Clinical utility of DaTscan™ imaging in the evaluation of patients with parkinsonism: a US perspective

ABSTRACT

Introduction: Single photon emission computed tomography (SPECT) with Ioflupane I123 injection (DaTscan™) was approved by the Food and Drug Administration in 2011 for striatal dopamine transporter visualization to assist in the evaluation of adult patients with suspected parkinsonian syndromes. While brain SPECT imaging using DaTscan is a covered service under Medicare policy, there is a lack of consensus on its role in routine clinical practice in the US.

Areas covered: To address this issue, an expert group of US-based movement disorders neurologists convened to discuss the clinical utility of DaTscan in movement disorders practices within the US. The group identified and discussed routine clinical scenarios where imaging with DaTscan can provide useful information that may impact management and/or clarify clinical diagnoses. This paper summarizes a consensus reached by the expert group at this meeting.

Expert commentary: The major utility of DaTscan imaging is the assistance it provides in distinguishing between nigrostriatal dopaminergic degeneration and non-nigrostriatal degeneration in patients displaying equivocal signs and symptoms of parkinsonism.

KEYWORDS:

• Dopamine transporter
• DaTscan
• imaging
• parkinson’s disease
• SPECT
• diagnosis
• treatment

Declaration of interest

S. Isaacson reports consultancy and/or promotional speaker on behalf of: Acadia, Acorda, Adamas, Allergan, Amarantus, Biotie, Britannia, Cynapsus, GE, Impax, Ipsen, Kyowa, Lundbeck, Teva, UCB, US WorldMeds. In addition, he reports research funding from Abbvie, Acadia, Acorda, Adamas, Addex, Allergan, Biotie, Civitas, Eisai, Ipsen, Kyowa, Lilly, Merck Michael J Fox, Foundation, Parkinson Study Group, Pharma2B, Roche, Serono, Teva, UCB and US WorldMeds. S. Fisher reports consultancy and promotional activities on speaker bureaus of TEVA, Lundbeck, UCB, GE, Avanir, Cynapsus, US WorldMeds, and Acadia. F. Gupta reports consultancy and promotional activities for GE Healthcare and US WorldMeds. D. Kremens reports advisor/consultant on behalf of Teva, US WorldMeds, UCB, Acadia, Acorda, Lundbeck, Cynapsus. He reports promotional speaker on behalf of Teva, US WorldMeds, UCB, Lundbeck, Acadia. In additional he reports research from Avid Radiopharmceuticals, Civitas, Cynapsus. M. Lew reports advisor/consultant on behalf of Teva, US WordMeds, Merz, UCB, Acadia, Auspex, Lundbeck, Abbvie. He reports promotional speaker on behalf of Teva, US WorldMeds, UCB, Lundbeck, Acadia. In additional he reports research support from NIH, Abbott/AbbVie, Parkinson’s Study Group, US WorldMeds, Michael J. Fox Foundation, Synosia Pharmaceuticals, Merz, Ipsen, Pharma 2B, Civitas, Biotie, Cynapsus, Amarantus, Pfizer. D. Russell reports personal fees from GE Healthcare, Teva Neuroscience, Lundbeck, and is employed by Molecular NeuroImaging, a division of inviCRO. J. Seibyl reports personal fees for GE Healthcare and consultancy with Piramal and Roche. He holds an equity interest in Molecular NeuroImaging, a division of inviCRO. R. Pahwa reports consultancy for Acadia, Adamas, Impax, St Jude Medical, Teva Neuroscience, Medtronic, and US WorldMeds. He has received honoraria from Medtronic, Teva Neuroscience, UCB, and US WorldMeds. He has received research grants from Acadia, Adamas, Avid, NIH/NINDS, NPF, and PSG/University of Rochester. He has also served on the data monitoring committee for Ceregene. He has received personal compensation as the Co-Editor-in-Chief of the International Journal of Neuroscience. K. Marek reports consultancy fees from GE Healthcare and from Pfizer, Merck, Lilly, BMS, Piramal, Prothena, Roche, Oxford Biomedica, Lysosomal Therapetic Inc, US WorldMeds, Neuropore, UCB, Biogen, Genzyme. He holds an equity interest in Molecular NeuroImaging, a division of inviCRO. Anita Chadha-Patel of ACP Clinical Communications Ltd (funded by GE Healthcare) provided medical writing support (literature searching, referencing and editing) in the development of this report. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper is the result of a meeting of US-based movement disorder neurologists with expertise in the use of DaTscan imaging. The meeting and paper were funded by GE Healthcare, who were not involved in the preparation of the paper, but who provided a full review of the article.