Diagnostic accuracy of cardiac metaiodobenzylguanidine scintigraphy in Parkinson disease

Sawada, Hideyuki; Oeda, Tomoko; Yamamoto, Kenji; Kitagawa, Naoki; Mizuta, Eiji; Hosokawa, R.; Ohba, Muneo; Nishio, Ryo; Yamakawa, Katsutoshi; Takeuchi, Hiroaki; Shimohama, Shun; Takahashi, Ryuji; Kawamura, Tetsuya

doi:10.1111/j.1468-1331.2008.02372.x

Cited by 78 publications

(67 citation statements)

References 28 publications

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“…For MIBG scintigraphy, the overall H/M ratio (1.34) of the PD patients in the present study confirms previous results reporting H/M ratios between 1.19 and 1.57 depending on disease duration, PD subtype, and (probably) also on the exact method of quantification such as size, shape, and positioning of ROIs and the use of maximum compared with mean count values (15,28,(37)(38)(39). Nevertheless, in any case considerable overlap exists for the PD-APD differentiation, suggesting also that MIBG scintigraphy alone is not sufficient to distinguish these entities and that low MIBG uptake alone does not necessarily indicate PD (40).…”

Section: Cardiac Mibg Uptakesupporting

confidence: 80%

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Diagnostic Accuracy of Combined FP-CIT, IBZM, and MIBG Scintigraphy in the Differential Diagnosis of Degenerative Parkinsonism: A Multidimensional Statistical Approach

Südmeyer

Antke²,

Zizek³

et al. 2011

J Nucl Med

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In vivo molecular imaging of pre-and postsynaptic nigrostriatal neuronal degeneration and sympathetic cardiac innervation with SPECT is used to distinguish idiopathic Parkinson disease (PD) from atypical parkinsonian disorder (APD). However, the diagnostic accuracy of these imaging approaches as standalone procedures is often unsatisfying. The aim of this study was therefore to evaluate to which extent diagnostic accuracy can be increased by their combined use together with a multidimensional statistical algorithm. Methods: The SPECT radiotracers 123 , and meta-123 I-iodobenzylguanidine (MIBG) were used to assess striatal postsynaptic D 2 receptor binding, striatal presynaptic dopamine transporter binding, and myocardial adrenergic innervation, respectively. Thirty-one PD and 17 APD patients were prospectively investigated. PD and APD diagnoses were established using consensus criteria and reevaluated after 37.4 6 12.4 and 26 6 11.6 mo in PD and APD, respectively. Test accuracy (TA) for PD-APD differentiation was computed for all logical (Boolean) combinations of imaging modalities by receiver-operating-characteristic analysis-that is, after multidimensional optimization of cutoff values. Results: Analysis showed moderate TA for PD-APD differentiation using each molecular approach alone (IBZM, 79%; MIBG, 73%; and FP-CIT, 73%). For combined use, the highest TA resulted under the assumption that at least 2 of the 3 biologic markers had to be positive for APD using the following cutoff values: 1.46 or less for IBZM, less than 2.10 for FP-CIT, and greater than 1.43 for MIBG. This algorithm distinguished APD from PD with a sensitivity of 94%, specificity of 94% (TA, 94%), positive predictive value of 89%, and negative predictive value of 97%. Conclusion: Results suggest that the multidimensional combination of FP-CIT, IBZM, and MIBG scintigraphy is likely to significantly increase TA in differentiating PD from APD. The differential diagnosis of degenerative parkinsonism may thus be facilitated.

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Section: Cardiac Mibg Uptakesupporting

confidence: 80%

“…Similarly, scintigraphy with meta-123 I-iodobenzylguanidine (MIBG) has recently attracted interest in this context, because it also may differentiate APD and PD based on displaying pronounced cardiac sympathetic denervation in PD (15).…”

mentioning

confidence: 99%

Diagnostic Accuracy of Combined FP-CIT, IBZM, and MIBG Scintigraphy in the Differential Diagnosis of Degenerative Parkinsonism: A Multidimensional Statistical Approach

Südmeyer

Antke²,

Zizek³

et al. 2011

J Nucl Med

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“…In their study, Kashihara et al found that 123 I-MIBG myocardial uptake was lower in patients with a long history of PD and the duration of the illness was inversely correlated with the H/M ratio (18). Our data suggest that myocardial sympathetic impairment detectable in PD remains with a worsening in the disease course over time (23). However, such a correlation is controversial (24).…”

mentioning

confidence: 81%

Different patterns of cardiac sympathetic denervation in tremor-type compared to akinetic-rigid-type Parkinson’s disease: Molecular imaging with 123I-MIBG

Chiaravalloti

Tavolozza

Pierantozzi

et al. 2012

Molecular Medicine Reports

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“…We chose to examine only individuals who did not use anti-PD drugs. Furthermore, although some authors consider not to exist any influence of the anti-PD drugs on the results of 123 I cMIBG , it was observed that selegiline increases the serum levels of norepinephrine 28 . Likewise, it was conjectured to have levodopa implication in changing the indexes and images concerning this exam 29 .…”

Section: Discussionmentioning

confidence: 99%

Cardiac 123I-MIBG uptake in de novo Brazilian patients with Parkinson's disease without clinically defined dysautonomia

Leite

Nascimento

Pereira

et al. 2014

Arq. Neuro-Psiquiatr.

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Myocardial scintigraphy with meta-iodo-benzyl-guanidine (123I cMIBG) has been studied in Parkinson's disease (PD), especially in Asian countries, but not in Latin America. Most of these studies include individuals with PD associated to a defined dysautonomia. Our goal is to report the cardiac sympathetic neurotransmission in de novo Brazilian patients with sporadic PD, without clinically defined dysautonomia. We evaluated retrospectively a series of 21 consecutive cases with PD without symptoms or signs of dysautonomia assessed by the standard bedside tests. This number was reduced to 14 with the application of exclusion criteria. 123I cMIBG SPECT up-take was low or absent in all of them and the heart/mediastinum ratio was low in 12 of 14. We concluded that 123I cMIBG has been able to identify cardiac sympathetic neurotransmission disorder in Brazilian de novo PD patients without clinically defined dysautonomia.

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Diagnostic accuracy of cardiac metaiodobenzylguanidine scintigraphy in Parkinson disease

Abstract: Although diagnostic accuracy of cardiac MIBG scintigram is high, it is limited because of insufficient sensitivity in patients with short duration.

Cited by 78 publications

References 28 publications

Diagnostic Accuracy of Combined FP-CIT, IBZM, and MIBG Scintigraphy in the Differential Diagnosis of Degenerative Parkinsonism: A Multidimensional Statistical Approach

Diagnostic Accuracy of Combined FP-CIT, IBZM, and MIBG Scintigraphy in the Differential Diagnosis of Degenerative Parkinsonism: A Multidimensional Statistical Approach

Different patterns of cardiac sympathetic denervation in tremor-type compared to akinetic-rigid-type Parkinson’s disease: Molecular imaging with 123I-MIBG

Cardiac 123I-MIBG uptake in de novo Brazilian patients with Parkinson's disease without clinically defined dysautonomia

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