We read with interest the article by Ribeiro et al.1 Although the 18F-dopa positron emission tomographic (PET) scan is the current imaging gold standard for the diagnosis of early Parkinson disease (PD) and for measuring disease progression in clinical trials, the authors concluded that the ligand, 76Br-FE-CBT, that binds to the dopamine transporter (DAT) may be more suitable for detecting cases of early PD and assessing disease progression than 18F-dopa. This is because 18F-dopa uptake depends not only on the density of dopaminergic terminals in the striatum but also on dopamine turnover, which may be compensatorily increased in early PD.2,3 Thus, 18F-dopa uptake might overestimate the number of striatal dopaminergic nerve terminals in these patients.
Fernandez HH, Friedman JH. 18F-Dopa vs Dopamine Transporter Ligands in Positron Emission Tomographic and Single-Photon Emission Computed Tomographic Scans for Parkinson Disease. Arch Neurol. 2002;59(12):1973. doi:
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