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.