Is There Any Clinical Value of Adding 123I-Metaiodobenzylguanidine Myocardial Scintigraphy to 123I-Ioflupane (DaTscan) in the Differential Diagnosis of Parkinsonism?


Journal

Clinical nuclear medicine
ISSN: 1536-0229
Titre abrégé: Clin Nucl Med
Pays: United States
ID NLM: 7611109

Informations de publication

Date de publication:
Aug 2020
Historique:
pubmed: 15 5 2020
medline: 23 10 2020
entrez: 15 5 2020
Statut: ppublish

Résumé

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. 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. 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. 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.

Identifiants

pubmed: 32404715
doi: 10.1097/RLU.0000000000003098
pii: 00003072-202008000-00002
doi:

Substances chimiques

Nortropanes 0
Radiopharmaceuticals 0
Tropanes 0
2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane 155797-99-2
3-Iodobenzylguanidine 35MRW7B4AD
ioflupane VF232WE742

Types de publication

Evaluation Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

588-593

Références

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Auteurs

Maria Stathaki (M)

From the Department of Nuclear Medicine, University Hospital.

Sophia Koukouraki (S)

From the Department of Nuclear Medicine, University Hospital.

Panagiotis Simos (P)

School of Medicine, University of Crete, Institute of Computer Science, Foundation for Research and Technology-Hellas.

Iro Boura (I)

Department of Neurology, University Hospital, Heraklion, Crete, Greece.

Emmanouela Papadaki (E)

From the Department of Nuclear Medicine, University Hospital.

Olga Bourogianni (O)

From the Department of Nuclear Medicine, University Hospital.

Angeliki Tsaroucha (A)

From the Department of Nuclear Medicine, University Hospital.

Nikolaos Kapsoritakis (N)

From the Department of Nuclear Medicine, University Hospital.

Panayiotis Mitsias (P)

Department of Neurology, University Hospital, Heraklion, Crete, Greece.

Cleanthe Spanaki (C)

Department of Neurology, University Hospital, Heraklion, Crete, Greece.

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