Potential diagnostic value of 131I-MIBG myocardial scintigraphy in discrimination between Alzheimer disease and dementia with Lewy bodies
•The myocardial uptake of 131I-MIBG is reduced in patients with DLB compared to patients with Alzheimer’s disease (AD).•Patients with DLB and AD can be differentiated by 131I-MIBG myocardial scintigraphy with an accuracy of more than 88%.•The optimal heart to mediastinal ratio of 131I-MIBG uptake ca...
Gespeichert in:
Veröffentlicht in: | Clinical neurology and neurosurgery 2017-12, Vol.163, p.163-166 |
---|---|
Hauptverfasser: | , , , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
Zusammenfassung: | •The myocardial uptake of 131I-MIBG is reduced in patients with DLB compared to patients with Alzheimer’s disease (AD).•Patients with DLB and AD can be differentiated by 131I-MIBG myocardial scintigraphy with an accuracy of more than 88%.•The optimal heart to mediastinal ratio of 131I-MIBG uptake calculated at 1.57 to differentiate patients with DLB and AD.•Myocardial scintigraphy and SPECT with 131I-MIBG is technically valid and could be used when 123I-MIBG is not available.
Clinical difficulty to discriminate between the Alzheimer disease (AD) and dementia with Lewy bodies (DLB) has led researchers to focus on highly sensitive functional imaging modalities. The aim of the present study was to assess 131I-MIBG cardiac imaging to distinguish between AD and DLB.
Seventeen patients who were known cases of dementia underwent 131I-MIBG myocardial scintigraphy to differentiate AD from DLB. Planar and 131I-MIBG SPECT were obtained 2h after the injection of 1mCi 131I-MIBG on a dual head gamma camera. The visual assessment of the heart uptake compared with lungs and the quantification based on the heart to mediastinal ratio (HMR) were done. The cardiac receiver operating characteristic (ROC) curve was designed for the optimal HMR cut-off values to predict the diagnoses of the patients. The diagnoses were clinically confirmed during the follow up of 14±8.2 months.
Out of 17 patients (13 males; 76.5%), 10 patients had AD (7 males; 70%) and 7 patients had DLB (6 males; 85%). The pooled HMR was 1.74±0.33 in the study population; with 1.95±0.22 in the AD group and 1.43±0.20 in the DLB group to demonstrate significantly different HMR scores between patients with AD and DLB (p value=0.001). The visual interpretation was positive in 10 patients (accuracy of 88.2%). The shortest distance on the ROC curve to the optimal value corresponding to HMR=1.57 identified 10 patients with a high HMR (positive cardiac uptake) and 7 patients with a low HMR (negative cardiac uptake), the accuracy calculated at 88.2%.
131I-MIBG myocardial scintigraphy is a potential alternative diagnostic modality for discrimination between AD and DLB when 123I is not available. |
---|---|
ISSN: | 0303-8467 1872-6968 |
DOI: | 10.1016/j.clineuro.2017.10.024 |