[Efficacy of 123i-ioflupane (DaTSCAN) on the diagnosis of parkinsonism syndromes. Systematic review and case registry]

Varela Lema L, Punal Rioboo J, Ruano Ravina
Record ID 32008100090
Authors' objectives:

To assess the efficacy of DaTSCAN© in the diagnosis of early Parkinson’s disease and determine the efficacy of 123I-FP in the differential diagnosis of vascular parkinsonism, drug-induced parkinsonism, essential tremor, DLB and AD. To establish patient’s characteristics with similar symptoms to PD who will obtain the most benefit of image technique.

Authors' results and conclusions: The search strategy identified 185 references. After applying inclusion/exclusion criteria 9 articles were included in the systematic review. Two additional papers were included after updating. Of all included studies, 5 were cohort studies and 6 were cross-over clinical trials. No randomized clinical trials were found. Three papers assessed the effect of DaTSCAN© in medication of patients and found that 17 to 69% of the patients treatment changed after SPECT. Six studies assessed the change in the diagnosis for patients with parkinsonian syndromes after SPECT. Four of them showed that 123I-FP could be useful for the differential diagnosis between PD and non-degenerative disorders (vascular parkinsonism, drug-induced parkinsonism, ET). One observed that ioflupane could help differentiate between PD and Alzheimer’s disease and between this last disease and DLB. The other investigation group showed that DaTSCAN© could help in the differential diagnosis between PD and parkinsonism syndromes such as multiple system atrophy (MSA) and progressive supranuclear palsy (PSP). The mean age of included patients was 62 years and 43% were women. The 78% of reported indications were: postural tremor, drug-induced parkinsonism and parkinsonism that did not respond to L-dopa. At 1 year follow-up, a change in the diagnosis was observed in 33% patients and a change in therapy in 51%.
Authors' recommendations: The scientific evidence available indicates that 123I-FP can be useful to differentiate PD from non-degenerative disorders such as vascular and drug-induced parkinsonism, differentiate PD from Alzheimer’s disease and this last one from DLB. The quality of evidence was low, which limits the validity of the conclusions. DaTSCAN© seems to show a greater clinical utility when it is used in patients with suspicious early PD, especially when symptoms have started in the previous 1-2 years, but is not useful in patients with advanced PD and responsiveness to L-DOPA. The case registry showed that ane was more useful in the diagnosis of patients without response to L-dopa or with postural tremor. 123I-FP could not be indicated correctly in some patients.High quality studies are necessary to assess the diagnostic efficacy of DaTSCAN© to differentiate between movement disorders.
Authors' methods: Review
Project Status: Completed
Year Published: 2007
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Spain
MeSH Terms
  • Humans
  • Iodine Radioisotopes
  • Nortropanes
  • Parkinsonian Disorders
Organisation Name: Scientific Advice Unit, avalia-t; The Galician Health Knowledge Agency (ACIS)
Contact Address: Conselleria de Sanidade, Xunta de Galicia, San Lazaro s/n 15781 Santiago de Compostela, Spain. Tel: 34 981 541831; Fax: 34 981 542854;
Contact Name: avalia-t@sergas.es
Contact Email: avalia-t@sergas.es
Copyright: Galician Agency for Health Technology Assessment (AVALIA-T)
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