Dopamine transporter imaging in neurodegenerative movement disorders: PET vs. SPECT
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EXPERT REVIEW
Dopamine transporter imaging in neurodegenerative movement disorders: PET vs. SPECT Vera S. Kerstens1 · A. Varrone1 Received: 9 July 2020 / Accepted: 31 August 2020 / Published online: 15 September 2020 © The Author(s) 2020
Abstract Purpose The dopamine transporter (DAT) serves as biomarker for parkinsonian syndromes. DAT can be measured in vivo with single-photon emission computed tomography (SPECT) and positron emission tomography (PET). DAT-SPECT is the current clinical molecular imaging standard. However, PET has advantages over SPECT measurements, and PET radioligands with the necessary properties for clinical applications are on the rise. Therefore, it is time to review the role of DAT imaging with SPECT compared to PET. Methods PubMed and Web of Science were searched for relevant literature of the previous 10 years. Four topics for comparison were used: diagnostic accuracy, quantitative accuracy, logistics, and flexibility. Results There are a few studies directly comparing DAT-PET and DAT-SPECT. PET and SPECT both perform well in discriminating neurodegenerative from non-neurodegenerative parkinsonism. Clinical DAT-PET imaging seems feasible only recently, thanks to simplified DAT assessments and better availability of PET radioligands and systems. The higher resolution of PET makes more comprehensive assessments of disease progression in the basal ganglia possible. Additionally, it has the possibility of multimodal target assessment. Conclusion DAT-SPECT is established for differentiating degenerative from non-degenerative parkinsonism. For further differentiation within neurodegenerative Parkinsonian syndromes, DAT-PET has essential benefits. Nowadays, because of wider availability of PET systems and radioligand production centers, and the possibility to use simplified quantification methods, DAT-PET imaging is feasible for clinical use. Therefore, DAT-PET needs to be considered for a more active role in the clinic to take a step forward to a more comprehensive understanding and assessment of Parkinson’s disease. Keywords Parkinson’s disease · SPECT · PET · Dopamine transporter · Biomarker
Introduction DAT as imaging marker Parkinson’s disease (PD) is the most common neurodegenerative movement disorder, with approximately 1 out of 1000 people age 50 and older having the disease. Current treatment is solely symptomatic. Considerable efforts and resources are being invested in finding suitable targets for disease-modifying treatments [1]. To be able to assess the effectiveness of a new treatment, a reliable outcome measure * Vera S. Kerstens [email protected] 1
Department of Clinical Neuroscience, Centre of Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden
is needed. Clinical neurological assessment with the (Movement Disorder Society) Unified Parkinson’s Disease Rating scale ([MDS-]UPDRS) is currently the most frequently used outcome measure in clinical trials and clinical practice, but is sensitive to interpretation bias. A bioma
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