Objective: This study was a retrospective chart review of patients who underwent DAT-SPECT imaging for parkinsonism while on drugs listed as potentially interacting with the accuracy of DAT-SPECT tracer uptake. The purpose of this study is to better inform movement disorders specialists and the general medical community of specific risks to quality and accuracy of DaTscan imaging based on specific medications of interest.

Background: Parkinson’s disease (PD) is characterized pathologically by early loss of dopaminergic neurons. DAT-SPECT imaging is approved as a diagnostic tool for the evaluation of suspected Parkinsonian syndromes, but the FDA approved package insert lists 16 potential drugs that may interfere with the image obtained. The clinical impact of these drugs upon imaging results has not been established, nor is it a universal practice to stop these drugs when ordering a DaTscan. This study aims to determine the accuracy of DAT-SPECT imaging in assessing presynaptic dopaminergic denervation in the setting of drugs that may interfere with scan results.

Method: This is a retrospective chart review of patients at a single center who underwent DAT-SPECT imaging while taking “contraindicated” drugs between December 2012 to December 2022. This was accomplished by reviewing scan results as being consistent or inconsistent with a diagnosis of PD and then comparing the initial diagnosis with a clinical follow-up to assess whether the scan results match the clinical outcomes. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each drug.

Results: A total of 1224 charts were screened, and 153 (12.5%) charts met the inclusion criteria. Bupropion (32%, n=49) and sertraline (26%, n=40) were the most common contraindicated drugs. The false positive rate was 9.2%.

Conclusion: This retrospective analysis supports the concern that certain drugs may interfere with DaTscan results, leading to the potential for false positives. This has implications for how clinicians interpret DaTscans in patients taking these drugs, and whether they advise patients to stop these drugs before a scan is performed.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-impact-of-drug-interactions-on-the-results-of-dat-spect-imaging-in-a-specialty-movement-disorders-practice-a-retrospective-analysis-of-outcomes/