Is There Any Clinical Value of Adding 123I-Metaiodobenzylguanidine Myocardial Scintigraphy to 123I-Ioflupane (DaTscan) in the Differential Diagnosis of Parkinsonism?
| Autor: | Panayiotis Mitsias, Emmanouela Papadaki, Sophia Koukouraki, Angeliki Tsaroucha, Panagiotis G. Simos, Cleanthe Spanaki, Maria Stathaki, Iro Boura, Nikolaos Kapsoritakis, Olga Bourogianni |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Nortropanes Scintigraphy Diagnosis Differential Myocardial scintigraphy medicine Humans Radiology Nuclear Medicine and imaging Adverse effect Aged Tomography Emission-Computed Single-Photon medicine.diagnostic_test business.industry Dementia with Lewy bodies 123i mibg Parkinsonism Myocardial Perfusion Imaging Parkinson Disease General Medicine Middle Aged medicine.disease nervous system diseases 3-Iodobenzylguanidine Clinical value Female Radiology Differential diagnosis Radiopharmaceuticals business Tropanes |
| Zdroj: | Clinical nuclear medicine. 45(8) |
| ISSN: | 1536-0229 |
| Popis: | Purpose The aim of the study is to evaluate the impact of myocardial I-metaiodobenzylguanidine (MIBG) in the diagnosis, clinical management, and differential diagnosis of Parkinson disease (PD) and non-PD parkinsonism. Methods The study enrolled 41 patients with parkinsonism. An initial diagnosis was reached after thorough clinical and imaging evaluation. After 2 to 5 years of follow-up, a final diagnosis was established. All patients underwent, soon after their initial visit, presynaptic striatal DaT scintigraphy with I-FP-CIT (DaTscan) and I-MIBG myocardial scintigraphy. DaTscan is not specific to distinguish among different types of neurodegenerative parkinsonism. I-MIBG myocardial scintigraphy displays the functional status of cardiac sympathetic nerves, which is reduced in PD/dementia with Lewy bodies (DLB) and normal in atypical parkinsonian syndromes and secondary or nondegenerative parkinsonism. Results No patients showed adverse effects during or after both scintigraphies. A positive DaTscan was found in all patients in the PD/DLB group (17/17) and in 15 of 24 patients in the non-PD group. Myocardial I-MIBG scintigraphy was associated with lower sensitivity (82% vs 100%) but higher specificity than DaTscan (79% vs 38%) in diagnosis PD/DLB from non-PD parkinsonism. A positive scan result on both techniques, to confirm diagnosis of PD/DLB, significantly improved the specificity of DaTscan, from 38% to 75%, with no reduction in sensitivity. Conclusions Myocardial I-MIBG imaging provides complementary value to I-FP-CIT in the proper diagnosis, treatment plan, and differential diagnosis between PD and other forms of parkinsonism. |
| Databáze: | OpenAIRE |
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