Nigrostriatal Imaging with Dopamine Transporter SPECT

An update on nigrostiatal dopamine terminal imaging with emphasis on SPECT performed with the presynaptic dopamine transporter ligand.

Course ID: Q00394 Category:


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Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after May 9, 2023:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

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

Registered Radiologist Assistant: 2.25
Safety: 0.25
Patient Safety, Radiation Protection, and Equipment Operation: 0.25
Procedures: 2.00
Neurological, Vascular, and Lymphatic Sections: 2.00


  1. Introduction
  2. Proof of Neurodegenerative PS
  3. Early Diagnosis of Neurodegenerative PS
    1. Assessment of Disease Progression
    2. Differential Diagnosis Between Neurodegenerative Types of PS
  5. Proof of Symptomatic Parkinsonism
    1. Tremor Syndromes
    2. Vascular PS
    3. Drug-Induced PS
    4. Psychogenic PS
    5. Normal-Pressure Hydrocephalus
    6. Dopa-Responsive Dystonia (DRD
  6. Differential Diagnosis of DLB
  7. Selected Methodologic Considerations
  8. Economic Considerations
  9. Conclusion


Upon completion of this course, students will:

  1. know the anatomical structures targeted by 123I-FP-CIT
  2. discuss the various key functions that can be assessed with radioligant imaging
  3. understand the physiologic process of DAT
  4. identify the various reasons why the diagnosis of PD is clinically difficult
  5. be familiar with the first structure affected by the loss of dopaminergic neurons
  6. understand the distribution of 123I-FP-CIT on a positive study
  7. discuss what marked loss of striatal DAT binding indicates for a clinical patient
  8. identify the threshold of nigrostriatal neuron loss where clinical symptoms appear
  9. be familiar with SWEDD patients and why they are unique in 123I-FP-CIT imaging
  10. discuss the possible cause of SWEDD
  11. discuss the differences between SWEDD patients and patients with classic PD
  12. promote knowledge of disease progression for SWEDD patients as it compares to PS
  13. be familiar with the differences between aPS and PD in terms of unique results of long term follow-up
  14. understand the differences with annual rates of disease progression for early versus late stage patients
  15. identify other imaging methods that can aid in the diagnosis of disease
  16. understand the course of care when a study is reported as normal
  17. understand unique characteristics of ET that make it different from other forms of tremor
  18. understand the qualities and shortcomings of 123I-FP-CIT in the differentiation of disease
  19. know orthostatic tremor symptoms as they relate to other forms of tremor
  20. know the symptoms associated with vascular PS
  21. understand the effects of neuroleptic drugs and how they can induce parkinsonian symptoms
  22. know gait disturbances that affect patients with Normal-Pressure Hydrocephalus
  23. understand diseases that resemble PD in their symptoms
  24. understand how 123I-FP-CIT can be used to differentiate DLB from Alzheimer Disease
  25. understand how 123I-FP-CIT can be used to differentiate PS from Psychogenic PS
  26. be familiar with the length of time needed for medication withholding prior to imaging
  27. know the proper means of reducing radiation exposure to patients undergoing imaging
  28. understand the appropriate action in the event of a hypersensitivity reaction
  29. understand the required licensure for the handling and administration of 123I-FP-CIT
  30. be familiar with the manufacturer recommended wait time prior to the start of 123I-FP-CIT imaging