Health Problem: Parkinson disease (PD) is a neurodegenerative condition characterized by motor symptoms such as resting tremor, muscle rigidity, postural instability, and bradykinesia and nonmotor symptoms such as sleep disorders, olfactory impairment, attention/memory impairment, apathy, depression, and anxiety. The cause of PD is degeneration of the dopaminergic system due to loss of cells that produce dopamine in the substantia nigra of the brain. This degeneration leads to a marked loss of dopamine transporters (DaTs) and decline in dopamine-related brain functions such as control of movement. In the United States, PD currently affects > 1 million individuals and is newly diagnosed in approximately 60,000 patients each year.

Technology Description: DaTscan imaging allows visualization of the location and relative number of dopamine-producing cells in the brain. DaTscan is a radiotracer that consists of the molecule ioflupane, which is chemically similar to cocaine, attached to an atom of radioactive iodine-123 (123I). After injection, ioflupane binds to DaTs in the striatum that is located near the base of the brain. Radioactive decay of 123I attached to ioflupane produces gamma rays that allow detection of DaTs by single photon emission computed tomography (SPECT).

Controversy: Although DaTscan SPECT can detect dopamine deficiency, it may not be necessary in most of the patients with a reasonably certain or clear clinical diagnosis made based on clinical presentation, monitoring of initial responses to medications, and more prolonged follow-up.

Key Questions:

  • Is DaTscan SPECT an accurate diagnostic test for detection of PD?
  • What effect does DaTscan SPECT have on clinical management and health outcomes?
  • Are there any safety issues associated with DaTscan SPECT for diagnosis or management of PD?
  • Have definitive patient selection criteria been identified for use of DATscan SPECT for diagnosis and management of PD?

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