[SPECT with 123I-IBZM: utility in differential diagnosis of degenerative Parkinsonisms and establishment of...

To assess utility of SPECT with 123I-Iolopride ( 123I-IBZM) in the differential diagnosis of patients with Parkinsonian symptoms and try to establish an adequate quantification method.

We analyzed a total of 34 patients who underwent a study with 123I-IBZM SPECT. Studies were analyzed qualitatively (visually) and quantitatively, using different quantification methods. We used different sums of slices (2, 3, 4, and 7 slices) with different cortical regions as a reference (frontal and occipital regions). Results were analyzed statistically. The final diagnosis of patients was established by two neurologists, specialized in movement disorders.

Studies were visually assessed as normal in 24 cases and as pathologic in the other 10 cases. Scintigraphic studies had an adequate diagnostic correlation in 33 of the 34 patients. Four of the 8 methods used in the quantification were statistically significant in the differentation between normal and pathological. The use of different cortical brain regions as reference did not improve differentation between normal and pathologic studies. Global quantitative assessment of the studies showed that normal studies had higher values than pathological ones, with important overlapping between both categories.

123I-IBZM SPECT is an effective diagnostic tool in the establishment of the differential diagnosis in patients with Parkinson's disease and Parkinson-Plus. Quantification of these studies had limited utility since the overlapping of index values between normal and pathological restricts their use in individual cases.