Nicolas Nicastro1, Valentina Garibotto2, Antoine Poncet3, Simon Badoud1,4, Pierre R Burkhard5. 1. Department of Neurology, Geneva University Hospitals, 4, rue Gabrielle Perret-Gentil, 1205, Geneva, Switzerland. 2. Department of Nuclear Medicine, Geneva University Hospitals, Geneva, Switzerland. 3. Department of Epidemiology, Geneva University Hospitals, Geneva, Switzerland. 4. Physiology Unit, Department of Medicine, University of Fribourg, Geneva, Switzerland. 5. Department of Neurology, Geneva University Hospitals, 4, rue Gabrielle Perret-Gentil, 1205, Geneva, Switzerland. pierre.burkhard@hcuge.ch.
Abstract
PURPOSE: To overcome the issue of reference values for DaTSCAN® requiring healthy controls, we propose an original approach using scans from individuals with non-degenerative conditions performed at one single center following the same acquisition protocol. PROCEDURES: From a cohort of 970 consecutive patients, we identified 182 patients with a clinical diagnosis of non-degenerative parkinsonism or tremor and a visually normal DATSCAN®. Caudate nucleus (C), putamen (P), and striatum (S) uptake values, C/P ratios, and asymmetry indexes (AI) were calculated using semi-quantitative methods. Outcomes were assessed according to age and gender, and reference limits were established using the percentile approach. RESULTS: A significant negative linear effect of age was found upon striatal nuclei uptake of 0.21-0.22 per decade (6.8%/decade for striatum), whereas a potential gender influence proved unclear. Inferior reference limits were established at the 5th percentile. C/P ratios and AIs were not influenced by age or gender, and superior reference limits were set at the 95th percentile. CONCLUSIONS: We here propose a convenient approach to calculate site-specific reference limits for DaTSCAN® outcomes not requiring scanning healthy controls. The method appears to yield robust values that range within nearly identical limits as those obtained in healthy subjects.
PURPOSE: To overcome the issue of reference values for DaTSCAN® requiring healthy controls, we propose an original approach using scans from individuals with non-degenerative conditions performed at one single center following the same acquisition protocol. PROCEDURES: From a cohort of 970 consecutive patients, we identified 182 patients with a clinical diagnosis of non-degenerative parkinsonism or tremor and a visually normal DATSCAN®. Caudate nucleus (C), putamen (P), and striatum (S) uptake values, C/P ratios, and asymmetry indexes (AI) were calculated using semi-quantitative methods. Outcomes were assessed according to age and gender, and reference limits were established using the percentile approach. RESULTS: A significant negative linear effect of age was found upon striatal nuclei uptake of 0.21-0.22 per decade (6.8%/decade for striatum), whereas a potential gender influence proved unclear. Inferior reference limits were established at the 5th percentile. C/P ratios and AIs were not influenced by age or gender, and superior reference limits were set at the 95th percentile. CONCLUSIONS: We here propose a convenient approach to calculate site-specific reference limits for DaTSCAN® outcomes not requiring scanning healthy controls. The method appears to yield robust values that range within nearly identical limits as those obtained in healthy subjects.
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