Impact of DaTscan in the Clinical Evaluation of Patients with Diagnostically Uncertain Parkinsonism

Abstract

Abstract
Functional imaging of presynaptic dopamine receptor transporter using DaTscan defines the integrity of the dopaminergic system in the niagrostriatum. It is a valuable diagnostic adjunct to supplement the diagnosis of clinically uncertain Parkinsonism. We conducted a retrospective audit to study the role of DaTscan in the diagnosis and management of patients with clinically uncertain Parkinsonism.

Methods
Case notes of patients who underwent DaTscan over a period of two years (April 2009 - April 2011) were reviewed. We looked at indications for DaTscan, any change in diagnosis and management following DaTscan and complications related to it.

Results
62 patients had DaTscan. Majority was elderly male 88.7% patients were referred from neurology clinics. Commonest indication (77.5%) of DaTscan was to confirm or exclude a diagnosis of Parkinson’s disease. DaTscan was abnormal in 60% cases. In 59.6% cases DaTscan confirmed the pre-DaTscan diagnosis and in 35.4% cases the diagnosis was changed following the scan. DaTscan led to change in treatment in 62.9% cases. No complications related to DaTscan noted.

Conclusion
DaTscan proves to be an important objective tool in the clinical evaluation of diagnostically uncertain Parkinsonism and rationalizes the appropriate management. It seems to be an underutilised tool in elderly medicine.