. 2016 Aug;16(4):371–375. doi: 10.7861/clinmedicine.16-4-371

Box 1.

Use of neuroimaging in Parkinson’s disease clinical practice.

In clinical practice, no neuroimaging modalities are currently recommended for routine use.

Structural MRI

Brain MRI is helpful to detect cerebrovascular damages and to quantify brain atrophy in patients with parkinsonism. MRI is needed to identify the presence of a structural lesion (or lesions) that may cause or contribute to parkinsonism, gait disorder and tremor and should be considered in differential diagnosis between PD and other types of parkinsonism.

SPECT

DaTSCAN^TM SPECT should be considered in differential diagnosis between degenerative and nondegenerative parkinsonism in patients with tremor (Box 2). Cardiac ¹²³I-mIBG SPECT and ¹⁸F-FDG PET scanning should be considered in differential diagnosis between PD and atypical forms of degenerative parkinsonism (MSA-P, PSP).

¹²³I-mIBG = ¹²³I-metaiodobenzylguanindine; ¹⁸F-FDG = ¹⁸F-fludeoxyglucose; DaTSCAN^TM = ¹²³I-ioflupane; MRI = magnetic resonance imaging; MSA-P = multiple system atrophy parkinsonian type; PD = Parkinson’s disease; PET = positron emission tomography; PSP = progressive supranuclear palsy; SPECT = single-photon emission computed tomography.