Objective: To evaluate the diagnostic value and capability of DaT scan to increase clinical confidence in order to confirm/rule out the diagnosis, change management and may give sense to recommend further more specific workup, as well as to share our institutional experience with others.

Background: The functional imaging technique dopamine-transporter SPECT (DaT scan) has been established since long time back and proved as a useful tool in differentiating parkinsonism syndromes due to nigrostriatal degeneration from non-degenerative causes. An accurate diagnosis is a very important for timely and adequate treatment in patients with clinically uncertain and suspected for Parkinsonism disease.

Methods: A retrospective evaluation of (66) consecutive patients (32 Females and 34 males), ranging age of (33 to 80 years old) with mean age of (60 year old). All who underwent DaT scan during 2 years in our institution, between December 2015 and December 2017. The patients’ demographics, symptoms, suspected clinical diagnosis, and medications were collected. The patients were prepared and images has acquired according SNM guideline protocol. Subsequently, the scan findings were reviewed and were reported visually in coherent with DaT quant semi quantitative scale as follows: Symmetrical normal; Asymmetrical abnormal of the DaT tracer uptake in the nigrostriatal hemispheric nuclei (unilateral and/or bilateral involvement).

Results: There was an overall increase in confidence of clinical diagnosis after DaT scan evaluation. Physicians stated that, the DaTscan was matched to their clinical diagnosis, confirmed and ruled out of 48.5% and 50.8% respectively of the patients with neurodegenerative Parkinsonism diseases. As well as, they stated, DaTscan was helped them to recommended further clinical studies in 6% of patient with asymmetrical abnormal scan results, in order to distinguish and determine the other type of neurodegenerative Parkinsonism Syndromes. The diagnostic limitation of DaT scan have been shown in 4.5% of patients with symmetrical normal scan results but clinically had the disease based on their clinical criteria.

Conclusions: The DaT scan can be used as a valuable diagnostic tool to help to confirm or rule out clinical diagnosis of the neuro-degenerative Parkinson’s diseases in patients with unclear or confused clinical signs and symptoms, with high confidence and diagnostic capability of (91%) sensitivity, (100%) specificity, (91%) negative predictive value, (100%) positive predictive value and (95%) accuracy.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/diagnostic-value-and-capability-of-dat-dopamine-transporter-sepct-scan-to-assess-clinically-uncertain-parkinsonism-diseases-as-a-single-institutional-experience-in-kuwait-population/