 had substantial management impact in patients with clinically uncertain Parkinsonian syndromes. VMAT2 imaging with 18F-AV133 might improve diagnosis, prognosis, and appropriate use of medication, translating into better patient outcomes.