Ioflupane (I-123)

Last revised by Francis Deng on 8 Nov 2023

Ioflupane (I-123) is a radiopharmaceutical for the diagnosis of Parkinson disease and its differential diagnoses, e.g. essential tremor versus tremor due to parkinsonian syndromes (idiopathic Parkinson disease, multiple system atrophy and progressive supranuclear palsy). 

  • iodine-123 is a cyclotron product

  • decay by electron capture to tellurium-123

  • physical half-life is 13.22 hours

  • predominant energy of its gamma spectrum is 159 keV

Ioflupane is the international non-proprietary name of the radiolabeled cocaine analog usually abbreviated to [123I]FP-CIT: N-(3-Fluoropropyl)-2β-carbomethoxy-3β-(4-[123I]iodophenyl)nortropane. I-123 ioflupane is available worldwide and marketed under the trade name DaTSCANTM.

Ioflupane has a high affinity for presynaptic dopamine transporters (DAT), which are abundant in the striatal region.

  • as a cyclotron product, the solution is supplied ready to inject

  • the dose reference activity of I-123 ioflupane is 185 MBq (5 mCi)

  • administration is intravenous

  • thyroid blocking with 120 mg potassium iodide 2 hours before and 24 hours after the injection is recommended

  • SPECT is typically performed 3-6 hours after injection

Reduced putaminal uptake as evidenced visually by the loss of the normal comma- or crescent-shaped uptake in the striatum and the appearance of abnormal period- or oval-shaped uptake in the caudate only is supportive of a diagnosis of a parkinsonian syndrome:

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Cases and figures

  • Case 1: normal scan
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  • Case 2a: normal scan
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  • Case 2b: normal scan
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