Clinical Utility Of (Tc-99m)-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 (Tc-99m)-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 (Tc-99m)-TRODAT-1 scans are described. From experience overseas, the (Tc-99m)-TRODAT-1 scan has clinical utility in the differential diagnosis of Parkinsonian syndromes. (Tc-99m)-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. (Tc-99m)-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.