What is the role of positron emission tomography (PET) scanning in the workup of multiple system atrophy (MSA)?

Updated: Oct 17, 2018
  • Author: André Diedrich, MD, PhD; Chief Editor: Selim R Benbadis, MD  more...
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MSA can be differentiated from Parkinson disease with the use of FDG-PET scanning. The caudate-putamen index, which is calculated using a formula based on the difference in the uptakes in the caudate and putamen divided by the caudate uptake, is lower in patients with MSA than in patients with Parkinson disease. [36]

Expected findings in MSA are as follows:

  • Reduced putaminal FDG uptake

  • Reduced [11 C]raclopride and [11 C]diprenorphine levels

  • Reduced cerebellar glucose metabolism in OPCA

Absence of parkinsonian features but evidence of striatonigral dopaminergic denervation may point to MSA.

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