SPECT WITH HMPAO COMPARED TO PET WITH FDG IN HUNTINGTON DISEASE

Objective: It is the aim of this study to compare the performance of 9 9(m)Tc-d, l-hexamethylpropyleneamine oxime (HMPAO) SPECT with that of [F-18]fluorodeoxyglucose (FDG) PET in detecting striatal dysfunction a s it occurs in Huntington disease (HD). Materials and Methods: For the determination of regional cerebral glucose consumption, the PET camer a PC-4096 was used; the cerebral uptake of HMPAO was measured using th e three-head SPECT camera TRIAD. Eight patients with manifest HD, seve n subjects at risk for HD, and nine normal individuals were included i n the study. In both modalities data evaluation was performed using ca udate-to-whole-slice (C/S) ratios. The patients' data were compared to 95% confidence intervals determined in the nine controls. Results: Th e PET and SPECT CIS values correlated significantly (n = 24; r = 0.87; p < 0.0001). The CIS values were significantly reduced in PET in all eight and in SPECT in seven of the eight HD patients studied. Five of the seven at-risk subjects had normal CIS values in PET and SPECT, one showed reduced C/S values in both diagnostic methods, and the remaini ng at-risk individual showed a reduced C/S value in PET only. Thus, co ncordant results between PET and SPECT were obtained in seven of eight patients and six of seven at-risk subjects studied, corresponding to an 87% accuracy of SPECT in the detection of striatal dysfunction as c ompared to the ''gold standard'' PET. Conclusion: With use of a multid etector camera, HMPAO-SPECT comes near the performance of FDG-PET in t he diagnosis of striatal dysfunction as it occurs in HD.