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Current Radiopharmaceuticals

Editor-in-Chief

ISSN (Print): 1874-4710
ISSN (Online): 1874-4729

General Research Article

Diagnostic Value of the Early Heart-to-Mediastinum Count Ratio in Cardiac 123I-mIBG Imaging for Parkinson's Disease

Author(s): Viviana Frantellizzi, Valentina Lavelli*, Cristina Ferrari, Angela Sardaro, Alessio Farcomeni, Massimiliano Pacilio, Cristian Borrazzo, Roberto Pani, Giuseppe Rubini and Giuseppe De Vincentis

Volume 14, Issue 1, 2021

Published on: 27 July, 2020

Page: [64 - 69] Pages: 6

DOI: 10.2174/1874471013999200727211633

Price: $65

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Abstract

Background: Early diagnosis of Parkinson's disease (PD) is of primary importance. The delayed (3-4 h after injection) Iodine-123-Metaiodobenzylguanidine (123I-mIBG) scintigraphy has been proven to be effective in early differential diagnosis for Lewy body disease. But early imaging (15-30 min after injection) has only been marginally studied for its possible diagnostic role. In this prospective study, a threshold for the early Heart-to-Mediastinum (H/M) count ratio has been investigated, obtaining a diagnostic accuracy analogous to conventional, delayed imaging.

Methods: One hundred and eight patients with suspected Parkinson's disease (PD) were acquired after 15 and 240 minutes from the injection of 150-185 MBq of 123I-mIBG. The early and late H/M (He/Me and Hl/Ml) were evaluated by drawing Region-of-Interests on the heart and the upper half of the mediastinum. Optimal threshold (Youden index) and overall predictive performance were determined by receiver operating characteristic curve, classifying tentatively patients having an Hl/Ml lower than 1.6 as suffering from PD.

Results: He/Me was not significantly different from Hl/Ml (p-value=0.835). The Area-under-curve was 0.935 (95%CI: 0.845-1.000). The He/Me optimal threshold was 1.66, with sensitivity, specificity, and diagnostic accuracy of 95.5%, 85.7 and 90.7% respectively.

Conclusion: The He/Me Ratio is almost as accurate as the widely used delayed 123I-mIBG imaging, reducing the burden of delayed imaging but preserving the diagnostic accuracy of the method. Moreover the differential diagnosis in Parkinson's disease can be made in just 25 minutes against the 4 hours currently needed, lowering costs of the healthcare system and improving patients compliance.

Keywords: Cardiac imaging, Parkinson's disease, 123I-mIBG, planar imaging, heart-to-mediastinum, lewy body disease.

Graphical Abstract
[1]
Litvan, I.; MacIntyre, A.; Goetz, C.G.; Wenning, G.K.; Jellinger, K.; Verny, M.; Bartko, J.J.; Jankovic, J.; McKee, A.; Brandel, J.P.; Chaudhuri, K.R.; Lai, E.C.; D’Olhaberriague, L.; Pearce, R.K.B.; Agid, Y. Accuracy of the Clinical Diagnoses of Lewy Body Disease, Parkinson Disease, and Dementia With Lewy Bodies. Accuracy of the clinical diagnoses of Lewy body disease, Parkinson disease, and dementia with Lewy bodies: a clinicopathologic study. Arch. Neurol., 1998, 55(7), 969-978.
[http://dx.doi.org/10.1001/archneur.55.7.969] [PMID: 9678315]
[2]
Gabilondo, I.; Llorens, V.; Rodriguez, T.; Fernández, M.; Concha, T.P.; Acera, M.; Tijero, B.; Murueta-Goyena, A.; Del Pino, R.; Cortés, J.; Gómez-Esteban, J.C. Myocardial MIBG scintigraphy in genetic Parkinson’s disease as a model for Lewy body disorders. Eur. J. Nucl. Med. Mol. Imaging, 2019, 46(2), 376-384.
[http://dx.doi.org/10.1007/s00259-018-4183-0] [PMID: 30324423]
[3]
Okada, Y.; Shiraishi, M.; Nakamura, H.; Maki, F.; Sasaki, N.; Hasegawa, Y.; Sasaki, O.; Nakashima, Y. Usefulness of the combination of iodine-123-metaiodobenzylguanidine scintigraphy and iodine-123-ioflupane scintigraphy in new-onset Parkinson’s disease. Nucl. Med. Commun., 2018, 39(11), 983-988.
[http://dx.doi.org/10.1097/MNM.0000000000000898] [PMID: 30180045]
[4]
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), 189-194.
[http://dx.doi.org/10.1136/jnnp.67.2.189] [PMID: 10406987]
[5]
Watanabe, H.; Ieda, T.; Katayama, T.; Takeda, A.; Aiba, I.; Doyu, M.; Hirayama, M.; Sobue, G. Cardiac (123)I-meta-iodobenzylguanidine (MIBG) uptake in dementia with Lewy bodies: comparison with Alzheimer’s disease. J. Neurol. Neurosurg. Psychiatry, 2001, 70(6), 781-783.
[http://dx.doi.org/10.1136/jnnp.70.6.781] [PMID: 11385013]
[6]
Strano, S.; Fanciulli, A.; Rizzo, M.; Marinelli, P.; Palange, P.; Tiple, D.; De Vincentis, G.; Calcagnini, G.; Censi, F.; Meco, G.; Colosimo, C. Cardiovascular dysfunction in untreated Parkinson’s disease: A multi-modality assessment. J. Neurol. Sci., 2016, 370, 251-255.
[http://dx.doi.org/10.1016/j.jns.2016.09.036] [PMID: 27772769]
[7]
Bonanni, L.; Thomas, A.; Onofrj, M.; McKeith, I.G. Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology, 2006, 66(9), 1455-1455.
[http://dx.doi.org/10.1212/01.wnl.0000224698.67660.45] [PMID: 16682691]
[8]
Treglia, G.; Stefanelli, A.; Cason, E.; Cocciolillo, F.; Di Giuda, D.; Giordano, A. Diagnostic performance of iodine-123-metaiodobenzylguanidine scintigraphy in differential diagnosis between Parkinson’s disease and multiple-system atrophy: a systematic review and a meta-analysis. Clin. Neurol. Neurosurg., 2011, 113(10), 823-829.
[http://dx.doi.org/10.1016/j.clineuro.2011.09.004] [PMID: 21962800]
[9]
Sawada, H.; Oeda, T.; Yamamoto, K.; Kitagawa, N.; Mizuta, E.; Hosokawa, R.; Ohba, M.; Nishio, R.; Yamakawa, K.; Takeuchi, H.; Shimohama, S.; Takahashi, R.; Kawamura, T. Diagnostic accuracy of cardiac metaiodobenzylguanidine scintigraphy in Parkinson disease. Eur. J. Neurol., 2009, 16(2), 174-182.
[http://dx.doi.org/10.1111/j.1468-1331.2008.02372.x] [PMID: 19146639]
[10]
Maruyama, Y.; Yamada, T.; Murakami, K.; Kumano, R. Comparison of the diagnostic performance of H/M ratio between early and delayed phases for Lewy body disease. Nucl. Med. Commun., 2015, 36(5), 477-480.
[http://dx.doi.org/10.1097/MNM.0000000000000271] [PMID: 25714666]
[11]
Sakamoto, F.; Shiraishi, S.; Tsuda, N.; Hashimoto, M.; Tomiguchi, S.; Ikeda, M.; Yamashita, Y. Diagnosis of dementia with Lewy bodies: can 123I-IMP and 123I-MIBG scintigraphy yield new core features? Br. J. Radiol., 2017, 90(1070)20160156
[http://dx.doi.org/10.1259/bjr.20160156] [PMID: 27897064]
[12]
Manabe, Y.; Inui, Y.; Toyama, H.; Kosaka, K. 123I-metaiodobenzylguanidine myocardial scintigraphy with early images alone is useful for the differential diagnosis of dementia with Lewy bodies. Psychiatry Res. Neuroimaging, 2017, 261, 75-79.
[http://dx.doi.org/10.1016/j.pscychresns.2016.12.011] [PMID: 28152401]
[13]
Gelb, D.J.; Oliver, E.; Gilman, S. Diagnostic criteria for Parkinson disease. Arch. Neurol., 1999, 56(1), 33-39.
[http://dx.doi.org/10.1001/archneur.56.1.33] [PMID: 9923759]
[14]
Gilman, S.; Wenning, G.K.; Low, P.A.; Brooks, D.J.; Mathias, C.J.; Trojanowski, J.Q.; Wood, N.W.; Colosimo, C.; Dürr, A.; Fowler, C.J.; Kaufmann, H.; Klockgether, T.; Lees, A.; Poewe, W.; Quinn, N.; Revesz, T.; Robertson, D.; Sandroni, P.; Seppi, K.; Vidailhet, M. Second consensus statement on the diagnosis of multiple system atrophy. Neurology, 2008, 71(9), 670-676.
[http://dx.doi.org/10.1212/01.wnl.0000324625.00404.15] [PMID: 18725592]
[15]
De Vincentis, G.; Frantellizzi, V.; Fedele, F.; Farcomeni, A.; Scarparo, P.; Salvi, N.; Fegatelli, D.A.; Mancone, M.; Verschure, D.O.; Verberne, H.J. Role of cardiac 123I-mIBG imaging in predicting arrhythmic events in stable chronic heart failure patients with an ICD. J. Nucl. Cardiol., 2019, 26(4), 1188-1196.
[http://dx.doi.org/10.1007/s12350-018-1258-z] [PMID: 29594915]
[16]
Bewick, V.; Cheek, L.; Ball, J. Statistics review 13: receiver operating characteristic curves. Crit. Care, 2004, 8(6), 508-512.
[http://dx.doi.org/10.1186/cc3000] [PMID: 15566624]
[17]
Courbon, F.; Brefel-Courbon, C.; Thalamas, C.; Alibelli, M.J.; Berry, I.; Montastruc, J.L.; Rascol, O.; Senard, J.M. Cardiac MIBG scintigraphy is a sensitive tool for detecting cardiac sympathetic denervation in Parkinson’s disease. Mov. Disord., 2003, 18(8), 890-897.
[http://dx.doi.org/10.1002/mds.10461] [PMID: 12889078]
[18]
Orimo, S.; Amino, T.; Itoh, Y.; Takahashi, A.; Kojo, T.; Uchihara, T.; Tsuchiya, K.; Mori, F.; Wakabayashi, K.; Takahashi, H. Cardiac sympathetic denervation precedes neuronal loss in the sympathetic ganglia in Lewy body disease. Acta Neuropathol., 2005, 109(6), 583-588.
[http://dx.doi.org/10.1007/s00401-005-0995-7] [PMID: 15933869]
[19]
Nakajima, K.; Verschure, D.O.; Okuda, K.; Verberne, H.J. Standardization of 123I-meta-iodobenzylguanidine myocardial sympathetic activity imaging: phantom calibration and clinical applications. Clin. Transl. Imaging, 2017, 5(3), 255-263.
[http://dx.doi.org/10.1007/s40336-017-0230-2] [PMID: 28596948]
[20]
Brumberg, J.; Blazhenets, G.; Schröter, N.; Frings, L.; Jost, W.H.; Lapa, C.; Meyer, P.T. Imaging cardiac sympathetic innervation with MIBG: linear conversion of the heart-to-mediastinum ratio between different collimators. EJNMMI Phys., 2019, 6(1), 12.
[http://dx.doi.org/10.1186/s40658-019-0250-2] [PMID: 31338697]
[21]
Flotats, A.; Carrió, I.; Agostini, D.; Le Guludec, D.; Marcassa, C.; Schäfers, M.; Somsen, G.A.; Unlu, M.; Verberne, H.J. EANM Cardiovascular Committee; European Council of Nuclear Cardiology. 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), 1802-1812.
[http://dx.doi.org/10.1007/s00259-010-1491-4] [PMID: 20577740]
[22]
Murakami, N.; Sako, W.; Haji, S.; Furukawa, T.; Otomi, Y.; Otsuka, H.; Izumi, Y.; Harada, M.; Kaji, R. Potential Utility of 123I-MIBG Scintigraphy as a Predictor of Falls in Parkinson’s Disease. Front. Neurol., 2019, 10, 376.
[http://dx.doi.org/10.3389/fneur.2019.00376] [PMID: 31031701]
[23]
Nakajima, K.; Yamada, M. (123)I-Meta-iodobenzylguanidine Sympathetic Imaging: Standardization and Application to Neurological Diseases. Chonnam Med. J., 2016, 52(3), 145-150.
[http://dx.doi.org/10.4068/cmj.2016.52.3.145] [PMID: 27689024]
[24]
Christensen, T.E.; Kjaer, A.; Hasbak, P. The clinical value of cardiac sympathetic imaging in heart failure. Clin. Physiol. Funct. Imaging, 2014, 34(3), 178-182.
[http://dx.doi.org/10.1111/cpf.12091] [PMID: 24138454]
[25]
Verschure, D.O.; Poel, E.; Nakajima, K.; Okuda, K.; van Eck-Smit, B.L.F.; Somsen, G.A.; Verberne, H.J. A European myocardial 123I-mIBG cross-calibration phantom study. J. Nucl. Cardiol., 2018, 25(4), 1191-1197.
[http://dx.doi.org/10.1007/s12350-017-0782-6] [PMID: 28120154]

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