Dopamine transporter single photon emission computed tomography (DaT-SPECT) use in the diagnosis and clinical management of parkinsonism: an 8-year retrospective study

IntroductionParkinson's disease (PD) is a neurodegenerative movement disorder that is typically diagnosed clinically. DaT-SPECT scanning (DaT Scan) can be used when there is diagnostic difficulty differentiating from non-neurodegenerative Parkinsonism. This study assessed the effect of DaT Scan imaging on diagnosis and subsequent clinical management of these disorders.MethodsThis single-trust retrospective study involved 455 patients who had undergone DaT scans for investigation for Parkinsonism, between 01/01/2014 and 31/12/2021. Data collected included patient demographics, date of clinical assessment, scan report, pre-scan and post-scan diagnosis, and clinical management.ResultsThe mean age at scan was 70.5 years and 57% were male. The percentage of patients who had an abnormal scan result was 40% (n = 184), whilst 53% (n = 239) had a normal scan result, and 7% (n = 32) had an equivocal scan. Pre-scan diagnosis was consistent with scan results in 71% of cases of neurodegenerative Parkinsonism, whereas this figure was 64% for cases of non-neurodegenerative Parkinsonism. For all DaT scans, the diagnosis was changed in 37% of patients (n = 168), whilst the clinical management was changed in 42% of patients (n = 190). Change in management involved 63% starting dopaminergic medication, 5% stopping dopaminergic medications, and 31% undergoing other changes in management.ConclusionDaT imaging is useful for confirming the correct diagnosis and clinical management for patients with clinically indeterminate Parkinsonism. Pre-scan diagnoses were generally consistent with scan results.

Automated summary

This study assessed the impact of DaT Scan imaging on the diagnosis and subsequent clinical management of patients with indeterminate Parkinsonism. The results showed that DaT scanning is useful for confirming the correct diagnosis and guiding the clinical management of Parkinsonism patients.