Comparison of 99mTc-TRODAT-1 SPECT and 18 F-AV-133 PET imaging in healthy controls and Parkinson's disease patients

Ing Tsung Hsiao, Yi Hsin Weng, Wey Yil Lin, Chia Ju Hsieh, Shiaw Pyng Wey, Tzu Chen Yen, Mei Ping Kung, Chin Song Lu, Kun Ju Lin*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

19 Scopus citations


99mTc-TRODAT-1 is the first clinical routine 99mTc radiopharmaceutical to evaluate dopamine neurons loss in Parkinson's disease (PD). 18F-AV-133 is a novel PET radiotracer targeting the vesicular monoamine transporter type 2 (VMAT2) to detect monoaminergic terminal reduction in PD patients. The aim of this study is to compare both images in the same health control (HC) and PD subjects. Methods: Eighteen subjects (8 HC and 10 PD) were recruited for 99mTc-TRODAT-1 SPECT, 18F-AV-133 PET and MRI scans within two weeks. The SPECT images were performed at 4-h post-injection for 45min, and the PET images were performed at 90min post-injection for 10min. Each PET and SPECT image was normalized into Montreal Neurological Institute template aided from individual MRI for comparison. For regional analysis, volume of interest (VOIs) of bilateral caudate nuclei, anterior, posterior putamen and occipital cortex (as reference region) were delineated from the normalized MRI. The specific uptake ratio (SUR) was calculated as (regional mean counts/reference mean counts-1). The nonparametric Mann-Whitney U test was used to evaluate the power of differentiating control from PD subjects for both image modalities. The correlations of the SURs to the clinical parameters were examined. For voxelwise analysis, two-sample t-test for group comparison between HC and PD was computed in both image modalities. Results: The SURs of caudate nucleus and putamen correlated well between two image modalities (r=0.81, p<0.001), and showed significant different between HC and PD subjects. Of note, the 18F-AV-133 SUR displayed a better correlation to PD clinical laterality index as compared to 99mTc-TRODAT-1 (r=0.73 vs. r=0.33). Voxelwise analysis showed more lesions for PD subjects from 18F-AV-133 image as compared to 99mTc-TRODAT-1 especially at the substantia nigra region. Conclusion: 18F-AV-133 PET demonstrated similar performance in differentiation PD from control, and a better correlation to clinical characteristics than that of 99mTc-TRODAT-1 SPECT. 18F-AV-133 PET also showed additional information in substantia nigra integrity in PD subjects by voxelwise analysis. Collectively, 18F-AV-133 could be a promising and better tracer for clinical use to detect monoaminergic terminal reduction in PD patients.

Original languageEnglish
Pages (from-to)322-329
Number of pages8
JournalNuclear Medicine and Biology
Issue number4
StatePublished - 04 2014


  • DAT
  • Parkinson's disease
  • VMAT2


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