Purpose

Dopamine transporter (DAT) imaging is used to support the diagnosis of neurodegenerative parkinsonian disorders. Specific medications have been reported to confound the interpretation of [¹²³I]I-FP-CIT SPECT scans, but there is limited data. The aim of the current study is to identify potential medication effects on the interpretation of [¹²³I]I-FP-CIT SPECT scans in routine practice.

Materials and methods

Consecutive patients undergoing a [¹²³I]I-FP-CIT SPECT/CT scan on a 360° CZT camera between September 2019 and December 2022 were included. An exhaustive review of patient medications (antidepressants, antipsychotics, anti-epileptics, anti-parkinsonians, benzodiazepines, lithium, opioids, and stimulants) was performed. Two experienced nuclear physicians, blinded to the medication reports, interpreted the [¹²³I]I-FP-CIT SPECT scans visually and a semi-quantitative analysis was performed using a local normal database.

Results

The study included 305 patients (71.0 ± 10.4, 135 women) and 145 (47.5%) visually interpreted normal scans. In normal scans, the striatum/occiput radioligand uptake ratio was decreased by noradrenergic and specific serotonergic antidepressants (NASSAs) (n = 15, z-score of − 0.93) and opioid medication (tramadol, n = 6, z-score of − 0.85) and was associated with a younger age in the multivariate analysis. In the overall population, the striatum/occiput ratio was influenced by NASSAs and associated with consensual visual analysis, age, sex, and anti-parkinsonian medications related to the status of the disease.

Conclusion

Our study confirms the potential impact of antidepressant (NASSA) and opioid (tramadol) medications on the semi-quantitative analysis of [¹²³I]I-FP-CIT SPECT scans. However, when performing a visual analysis, only NASSAs significantly impacted the interpretation of [¹²³I]I-FP-CIT SPECT scans.

中文翻译：

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在常规实践中使用 [123I]I-FP-CIT SPECT 进行药物对多巴胺转运蛋白成像的影响

目的

多巴胺转运蛋白 (DAT) 成像用于支持神经退行性帕金森病的诊断。据报道，特定药物会混淆 [¹²³I]I-FP-CIT SPECT 扫描的解释，但数据有限。当前研究的目的是确定常规实践中药物对 [¹²³I]I-FP-CIT SPECT 扫描解读的潜在影响。< /span>

材料和方法

2019 年 9 月至 2019 年 9 月期间连续接受 [¹²³I]I-FP-CIT SPECT/CT 360° CZT 相机扫描的患者2022 年 12 月也包括在内。对患者的药物（抗抑郁药、抗精神病药、抗癫痫药、抗帕金森病、苯二氮卓类药物、锂、阿片类药物和兴奋剂）进行了详尽的审查。两名经验丰富的核医生对药物报告视而不见，对 [¹²³I]I-FP-CIT SPECT 扫描进行目视解读并进行半定量分析使用本地普通数据库执行。

结果

该研究包括 305 名患者（71.0±10.4，135 名女性）和 145 名 (47.5%) 目视解释的正常扫描。在正常扫描中，去甲肾上腺素能和特异性血清素能抗抑郁药 (NASSA) 降低了纹状体/枕骨放射性配体摄取比 (n = 15，z 分数为 − 0.93）和阿片类药物（曲马多，n = 6，z 分数为 − 0.85），并且在多变量分析中与较年轻的年龄相关。在总体人群中，纹状体/枕骨比例受到 NASSA 的影响，并与一致的视觉分析、年龄、性别和与疾病状态相关的抗帕金森病药物相关。

结论

我们的研究证实了抗抑郁药 (NASSA) 和阿片类药物（曲马多）对半定量分析的潜在影响[¹²³I ]I-FP-CIT SPECT 扫描。然而，在执行可视化分析时，只有 NASSA 会显着影响 [¹²³I]I-FP-CIT SPECT 扫描的解释。