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- Title
The Utility of the Combined Use of <sup>123</sup>I-FP-CIT and <sup>123</sup>I-MIBG Myocardial Scintigraphy in Differentiating Parkinson's Disease from Other Parkinsonian Syndromes.
- Authors
Eiji Matsusue; Yoshio Fujihara; Kenichiro Tanaka; Yuki Aozasa; Manabu Shimoda; Hiroyuki Nakayasu; Kazuhiko Nakamura; Toshihide Ogawa
- Abstract
Background 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy and 123I-FP-CIT dopamine transporter single photon emission computed tomography (DAT-SPECT) provide specific information that distinguish Parkinson's disease (PD) from parkinsonian syndromes other than PD (non-PD), including atypical parkinsonian disorder (APD) and non-PD other than APD (nPD-nAPD). The purpose of this study was to determine whether combining DAT-SPECT and MIBG myocardial scintigraphy using multiparametric scoring system (MSS) could improve diagnostic test accuracy in discriminating PD from APD or discriminating PD from nPD-nAPD. Methods A total of 52 patients, including 36 PD, eight APD and eight nPD-nAPD, underwent both MIBG myocardial scintigraphy and DAT-SPECT, were evaluated. The heart-to-mediastinum (H/M) ratios (early and delayed), washout-rate (WR), the average (Ave) and asymmetry index (AI) of specific binding ratio (SBR) were calculated. Cutoff values were determined, using ROC analysis, for discriminating PD from APD and for discriminating PD from nPD-nAPD, on five parameters. All cases were scored as either 1 (PD) or 0 (nPD-nAPD or APD) for each parameter according to its threshold in each discrimination. These individual scores were summed for each case, yielding a combined score to obtain a cutoff value for the MSS in each discrimination. Results For discriminating PD from nPD-nAPD, thehighest accuracy was 80% at a cutoff value of 19% for the WR and a cut off value of 2 improved diagnostic accuracy to 84% for MSS. For discriminating PD from APD, the highest accuracy was 86% at a cutoff value of 2.8 for the H/M ratio (late) and a cut off value of 2 showed diagnostic accuracy of 86% for MSS. Conclusion A MSS has comparable or better accuracy compared to each parameter of MIBG myocardial scintigraphy and DAT-SPECT in distinguishing PD from nPD-nAPD or distinguishing PD from APD.
- Subjects
MYOCARDIAL perfusion imaging; PARKINSON'S disease; SINGLE photon emission computerized tomography centers; DISCRIMINATION (Sociology); PHOTON emission
- Publication
Yonago Acta Medica, 2018, Vol 61, Issue 2, p117
- ISSN
0513-5710
- Publication type
Article
- DOI
10.33160/yam.2018.06.004