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Review
. 2021 Nov;90(5):711-719.
doi: 10.1002/ana.26187. Epub 2021 Aug 27.

Single Photon Emission Computed Tomography/Positron Emission Tomography Molecular Imaging for Parkinsonism: A Fast-Developing Field

Antoine Verger  1   2 , Stephan Grimaldi  3 , Maria-Joao Ribeiro  4 , Solène Frismand  5 , Eric Guedj  6   7   8
Affiliations
Review

Single Photon Emission Computed Tomography/Positron Emission Tomography Molecular Imaging for Parkinsonism: A Fast-Developing Field

Antoine Verger et al. Ann Neurol. 2021 Nov.

Abstract

The early differential diagnosis of Parkinson disease and atypical parkinsonism is a major challenge. The use of single photon emission computed tomography (SPECT)/positron emission tomography (PET) molecular imaging to investigate parkinsonism is a fast-developing field. Imaging biomarker research may potentially lead to more accurate disease detection, enabling earlier diagnosis and treatment. This review summarizes recent SPECT/PET advances in radiopharmaceuticals and imaging technologies/analyses that improve the diagnosis of neurodegenerative parkinsonism. We are currently witnessing a turning point in the field. Integrating molecular imaging as a diagnostic technique represents an opportunity to reassess the strategies for diagnosing neurodegenerative parkinsonism. ANN NEUROL 2021;90:711-719.

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Conflict of interest statement

E.G. consults for amyloid PET imaging in AD (General Electric Healthcare).

Figures

FIGURE 1
FIGURE 1
Flow diagram showing the rationale for performing single photon emission computed tomography (SPECT)/positron emission tomography (PET) molecular imaging in a patient with parkinsonism. FDG = fluorodeoxyglucose; MIBG = metaiodobenzylguanidine; MRI = magnetic resonance imaging.
FIGURE 2
FIGURE 2
Representative single photon emission computed tomography (SPECT)/positron emission tomography (PET) images investigating parkinsonism from clinical routine practice radiotracers in normal subjects and patients with parkinsonism. (A) SPECT with 123I‐labeled dopamine transporter ligands (left panel) and 18F‐fluorodopa PET (right panel). (B) 18F‐FDG PET. (C) 123I‐metaiodobenzylguanidine scintigraphy. CBD = corticobasal degeneration; DLB = dementia with Lewy bodies; MSA = multiple system atrophy; PD = Parkinson disease; PSP = progressive supranuclear palsy.
FIGURE 3
FIGURE 3
Representative positron emission tomography images investigating parkinsonism with new radiotracers. (A) 18F‐LBT‐999 targeting the dopamine transporters in a normal subject (left panel) and a Parkinson disease (PD) patient (right panel). (B) 18F‐Flortaucipir targeting the tau protein in a normal subject (left panel) and a tauopathy patient (Alzheimer disease, right panel). LBT = Laboratoire Biophysique de Tours.
FIGURE 4
FIGURE 4
Pathophysiological mechanisms of single photon emission computed tomography (SPECT)/positron emission tomography (PET) radiotracers in neurodegenerative parkinsonism. FDG = fluorodeoxyglucose; MIBG = metaiodobenzylguanidine.
See this image and copyright information in PMC

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