A multicenter assessment of dopamine transporter imaging with DOPASCAN/SPELT in parkinsonism

Background: In vivo imaging of the dopamine transporter (DAT) with SPELT is a quantitative biomarker for PD onset and severity. Objective: To use a mu lticenter study to evaluate the diagnostic accuracy of DOPASCAN and SPELT i n patients with PD, progressive supranuclear palsy (PSP), and essential tre mor (ET), and in healthy controls (HC). Methods: Ninety-six individuals wit h known clinical diagnosis were imaged with DOPASCAN at five sites with dif ferent multidetector SPELT systems. Both masked visual interpretation and r egion of interest (ROI) analysis were performed at each site and at a core analysis center. Results: Visual interpretation of the images by an expert panel demonstrated a sensitivity of 0.98 and specificity of 0.83 comparing parkinsonian (PD + PSP) versus nonparkinsonian (ET + HC) controls. Quantita tive analysis of putamen and caudate DOPASCAN uptake for each region in the PD or PSP groups was significantly reduced compared to the ET or HC groups . Comparison of parkinsonian (PD + PSP) versus nonparkinsonian (ET + HC) in dividuals demonstrated a reduction of 76% in mean putamen and 48% in mean c audate DOPASCAN uptake. Conclusions: DOPASCAN and SPELT imaging reliably an d effectively distinguish between subjects with Parkinson's syndrome (PD PSP) and without Parkinson's syndrome (HC + ET). This is the first multicen ter assessment of dopamine transporter imaging demonstrating that this tool may be used widely to assess dopaminergic degeneration in patients with pa rkinsonism.