Dopamintransporter-SPECT mit [¹²³I]FP-CIT: Empfehlungen für die visuelle Beurteilung

Zusammenfassung

SPECT mit dem Kokain-Analogon [¹²³I]FP-CIT wird für den Nachweis oder Ausschluss der Degeneration nigrostriataler Neurone bei Patienten mit klinisch unklarem Parkinson-Syndrom eingesetzt. Die Beurteilung der Untersuchung basiert auf der visuellen Interpretation der SPECT-Bilder, die durch semiquantitative Analysen unterstützt werden kann. Wesentlicher Nachteil der visuellen Bildbeurteilung gegenüber der semiquantitativen Analyse ist, dass sie prinzipiell subjektiv und insbesondere von der Erfahrung des Befunders abhängig ist. Im vorliegenden Artikel sind daher einfach anzuwendende Empfehlungen zusammengestellt, die den Arzt in der täglichen Routine bei der visuellen Differenzierung zwischen normaler und reduzierter striataler [¹²³I]FP-CIT-Aufnahme im Sinne nigrostriataler Degeneration unterstützen sollen. Anwendung der Empfehlungen sollte die Befunder-Abhängigkeit der visuellen Bildinterpretation bei der [¹²³I]FP-CIT-SPECT reduzieren.

Abstract

SPECT with the cocaine analog [¹²³I]FP-CIT is widely used for the detection or exclusion of nigrostriatal degeneration in patients with clinically uncertain parkinsonian syndrome. The interpretation of [¹²³I]FP-CIT SPECT is based on visual assessment of the SPECT images, which can be supported by semi-quantitative analysis of [¹²³I]FP-CIT uptake in the striatum and its substructures. The main limitation of visual interpretation of [¹²³I]FP-CIT SPECT images is its inter-rater variability. The present paper compiles easily applicable recommendations for visual interpretation of [¹²³I]FP-CIT SPECT that are intended to support the physician in the differentiation between normal and reduced striatal uptake of [¹²³I]FP-CIT in everyday clinical routine. Application of these recommendations is expected to reduce inter-rater variability.

Schlüsselwörter

Parkinson-Syndrom - Dopamintransporter - SPECT - [¹²³I]FP-CIT - DaTSCAN - visuelle Beurteilung - Befundungskriterien

Key words

parkinsonian syndrome - dopamine transporter - SPECT - [¹²³I]FP-CIT - DaTscan - visual interpretation - criteria

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