DaTscan

Indications:
DaTscan (Ioflupane I 123 Injection) is a radiopharmaceutical indicated for striatal dopamine transporter visualization using single photon emission computed tomography (SPECT) brain imaging to assist in the evaluation of adult patients with suspected Parkinsonian syndromes (PS). DaTscan may be used to help differentiate essential tremor from tremor due to PS (idiopathic Parkinson's disease, multiple system atrophy and progressive supranuclear palsy)
Contraindications:
DaTscan is contraindicated in patients with known hypersensitivity to the active substance, any of the excipients, or iodine.
Patient utilizing any of the following drugs that may affect the results of the scan and therefore the scan should not be conducted: Amoxapine, amphetamine, benztropine, bupropion, buspirone, cocaine, mazindol, methamphetamine, methylphenidate, norephedrine, phentermine, phenylpropanolamine, selegiline, sertraline, citalopram and paroxetine
Questions asked in Patient History:
Are you pregnant or nursing?
Do you have any Hx of Kidney or Liver disease?

Radiopharmaceutical information:
DaTscan is a federally controlled substance (Schedule II). A DEA license is required for handling or administering this controlled substance.

  • Radionuclide:I-123
  • Radiopharmaceutical: Ioflupane I 123 Injection
  • Adult dosing: 3-5 mCi SSKI administered 1 hr prior to injection
  • Pediatric dosing: Not to be used in Pediatrics
  • Method of administration: IV slow injection over 15-20 sec
  • Method of Localization: Receptor binding to the dopamine transporter
  • Physical Half-life: 13.1 hrs

Patient Preparation:

Patient must stop the following drugs:
Amoxapine, amphetamine, benztropine, bupropion, buspirone, cocaine, madindol, methamphetamine, methylphenidate, norephedrine, phentermine, phenylpropanolamine, selegiline, sertraline, citalopram and paroxetine
Side Effects:

Will the patient feel any different during or after the procedure?

Patient should not feel different during or after a normal reaction to the procedure, but adverse reactions can occur in hypersensitive patients. In only 1% of observed patients was there an adverse reaction. Side Effects included headache, nausea, vertigo, dry mouth and dizziness.

Equipment Used:
SPECT Dual headed Gama camera
LEHR

Acquisition Setup:

Photopeak(s): 159keV

Window(s): 15%


SPECT:
180 degree configuration
Total Rotation: 360
Starting point: 0
Matrix:128x128
Time/Azimuths: 30sec/frame
Number of Azimuths: minimum of 60azimuths per Gama camera detector head
1.23 Zoom

Processing:
Filter: 2-D butterworth pre-filter
Cut-off: 0.6
Frequency:power factor 8

Procedure:
Administer SSKI ( or any other drug to protect thyroid) at least 1 hour before radiopharmeceutical is injected
Administer 3-5mCi slowly through IV over 15-20 seconds
After 3-6 hours image patient this will take about 30min

Normal Uptake and common variants:
N1.gifNormal quotation symmetry bilaterally

Abnormal Uptake and causes:
ABn.gif
Decreased uptake in left putnam while is seems that the right putnam has slight decreased activity as well. The activity is confined to the caudate nuclei bilaterally.

Artifacts:
Artifact_Dat.jpg Incorrect Energy window outside 10%

Normal_Dat.jpg NORMAL ENERGY WINDOW



References:
http://us.datscan.com
Procedures Slides