Aims: The clinical diagnosis of idiopathic Parkinson's disease (IPO) and its associated parkinsonian syndromes is not simple as it can be mimicked by a variety of other conditions. Objective assessment of the dopamine transport (DAT) system by 123I-Ioflupane SPECT has proven to be a highly accurate method for establishing a diaqnosis of IDP. However, the test is expensive and can only be justified if it can lead to a change in patient management. This retrospective study therefore aimed to determine the clinical impact of 123I-Ioflupane SPECT scan in our Institute. Methods: A retrospective review of the clinical impact of 123I-Ioflupane imaging in a single University Hospital site over a 5-year period was undertaken. Of the total of 152 patients imaqed, follow-up information was available in 85 of the patients who presented with either a high pre-test probability of IPD (43 patients), or unlikely to have IPD (15 patients) or atypical movement disorders (27 patients). Results: In those patients in whom a diagnosis of IPD was suspected, the scan confirmed the disease in 79%, with a change in management in 23. In those with a low likelihood of IPD, 33% had a diagnostic 123I-Ioflupane scan suggestive of IPD, with resultant change in management in 20% of patients. Of those with atypical presentation, IPD was confirmed in 48%, all of whom had a change in management. Conclusion: In conclusion, there was a 64% agreement between the clinical diagnosis and imaging, resultinq in a change in management in 28 percent of the patients.
|
