Dopamine Transporter Imaging Workshop - Toulouse
By Olivier Rascol, MD, PhD
Professor of Clinical Pharmacology in Toulouse University Hospital; Chair
The MDS-ES Workshop on Dopamine Transporter (DTI) in Neurological Practice was held in Toulouse, France on December 5, 2008. The aim of this course was to familiarize Neurologists and Nuclear Medicine doctors with the SPECT technique when used for diagnostic purposes in the management of patients with Movement Disorders and parkinsonian motor and non-motor (cognitive) symptoms.
Both theoretical (description of PD features and related diagnostic issues, selection of patients for appropriate indications of the exam, advantages and limitations…) and practical (data acquisition, analysis and interpretation…) aspects were covered during this full-day course.
The course was organized by the Toulouse Movement Disorders Unit (Prof. O. Rascol) and the Toulouse Nuclear Medicine Department (Dr. P. Payoux). It took place in the Toulouse-Purpan University Hospital. Several distinguished European experts in the field of Movement Disorders were kind enough to come to Toulouse for the purpose of the course and to participate as Faculty members. They were: Prof. W. Oertel, Marburg, Germany; Prof. W. Poewe, Innsbruck, Austria; Prof. P. Rémy, Paris, France; Prof. E. Tolosa, Barcelona, Spain. Twenty-five young neurologists participated in this workshop, coming from countries such as France, Estonia, Armenia, Moldova, Tunisia, Morocco, and Saudi Arabia.
During the morning session, lectures were given in the library of the Department of Neurology. Prof. W. Poewe spoke on the diagnosis of motor aspects in Parkinson’s disease, while Dr J. Pariente (Toulouse, France) covered the diagnosis of non-motor aspects, particularly cognition, in Parkinson’s disease. Prof. P. Rémy then presented the theoretical and technical aspects of dopamine transporter imaging in humans and Prof. E. Tolosa discussed the role of dopamine transporter imaging in the diagnosis of patients with parkinsonism and/or dementia.
At the end of the morning session, Prof. W. Oertel, Prof. O. Rascol and Dr. C. Brefel-Courbon (Toulouse, France) worked with the audience to analyze 10 video cases of patients with involuntary abnormal movements or cognitive impairment leading to differential diagnostic problems with Parkinson’s disease (essential tremor, psychogenic parkinsonism, drug-induced parkinsonism, Alzheimer’s disease…). These practical cases showed the place and the role of DTI as a complement to clinical investigations in the broad diagnostic strategy of difficult cases in Movement Disorders.
During the afternoon, participants moved to the Department of Nuclear Medicine and were divided into small groups of 5 people. Each group was coordinated by a specialist in neuro-imaging techniques – Dr. P. Payoux, Dr. E. Guedj, Dr. C. Brefel-Courbon, Dr. T. Wagner, Prof. P. Remy - who explained, using a computer, the practical aspects of DTI using SPECT (patient’s preparation, set-up, data acquisition, data processing and analysis, image interpretation…). Participants were allowed to review images of DATScans and discuss possible diagnoses with the neuro-imaging specialists. Summary and conclusions of the workshop were then shared by the audience with the Faculty.