Positron emission tomography/computed tomography (PET/CT) is a molecular imaging method commonly used to diagnose and differentiate Parkinson’s disease (PD). This study aimed to evaluate the performance of PET/CT with ¹¹C-2β-Carbomethoxy-3β-(4-fluorophenyl) tropane (¹¹C-CFT) and ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) tracers in the differential diagnosis between PD, multiple system atrophy parkinsonian type (MSA-P), progressive supranuclear palsy (PSP) and vascular parkinsonism (VP) using the data of 220 patients with clinical PD-like symptoms. Of the 220 enrolled patients, 166 (PD, n = 80; MSA-P, n = 54; PSP, n = 15; VP, n = 17) completed the motor, cognitive and PET/CT assessment and were included in this study. ¹¹C-CFT and ¹⁸F-FDG PET/CT images were analyzed using the SNBPI toolbox and CortexID Suite software. The uptake values of ¹¹C-CFT and ¹⁸F-FDG PET/CT were compared among the groups after controlling for covariates using generalized linear models. Receiver operating characteristic (ROC) curves were generated to estimate the diagnostic values. Patients with PSP showed the most significant reduction on ¹¹C-CFT PET/CT, while patients with PD and MSA-P showed similar reductions, and patients with VP did not show any significant reduction in ¹¹C-CFT uptake. The areas under the curve (AUCs) for ¹¹C-CFT PET/CT for distinguishing PD from VP, PSP, and MSA-P were 0.902, 0.830, and 0.580, respectively, and 0.728 for distinguishing advanced-stage PD from PSP. On ¹⁸F-FDG PET/CT, the AUCs for distinguishing PD from PSP and MSA-P were 0.968 and 0.963, respectively. These results suggest that ¹¹C-CFT and ¹⁸F-FDG PET/CT complement each other in improving the accuracy in differential diagnosis of PD.

正电子发射断层扫描/计算机断层扫描（PET/CT）是一种常用于诊断和鉴别帕金森病（PD）的分子成像方法。本研究旨在评估¹¹ C-2β-甲氧基-3β-(4-氟苯基)托烷 ( ¹¹ C-CFT) 和¹⁸ F-氟脱氧葡萄糖 ( ¹⁸ F-FDG) 示踪剂在鉴别诊断中的 PET/CT 性能使用 220 名具有临床 PD 样症状的患者的数据，对 PD、多系统萎缩性帕金森型 (MSA-P)、进行性核上性麻痹 (PSP) 和血管性帕金森病 (VP) 进行了分析。在 220 名入组患者中，166 名（PD， n = 80；MSA-P， n = 54；PSP， n = 15；VP， n = 17）完成了运动、认知和 PET/CT 评估并被纳入本研究。使用SNBPI工具箱和CortexID Suite软件分析¹¹ C-CFT和¹⁸ F-FDG PET/CT图像。使用广义线性模型控制协变量后，比较各组之间¹¹ C-CFT 和¹⁸ F-FDG PET/CT 的摄取值。生成受试者工作特征（ROC）曲线来估计诊断值。 PSP 患者在¹¹ C-CFT PET/CT 上表现出最显着的降低，而 PD 和 MSA-P 患者表现出类似的降低，而 VP 患者在¹¹ C-CFT 摄取方面没有表现出任何显着降低。 ¹¹ C-CFT PET/CT 区分 PD 与 VP、PSP 和 MSA-P 的曲线下面积 (AUC) 分别为 0.902、0.830 和 0.580，区分晚期 PD 与 PSP 的曲线下面积 (AUC) 分别为 0.728。 在¹⁸ F-FDG PET/CT 上，区分 PD 与 PSP 和 MSA-P 的 AUC 分别为 0.968 和 0.963。这些结果表明¹¹ C-CFT 和¹⁸ F-FDG PET/CT 在提高 PD 鉴别诊断的准确性方面相辅相成。