Potential Diagnostic Value of Regional Myocardial Adrenergic Imaging Using (123)I-MIBG SPECT to Identify Patients with Lewy Body Diseases

Overview

Journal Eur J Nucl Med Mol Imaging

Specialties Biophysics
Nuclear Medicine
Radiology

Date 2015 Jan 29

PMID 25626701

Citations 7

Authors

Adrien Lebasnier

Guillaume Lamotte

Alain Manrique

Damien Peyronnet

Gerard Bouvard

Gilles Defer

Denis Agostini

Affiliations

Soon will be listed here.

Abstract

Purpose: The aim of this study was to determine the potential diagnostic value of regional myocardial adrenergic (123)I-metaiodobenzylguanidine (MIBG) single photon emission computed tomography (SPECT) imaging to identify patients with Lewy body diseases (LBD+).

Methods: Sixty-four consecutive patients who underwent cardiac (123)I-MIBG SPECT to differentiate LBD+, including Parkinson's disease (PD) and dementia with Lewy bodies (DLB), from patients without LBD (LBD-) were retrospectively reviewed. A neurologist expert in memory disorders determined the final clinical diagnosis by using international clinical diagnostic criteria. Planar [heart to mediastinum ratio (HMR)] and (123)I-MIBG SPECT[(innervation defect score (IDS)] using the 17-segment left ventricular model (five-point scale) were obtained 4 h after the injection of (123)I-MIBG on a low-energy high-resolution (LEHR) collimator. Receiver-operating characteristic (ROC) analysis was performed to determine the optimal HMR and IDS cut-off values to discriminate LBD+ from LBD-.

Results: Of the 64 patients, 45 (70 %) were diagnosed LBD+ (DLB, n = 27; PD, n = 18) and 19 were diagnosed LBD- (5 other dementias, 14 other parkinsonisms). The HMR and IDS of LBD+ were significantly different from those of LBD- (1.30 ± 0.21 vs 1.65 ± 0.26, p < 0.001; 39 ± 28 vs 8 ± 16, p = 0.001). The optimal HMR and IDS cut-off values to discriminate LBD+ (n = 45) from LBD- (n = 19) were 1.47 and 6/68, providing a sensitivity and specificity of 82.2 and 84.2% and 86.7 and 73.7%, respectively.

Conclusion: Regional myocardial adrenergic (123)I-MIBG imaging SPECT has a potential diagnostic value to identify LBD+.

Citing Articles

[The clinical value of I-metaiodobenzylguanidine myocardial imaging in the diagnosis of dementia with Lewy bodies].

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Cardiac sympathetic innervation in Parkinson's disease versus multiple system atrophy.

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Uniformity of cardiac I-MIBG uptake on SPECT images in older adults with normal cognition and patients with dementia.

Roberts G, Lloyd J, Jefferson E, Kane J, Durcan R, Lawley S J Nucl Cardiol. 2019; 28(5):2151-2163.

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Can Biomarkers Help the Early Diagnosis of Parkinson's Disease?.

Le W, Dong J, Li S, Korczyn A Neurosci Bull. 2017; 33(5):535-542.

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References

Hughes A, Daniel S, Kilford L, Lees A . Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992; 55(3):181-4. PMC: 1014720. DOI: 10.1136/jnnp.55.3.181. View

Muxi A, Paredes P, Navales I, Valldeoriola F, Gaig C, Lomena F . Diagnostic cutoff points for ¹²³I-MIBG myocardial scintigraphy in a Caucasian population with Parkinson's disease. Eur J Nucl Med Mol Imaging. 2011; 38(6):1139-46. DOI: 10.1007/s00259-011-1754-8. View

Stefanelli A, Treglia G, Bruno I, Rufini V, Giordano A . Pharmacological interference with 123I-metaiodobenzylguanidine: a limitation to developing cardiac innervation imaging in clinical practice?. Eur Rev Med Pharmacol Sci. 2013; 17(10):1326-33. View

Courbon F, Brefel-Courbon C, Thalamas C, Alibelli M, Berry I, Montastruc J . Cardiac MIBG scintigraphy is a sensitive tool for detecting cardiac sympathetic denervation in Parkinson's disease. Mov Disord. 2003; 18(8):890-7. DOI: 10.1002/mds.10461. View

Agostini D, Babatasi G, Manrique A, Saloux E, Grollier G, Potier J . Impairment of cardiac neuronal function in acute myocarditis: iodine-123-MIBG scintigraphy study. J Nucl Med. 1998; 39(11):1841-4. View

Orimo S, Ozawa E, Nakade S, Sugimoto T, Mizusawa H . (123)I-metaiodobenzylguanidine myocardial scintigraphy in Parkinson's disease. J Neurol Neurosurg Psychiatry. 1999; 67(2):189-94. PMC: 1736461. DOI: 10.1136/jnnp.67.2.189. View

Geis W, KAYE M . Distribution of sympathetic fibers in the left ventricular epicardial plexus of the dog. Circ Res. 1968; 23(2):165-70. DOI: 10.1161/01.res.23.2.165. View

Gilman S, Wenning G, Low P, Brooks D, Mathias C, Trojanowski J . Second consensus statement on the diagnosis of multiple system atrophy. Neurology. 2008; 71(9):670-6. PMC: 2676993. DOI: 10.1212/01.wnl.0000324625.00404.15. View

Cerqueira M, Weissman N, Dilsizian V, Jacobs A, Kaul S, Laskey W . Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation. 2002; 105(4):539-42. DOI: 10.1161/hc0402.102975. View

10.

Nakajima K, Okuda K, Yoshimura M, Matsuo S, Wakabayashi H, Imanishi Y . Multicenter cross-calibration of I-123 metaiodobenzylguanidine heart-to-mediastinum ratios to overcome camera-collimator variations. J Nucl Cardiol. 2014; 21(5):970-8. PMC: 4167440. DOI: 10.1007/s12350-014-9916-2. View

11.

Estorch M, Carrio I, Berna L, Torres G . Myocardial iodine-labeled metaiodobenzylguanidine 123 uptake relates to age. J Nucl Cardiol. 1995; 2(2 Pt 1):126-32. DOI: 10.1016/s1071-3581(95)80023-9. View

12.

Yates C, Ritchie I, Simpson J, Maloney A, Gordon A . Noradrenaline in Alzheimer-type dementia and Down syndrome. Lancet. 1981; 2(8236):39-40. DOI: 10.1016/s0140-6736(81)90269-5. View

13.

Nagayama H, Hamamoto M, Ueda M, Nagashima J, Katayama Y . Reliability of MIBG myocardial scintigraphy in the diagnosis of Parkinson's disease. J Neurol Neurosurg Psychiatry. 2005; 76(2):249-51. PMC: 1739515. DOI: 10.1136/jnnp.2004.037028. View

14.

Yoshita M . Differentiation of idiopathic Parkinson's disease from striatonigral degeneration and progressive supranuclear palsy using iodine-123 meta-iodobenzylguanidine myocardial scintigraphy. J Neurol Sci. 1998; 155(1):60-7. DOI: 10.1016/s0022-510x(97)00278-5. View

15.

Litvan I, Agid Y, Calne D, Campbell G, Dubois B, Duvoisin R . Clinical research criteria for the diagnosis of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome): report of the NINDS-SPSP international workshop. Neurology. 1996; 47(1):1-9. DOI: 10.1212/wnl.47.1.1. View

16.

Armstrong M, Litvan I, Lang A, Bak T, Bhatia K, Borroni B . Criteria for the diagnosis of corticobasal degeneration. Neurology. 2013; 80(5):496-503. PMC: 3590050. DOI: 10.1212/WNL.0b013e31827f0fd1. View

17.

. Radiation dose to patients from radiopharmaceuticals (addendum 2 to ICRP publication 53). Ann ICRP. 2000; 28(3):1-126. DOI: 10.1016/s0146-6453(99)00006-8. View

18.

Goldstein D, Orimo S . Cardiac sympathetic neuroimaging: summary of the First International Symposium. Clin Auton Res. 2009; 19(3):137-48. PMC: 2963152. DOI: 10.1007/s10286-009-0002-9. View

19.

Flotats A, Carrio I, Agostini D, Le Guludec D, Marcassa C, Schafers M . Proposal for standardization of 123I-metaiodobenzylguanidine (MIBG) cardiac sympathetic imaging by the EANM Cardiovascular Committee and the European Council of Nuclear Cardiology. Eur J Nucl Med Mol Imaging. 2010; 37(9):1802-12. DOI: 10.1007/s00259-010-1491-4. View

20.

Orimo S, Ozawa E, Nakade S, Hattori H, Tsuchiya K, Taki K . [123I] meta-iodobenzylguanidine myocardial scintigraphy differentiates corticobasal degeneration from Parkinson's disease. Intern Med. 2003; 42(1):127-8. DOI: 10.2169/internalmedicine.42.127. View