Efficiency of ¹²³I-ioflupane SPECT as the marker of basal ganglia damage in acute methanol poisoning: 6-year prospective study

Abstract

Context

Investigate whether ¹²³I-ioflupane SPECT (DaT SPECT) has the potential as a marker of basal ganglia damage in acute methanol poisoning.

Methods

Prospective, single-centre, cohort study of patients with confirmed methanol poisoning was conducted. DaT SPECT was performed twice with semi-quantification using DaTQUANT^TM and MRI-based volumetry was calculated. Specific binding ratios (SBR) of striatum, caudate nucleus, and putamen were correlated with laboratory parameters of outcome, volumetric data, and retinal nerve fibres layer (RNFL) thickness measurements.

Results

Forty-two patients (mean age 46.3 ± 4.2 years; 8 females), including 15 with MRI-detected putamen lesions (group I) and 27 patients with intact putamen (group II), underwent DaT SPECT. Volumetry was calculated in 35 of the patients assessed. SBR values for the left putamen correlated with putamen volume (r = 0.665; p < 0.001). Decreased bilateral SBR values were determined for the striatum and the putamen, but not for the nucleus caudate, in group I (p < 0.05). Significant correlation was observed between the SBR of the posterior putamen and arterial blood pH (r = 0.574; p < 0.001) and other toxicological parameters of severity of poisoning/outcome including serum lactate, glucose, and creatinine concentrations (p < 0.05). The SBR of the posterior putamen positively correlated with the global RNFL thickness (p < 0.05). ROC analysis demonstrated a significant discriminatory ability of SBR of the posterior putamen with AUC = 0.753 (95%CI 0.604–0.902; p = 0.007). The multivariate regression model demonstrated that arterial blood pH, age, and gender were the most significant factors associated with SBR of the posterior putamen.

Conclusion

DaT SPECT demonstrates significant potential for the diagnosis of methanol-induced basal ganglia damage.

Keywords:

• Methanol poisoning
• basal ganglia lesion
• toxic brain damage
• putamen necrosis
• 123I-ioflupane SPECT
• MRI-volumetry

Disclosure statement

The authors report no conflict of interest. The authors alone are responsible for the content and writing of this paper. The manuscript has been read and approved by all authors. The authors certify that the submission is not under review at any other publication. The authors certify that the authors have no other submissions and previous reports that might be regarded as overlapping with the current work. The authors declare no financial disclosures.

Additional information

Funding

1. Ministry of Health of the Czech Republic (AZV) Grant [16-27075A]. 2. First Faculty of Medicine, Charles University in Prague Grant [PROGRES Q25], Grant [PROGRES Q29]. 3. The complimentary 6-months licence of DaTQUANT was provided by GE Healthcare for the purposes of this project.