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Imaging of serotonin transporters with [123I]FP-CIT SPECT in the human hypothalamus

Anke J Borgers1*, Anneke Alkemade1, Elsmarieke M Van de Giessen2, Madeleine L Drent3, Jan Booij2, Peter H Bisschop1 and Eric Fliers1

Author Affiliations

1 Department of Endocrinology and Metabolism, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, Room F5-168, Amsterdam, 1105 AZ, The Netherlands

2 Department of Nuclear Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands

3 Department of Internal Medicine, Section of Endocrinology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands

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EJNMMI Research 2013, 3:34  doi:10.1186/2191-219X-3-34

Published: 25 April 2013



Serotonergic neurons in the rodent hypothalamus are implicated in key neuroendocrine and metabolic functions, including circadian rhythmicity. However, the assessment of the serotonergic system in the human hypothalamus in vivo is difficult as delineation of the hypothalamus is cumbersome with conventional region-of-interest analysis. In the present study, we aimed to develop a method to visualize serotonin transporters (SERT) in the hypothalamus. Additionally, we tested the hypothesis that hypothalamic SERT binding ratios are different between patients with hypothalamic impairment (HI), pituitary insufficiency (PI), and control subjects (C).


SERT availability was determined in 17 subjects (6 HI, 5 PI, and 6 healthy controls), 2 h after injection of 123I-N-ω-fluoropropyl-2β-carboxymethoxy-3β-(4-iodophenyl) nortropane ([123I]FP-CIT), using single-photon emission computed tomography (performed on a brain-dedicated system) fused with individual magnetic resonance imaging (MRI) scans of the brain. The hypothalamus (representing specific SERT binding) and cerebellum (representing nonspecific binding) were manually delineated on each MRI to assess [123I]FP-CIT binding and specific-to-nonspecific binding ratios.


In each healthy subject, [123I]FP-CIT binding was higher in the hypothalamus than in the cerebellum, and the mean hypothalamic binding ratio of SERT was 0.29 ± 0.23. We found no difference in hypothalamic binding ratios between HI, PI, and control subjects (HI 0.16 ± 0.24, PI 0.45 ± 0.39, C 0.29 ± 0.23, p value 0.281).


We were able to demonstrate SERT binding in the human hypothalamus in vivo. However, we did not find altered hypothalamic SERT binding in patients with hypothalamic impairment.

Trial registration

Netherlands Trial Register: NTR2520

Serotonin transporter imaging; [123I]FP-CIT; SPECT; Human; Pituitary insufficiency; Hypothalamus; SERT