March 1, 2012 Saint Peter's Healthcare System Community Calendar Featured Article.

At Saint Peter’s University Hospital, the latest technology is helping to diagnose Parkinson’s disease. With the use of the imaging drug Ioflupane I123, also called DaTscan, doctors are able to get an accurate picture of how well the body uses dopamine, the chemical the body needs to control movement.

When Ioflupane, a radiopharmaceutical used in nuclear medicine, is injected into the body, it is possible for a special camera to take pictures of the brain, specifically the area of the brain where dopamine is found. The imaging process is called SPECT – Single Photon Emission Computer Tomography. It is the SPECT technology that makes it possible to create 3-dimensional images of the brain which are then used to create the final transverse images read by radiologists.

The challenge for physicians is to differentiate Parkinsonian syndromes from other conditions that mimic it. While the symptoms are similar, treatment and management greatly differ. Having another diagnostic tool to help rule out one of these conditions will be tremendously helpful in reaching an appropriate and timely diagnosis for patients.

Nanik Khiamal, lead nuclear medicine technologist, views brain scans in the Radiology Department at Saint Peter’s University Hospital.

Parkinson’s Disease

According to the National Parkinson Foundation, 50,000 to 60,000 new cases of Parkinson’s disease are diagnosed each year in the U.S. Although stiffness can be a symptom, patients who have Parkinson’s usually cope with uncontrolled movement of the body or tremors. Symptoms flare up because the brain is not getting enough of the dopamine it needs. This in turn affects the ability of the brain to control movement and other muscle functions.

The Scan

In order to protect the thyroid from unnecessary radiation, an oral liquid medication is given to the patient. The radiopharmaceutical used for the scan is iodine-based and could be absorbed by the thyroid. The medication blocks the absorption of the radiopharmaceutical in the thyroid but does not block the absorption in the area of interest in the brain. An hour after the oral medication is ingested by the patient, the radio- pharmaceutical is injected through an intravenous (IV) line in the arm. It must be distributed through the patient’s body and absorbed by the area of interest in the brain. This process takes a minimum of three hours.

When the patient is ready for the imaging portion of the study, he/she is placed on a table with a camera positioned over his/ her head. The patient’s head is placed in a special holder to assist in maintaining his/her position and restrict movement which is an essential part of obtaining the study. The imaging portion of the test lasts approximately 30 minutes.

Before this new procedure, an accurate diagnosis for patients with a neurodegenerative movement disorder, such as Parkinson’s disease, could have taken up to six years.

This new imaging technology is a step in the right direction for timely and accurate diagnosis of Parkinson’s disease.

What is Parkinson’s disease?

Parkinson’s disease (PD) is a neurodegenerative brain disorder that progresses slowly in most people. It is one of several Parkinsonian syndromes. Patients can live with the condition for 20 years or more. While Parkinson’s disease itself is not fatal, complications from the disease can be. While there is no cure, treatment is available to help control symptoms.

Brain cells, called neurons, produce a chemical called dopamine in a specific part of the brain called the substantia nigra. Dopamine helps humans to have smooth coordinated muscle movements. When approximately 60 to 80% of the dopamine-producing cells are damaged, and do not produce enough dopamine, the symptoms of Parkinson’s disease appear, specifically body tremors.

Source: National Parkinson Foundation

Call 732-745-8600, ext. 6517 for radiology scheduling. Visit www.saintpetershcs.com/radiology to learn about radiology services at Saint Peter’s.