| B-CIT SPECT를 이용한 파킨슨병 진행정도의 평가 |
| 이원용, 최연성, 김경문, 지대윤, 김병태 |
| 삼성의료원 핵의학과. 신경과, 삼성생명과학연구소 임상의학연구센터 |
| Assessment of parkinson's disease severity with B-CIT and single-photon emission computed tomography |
| Sang Eun Kim, M.D., Won Yong Lee, M.D., Yearn Seong Choe, Ph.D., Gyeong-Moon Kim, M.D., Dae Yoon Chi, Ph.D., Byung-Tae Kim, M.D. |
| Department of Nuclear Medicine and Neurology, Samsung Medical Center: and Clinical Research Center, Samsung Biochemical Research Institute. |
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| Abstract |
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Previous single-photon emission computed tomography (SPECT) studies have demonstrated decreased 〔123 I〕β-CIT (2β-carbomethoxy-3β(4-iodophenyl) tropane) striatal binding in Parkinson's disease (PD) patients. The present study extends our previous work by examining SPECT measures of 〔123 I〕β-CIT binding in a larger group of PD patients with varying disease severity. Forty-six L-dopa-responsive PD patients(Hoehn-Yahr stage 1-3) had either a total of 15 SPECT scans over a 24 hr period or two scans at 12 hr and 24 hr after injection of 〔123 I〕β-CIT. 〔123 I〕β-CIT binding in the striatum was estimated using two indices: the specific-to nonspecific binding ratio, calculated as (striatal-cerebellar)/cerebellar radioactivity (specific binding ratio: SBR) at 24 hr postinjection as well as at its peak, which occurred at 12-24 hr postinjection; and the binding potential, the ratio of the rate constant of binding to the dopamine (DA) transporters (k3) to that of dissociation from the DA transporters (K4), as calculated by tracer kinetic modeling. The mean SBR at 24 hr postinjection, the mean peak SDR, and the mean binding potential in the striatum were all significantly correlated with Hoehn-Yahr stage, total store of UPDRS, motor score of UPDRS, and activities of daily living score of UPDRS. There were significant correlations between the sum of lateralizing UPDRS subscales (tremor, rigidity, bradykinesia) calculated for each individual limb and the SPECT measures of [123I]β-CIT binding in the contralateral striatum. There were excellent correlations among the peak striatal SBR, the stiiatal SBR at 24 hr postinjection, and the binding potential. The results indicate that [123I]β-CIT may be a useful marker of disease severity in PD. Additionally, the simple tissue ratio at 24 hr postinjection may be acceptable for the assessment of [123I]β-CIT binding in PD, making repeated scanning and complicated modeling procedures less necessary. [123I]β-CIT SPECT may be clinically useful for the early diagnosis and serial monitoring of PD. |
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