The Quantitative 18-fluorodeoxyglucose PET Study in the Differential Diagnosis between Idiopathic Parkinson's Disease and Multiple System Atrophy

J Korean Neurol Assoc > Volume 24(1); 2006 > Article

Journal of the Korean Neurological Association 2006;24(1): 31-37.

파킨슨병과 다계통위축증 감별 진단에 정량적 18-fluorodeoxyglucose PET의 유용성

류철형, 이승엽 유영훈a 이명식

연세대학교 의과대학 영동세브란스병원 신경과, 진단방사선과a

The Quantitative 18-fluorodeoxyglucose PET Study in the Differential Diagnosis between Idiopathic Parkinson's Disease and Multiple System Atrophy

Chul Hyoung Lyoo

Departments of Neurology and Radiologya, Youngdong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

Abstract

Background: Overlapping clinical features of idiopathic Parkinson's disease (IPD) and multiple system atrophy (MSA) make it difficult to conduct an accurate differential diagnosis. We performed a quantitative F18- fluorodeoxyglucose PET (FDG PET) and measured the striatal and cerebellar glucose metabolism to evaluate the efficacy of a FDG PET study in the differential diagnosis between IPD and MSA.
Methods: This study included 19 patients with IPD, 28 patients with MSA (MSA-P:MSA-C=19:9) and 12 age matched normal controls. A FDG PET study was performed in all subjects and the original PET image was corrected with the radioactivity curve obtained by repetitive sampling of the radial arterial blood.
Results: The measurements of striatal and cerebellar glucose metabolisms of the patients with MSA-P were significantly lower than those of the patients with IPD (P<0.001). However, the measurement of the caudate nucleus provided the most reliable clue for the differential diagnosis between IPD and MSA-P (sensitivity 94.7% and specificity 94.7%). In the patients with MSA-C, the glucose metabolism of the cerebellar vermis (P<0.001), cerebellar cortex (P<0.001) and putamen (P<0.05) was significantly lower than those of the patients with IPD.
Conclusions: Quantitative FDG PET is a useful and reliable method in making a differential diagnosis between IPD and MSA.