Potential diagnostic value of regional myocardial adrenergic imaging using (123)I-MIBG SPECT to identify patients with Lewy body diseases

Eur J Nucl Med Mol Imaging. 2015 Jun;42(7):1043-51. doi: 10.1007/s00259-015-2989-6. Epub 2015 Jan 28.

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+.

Publication types

  • Evaluation Study

MeSH terms

  • 3-Iodobenzylguanidine*
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Lewy Body Disease / diagnostic imaging*
  • Lewy Body Disease / pathology
  • Male
  • Middle Aged
  • Myocardial Perfusion Imaging*
  • Predictive Value of Tests
  • Radiopharmaceuticals*
  • Tomography, Emission-Computed, Single-Photon*

Substances

  • Radiopharmaceuticals
  • 3-Iodobenzylguanidine