Clinical utility of (99mTc)‐TRODAT‐1 scans to differentiate Parkinsonian syndromes: case studies and commentary
The differential diagnosis of Parkinsonian syndromes is challenging, especially in the elderly as they often have complex presentations. Nuclear imaging modalities can increase diagnostic accuracy. Single‐photon emission tomography (SPECT) using the ligand (99mTc)‐TRODAT‐1 is used overseas but is yet to be approved in Australia. Three pilot cases of clinically unclear Parkinsonian syndromes from the Royal North Shore Hospital Aged Care Department who underwent (99mTc)‐TRODAT‐1 scans are described. From experience overseas, the (99mTc)‐TRODAT‐1 scan has clinical utility in the differential diagnosis of Parkinsonian syndromes. (99mTc)‐TRODAT‐1 has a lower cost and greater availability than other ligands. Our initial scan findings are largely consistent with the clinical picture, but low specific binding can affect scan interpretation. (99mTc)‐TRODAT‐1 is a potential tool in the differential diagnosis of Parkinsonian syndromes. Further experience regarding its effect on patient outcomes and cost effectiveness is required before routine clinical use can be recommended.
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