MNJ (Malang Neurology Journal)
Vol. 12 No. 1 (2026): January

TECHNETIUM-99M TRODAT-1 NEUROMOLECULAR IMAGING FOR PARKINSONIAN SYNDROME: FIRST EXPERIENCE IN INDONESIAN PUBLIC HOSPITAL

Aliwarga, Randy (Unknown)
Kusumahstuti, Kharisma Perdani (Unknown)
Nugrahadi, Trias (Unknown)
Kartamihardja, Achmad Hussein Sundawa (Unknown)



Article Info

Publish Date
19 Feb 2026

Abstract

Background: Parkinsonian syndromes are characterized by progressive motor impairment resulting from nigrostriatal dopaminergic degeneration. Although diagnosis is primarily clinical, early disease stages often overlap with non-parkinsonian disorders, leading to misclassification. Dopamine transporter (DaT) imaging provides an objective biomarker for confirming presynaptic dopaminergic loss. However, the only internationally approved tracer, Iodine-123 ioflupane (DaTscan™), remains unavailable in Indonesia due to the absence of high-power cyclotron facilities and logistical constraints. Technetium-99m TRODAT-1, a generator-based alternative, offers a practical solution for countries with limited nuclear infrastructure. Objective: Two patients with confirmed Parkinson’s disease (A, B) underwent brain SPECT/CT imaging using 99mTc-TRODAT-1. Radiotracer preparation followed standard reconstitution and autoclaving procedures, achieving >95% radiochemical purity. Images acquired four hours post-injection were evaluated visually using the Fabiani scale to assess DaT binding patterns. Results: Patient A demonstrated asymmetric uptake loss in the posterior putamen consistent with mid-stage PD, while Patient B exhibited near-complete absence of striatal binding with increased extra-striatal activity, typical of advanced PD with cognitive decline. Both cases confirm that TRODAT-1 provides reliable visualization of nigrostriatal degeneration and remains technically feasible for local production and distribution. Conclusion: 99mTc-TRODAT-1 represents a viable and diagnostically robust DaT imaging option for Indonesia, offering both clinical accuracy and logistical practicality. Broader implementation could substantially improve diagnostic precision and disease staging in parkinsonian syndromes nationwide.

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Journal Info

Abbrev

MNJ

Publisher

Subject

Neuroscience

Description

Malang Neurology Journal is a peer-reviewed and open access journal that focuses on promoting neurological sciences generated from basic neurosciences and clinical neurology. This journal publishes original articles, reviews, and also interesting case reports. Brief communications containing short ...