Clinical utility of 18F-fluorodopa positron emission tomography in the movement disorder clinic: an Australian experience.

Abstract

Background: Differentiating idiopathic Parkinson disease (iPD) from other causes of tremor and parkinsonism based on clinical grounds can be challenging, particularly early in the course of disease or in the case of atypical clinical presentations. ¹⁸F-fluorodopa (F-DOPA) is a positron emission tomography (PET) radioligand that can be used to demonstrate the presence and pattern of striatal presynaptic dopaminergic deficit and, thus, assist in the diagnosis of iPD and related disorders.

Aims: To determine the clinical utility of F-DOPA PET in an Australian movement disorder clinic setting.

Methods: Retrospective cohort study of movement disorder clinic patients referred for F-DOPA PET by four movement disorder neurologists over a 10-year period to a single Australian nuclear medicine centre. Results of F-DOPA PET scans were correlated with changes in provisional diagnosis and management in the short term following review of F-DOPA PET results.

Results: A total of 105 F-DOPA PET scan results and patient records were examined. In this cohort, provisional clinical diagnosis was altered in 37.9% of patients, and changes to clinical management were made in 48.4% of patients in the short term following review of F-DOPA PET results. Changes in both diagnosis and management were more common following a normal F-DOPA PET scan result (42.4% and 53.0% respectively) than a scan consistent with iPD (23.5% and 32.4% respectively).

Conclusions: There was significant change in provisional clinical diagnosis and management in the short term following review of F-DOPA PET results indicating significant clinical utility of F-DOPA PET in the Australian movement disorder clinic setting.