The combination of the 18F-FDG and 18F-FP-DTBZ PET for early diagnosis of cerebral glucose metabolism and dopaminergic dysfunction in Parkinson's disease

Abstract Objective: This study aimed to use ¹⁸F-FDG and ¹⁸F-FP-DTBZ PET to illustrate the correlation between cerebral glucose metabolism and nigrostriatal dopamine function and to investigate the precision of early Parkinson's disease (PD) diagnosis. Methods: 18 healthy control participants and 32 patients with early PD were recruited for ¹⁸F-FDG and ¹⁸F-FP-DTBZ PET scans. Results: Patients with PD exhibited significant ¹⁸F-FDG metabolic reduction in the frontal, parietal, and temporal cortex, as well as notable increased metabolism in the putamen, thalamus, pons, and cerebellum (all P < 0.05). Additionally, there was a notable reduction in ¹⁸F-FP-DTBZ uptake in the bilateral caudate, anterior putamen, and posterior putamen (all P < 0.005). The reduction of ¹⁸F-FP-DTBZ uptake in the bilateral caudate and anterior putamen positively correlated with the reduction in ¹⁸F-FDG uptake in the frontal cortical regions (r=0.352, 0.324, 0.300, and 0.314, respectively; all P < 0.05) and the parietal cortical regions (r=0.329, 0.303, and 0.330, respectively; all P < 0.05). The combination of the ¹⁸F-FDG and ¹⁸F-FP-DTBZ model exhibited the highest reliable prognostic performance, yielding an area under the curve of 0.979 (95% CI [0.948–1.00], P < 0.01). Conclusions: Our study suggested that ¹⁸F-FDG and ¹⁸F-FP-DTBZ PET imaging was an excellent tool in differentiating PD from normal aging in the early stage of the disease.