Role of DaTSCAN and clinical diagnosis in Parkinson disease
- PMID: 22323748
- DOI: 10.1212/WNL.0b013e318248e520
Role of DaTSCAN and clinical diagnosis in Parkinson disease
Abstract
Objective: To assess the role of DaTSCAN in the diagnosis of Parkinson disease (PD).
Methods: Using the sensitivity and specificity values obtained in the 2 studies that recently led the US Food and Drug Administration to approve the use of DaTSCAN for the diagnosis of PD, calculations were carried out to estimate the accuracy of the clinical diagnosis taking DaTSCAN findings as the standard of truth.
Results: In early PD, a clinical diagnosis of "possible" or "probable" PD has a sensitivity of 98% and a specificity of 67%. The specificity increases to 94% once the clinical diagnosis becomes established. The overall accuracy of the clinical diagnosis is 84% in early PD and 98% at later stages. The clinical diagnostic accuracy is mathematically identical to the diagnostic accuracy of DaTSCAN imaging.
Conclusions: In the absence of neuropathologic validation, the overall accuracy of a clinical diagnosis of PD is very high and mathematically identical to the accuracy of DaTSCAN imaging, which calls into question the use of radiotracer neuroimaging as a diagnostic tool in clinical practice.
Comment in
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To scan or not to scan: DaT is the question.Neurology. 2012 Mar 6;78(10):688-9. doi: 10.1212/WNL.0b013e3182494c72. Epub 2012 Feb 8. Neurology. 2012. PMID: 22323757 No abstract available.
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Role of DaTSCAN and clinical diagnosis in PD.Neurology. 2012 May 8;78(19):1538-9; author reply 1589. doi: 10.1212/01.wnl.0000414832.22545.c3. Neurology. 2012. PMID: 22565571 No abstract available.
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Role of DaTSCAN and clinical diagnosis in Parkinson disease.Neurology. 2012 Oct 16;79(16):1744; author reply 1744. doi: 10.1212/01.wnl.0000422079.28545.80. Neurology. 2012. PMID: 23071169 No abstract available.
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