123I-Ioflupane Imaging in Parkinsonian Syndromes

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after February 10, 2026:

Nuclear Medicine Technology: 2.00
Procedures: 2.00
Other Imaging Procedures: 2.00

Outline

1. Introduction
2. Epidemiology
3. Pathophysiology
4. Clinical Presentation, Diagnosis, and Management
5. Indications for Dopamine Transporter Imaging
6. Clinical Impact on Diagnosis and Management of Parkinsonism
7. Radiopharmaceutical Properties and Adverse Reactions
8. Patient Preparation and Imaging Protocol
9. Interpretation of Dopamine Transporter SPECT
10. Pitfalls
    1. Motion Artifact
    2. Poor Patient Positioning
    3. Scaling Artifact
    4. Off-Peak Acquisition
    5. Prior Cerebral Infarction
11. Reporting
12. Alternatives to 123I-Ioflupane Imaging
13. Parkinsonian Syndromes: Additional Imaging Assessment
14. Conclusion

Objectives

Upon completion of this course, students will:

1. identify the conditions that are not considered a Parkinson-plus syndromes
2. understand how ¹²³I ioflupane SPECT imaging differentiates parkinsonian syndromes
3. describe what factors are associated with an increasing prevalence of PD
4. understand which factors are thought to contribute to PD
5. list the risks associated with developing PD
6. identify nonmotor symptoms of PD
7. list the medical management options available to treat symptoms associated with PD
8. identify diseases and conditions with abnormal dopamine transporter imaging
9. understand what benefits are offered with dopamine transporter SPECT imaging
10. describe the physical properties of ¹²³I
11. identify some issues that should be considered regarding the use of ¹²³I-ioflupane in patients with renal impairment
12. explain how breastfeeding should be managed after ¹²³I-ioflupane administration
13. list medications that should be held prior to dopamine transporter imaging with ¹²³I-ioflupane include
14. list thyroid blockade medications that can be administered prior to ¹²³I-ioflupane administration
15. understand the activity dose range for ¹²³I-ioflupane administration
16. describe the appearance of a normal dopamine transporter SPECT scan
17. describe the progression of striatum affected during the early stages of PD
18. identify the FDA-approved method for interpreting dopamine transporter SPECT images
19. explain artifacts that may produce a semicolon sign on dopamine transporter SPECT imaging
20. describe the most effective method for identifying motion artifacts during dopamine transporter SPECT
21. identify a pitfall that could lead to a false-positive result due to intense salivary gland uptake
22. explain how off-peak errors can occur in dopamine transporter SPECT imaging
23. describe how prior a striatal infarct can lead to a false-positive interpretation
24. list the parameters that should be included within the imaging report
25. describe an alternate FDA-approved imaging agent for evaluating nigrostriatal degeneration
26. list an imaging technique that may help differentiate PD and DLB from other Parkinson-plus syndromes
27. identify an imaging technique that can help differentiate Parkinsonian syndromes from nonparkinsonian causes