The role of radiotracer imaging in Parkinson disease
- 25 January 2005
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurology
- Vol. 64 (2), 208-215
- https://doi.org/10.1212/01.wnl.0000149403.14458.7f
Abstract
Radiotracer imaging (RTI) of the nigrostriatal dopaminergic system is a widely used but controversial biomarker in Parkinson disease (PD). Here the authors review the concepts of biomarker development and the evidence to support the use of four radiotracers as biomarkers in PD: [18F]fluorodopa PET, (+)-[11C]dihydrotetrabenazine PET, [123I]β-CIT SPECT, and [18F]fluorodeoxyglucose PET. Biomarkers used to study disease biology and facilitate drug discovery and early human trials rely on evidence that they are measuring relevant biologic processes. The four tracers fulfill this criterion, although they do not measure the number or density of dopaminergic neurons. Biomarkers used as diagnostic tests, prognostic tools, or surrogate endpoints must not only have biologic relevance but also a strong linkage to the clinical outcome of interest. No radiotracers fulfill these criteria, and current evidence does not support the use of imaging as a diagnostic tool in clinical practice or as a surrogate endpoint in clinical trials. Mechanistic information added by RTI to clinical trials may be difficult to interpret because of uncertainty about the interaction between the interventions and the tracer.Keywords
This publication has 56 references indexed in Scilit:
- Molecular Pathways of Neurodegeneration in Parkinson's DiseaseScience, 2003
- Positron emission tomography and its use to image the occupancy of drug binding sitesDrug Development Research, 2003
- Biomarkers and surrogate endpoints: Preferred definitions and conceptual frameworkClinical Pharmacology & Therapeutics, 2001
- Effect of treatment withL-dopa/carbidopa orL-selegiline on striatal dopamine transporter SPECT imaging with [123I]?-CITMovement Disorders, 1999
- Regional dopamine transporter gene expression in the substantia nigra from control and Parkinson's disease brainsJournal of Neurology, Neurosurgery & Psychiatry, 1998
- Differential diagnosis of parkinsonism with [18F]fluorodeoxyglucose and PETMovement Disorders, 1998
- Complementary PET studies of striatal neuronal function in the differential diagnosis between multiple system atrophy and Parkinson's diseaseBrain, 1997
- Mathematical tools for demonstrating the clinical usefulness of biochemical markersScandinavian Journal of Clinical and Laboratory Investigation, 1997
- Dopamine transporter messenger RNA in Parkinson's disease and control substantia nigra neuronsAnnals of Neurology, 1994
- Striatal hypometabolism distinguishes striatonigral degeneration from Parkinson's diseaseAnnals of Neurology, 1993