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Nakajima K, Matsumura T, Komatsu J, Wakabayashi H, Ono K, Kinuya S. Sympathetic 123I-metaiodobenzylguanidine index for Lewy body disease: probability-based diagnosis and identifying patients exempt from late imaging. Ann Nucl Med 2024:10.1007/s12149-024-01950-4. [PMID: 38869809 DOI: 10.1007/s12149-024-01950-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/31/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVE We aimed to establish a practical diagnostic index for Lewy body diseases (LBD), such as Parkinson's disease and dementia, with Lewy bodies in outpatient settings and criteria for exempting patients from late imaging. METHODS We acquired early and late 123I-metaiodobenzylguanidine (MIBG) images from 108 consecutive patients with suspected LBD and standardized heart-to-mediastinum (H/M) ratios for collimator conditions. Exclusions included young-onset Parkinson's disease (age < 50 years) and genetic transthyretin-type amyloidosis. We developed logistic models incorporating H/M ratios with or without age (n = 92). The sympathetic MIBG index for LBD (SMILe index), categorized LBD likelihood from 0 (lowest) to 1 (highest). Diagnostic accuracy was assessed as the area under the receiver operating characteristic (ROC) curve (AUC). The characteristics of the new index were compared with H/M ratios. The need for late imaging was explored using the SMILe index. RESULTS Early or late SMILe indexes using a single H/M ratio variable discriminated LBD from non-LBD. The AUC values for early and late SMILe indexes were 0.880 and 0.894 (p < 0.0001 for both), identical to those for early and late H/M ratios. The sensitivity and the specificity of early SMILe indexes with a 0.5 threshold were 76% and 90%, achieving accuracy of accuracy 86%. Similarly, the late SMILe index demonstrated a sensitivity of 76% and specificity of 87%, with an accuracy of 84%. Early SMILe indexes < 0.3 or > 0.7 (representing 84% patients) indicated a diagnosis without a late MIBG study. CONCLUSION The 123I-MIBG-derived SMILe indexes provide likelihood of LBD, and those with a 50% threshold demonstrated optimal diagnostic accuracy for LBD. The index values of either < 0.3 or > 0.7 accurately selected patients who do not need late imaging.
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Affiliation(s)
- Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8640, Japan.
- Department of Nuclear Medicine, Kanazawa University, Kanazawa, Japan.
| | - Takeshi Matsumura
- Department of Nuclear Medicine, Kanazawa University, Kanazawa, Japan
| | - Junji Komatsu
- Department of Neurology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | | | - Kenjiro Ono
- Department of Neurology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Seigo Kinuya
- Department of Nuclear Medicine, Kanazawa University, Kanazawa, Japan
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Yamashita S, Nakajima K, Okuda K, Yamamoto H, Shibutani T, Yoneyama T, Tsuji S, Yokoyama K. Phantom-Based Standardization Method for 123I-metaiodobenzylguanidine Heart-to-Mediastinum Ratio Validated by D-SPECT Versus Anger Camera. ANNALS OF NUCLEAR CARDIOLOGY 2023; 9:85-90. [PMID: 38058581 PMCID: PMC10696155 DOI: 10.17996/anc.23-00003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/14/2023] [Accepted: 07/15/2023] [Indexed: 12/08/2023]
Abstract
Background: The 123I-metaiodobenzylguanidine heart-to-mediastinum ratios (HMRs) have been standardized between D-SPECT and Anger cameras in a small patient cohort using a phantom-based conversion method. This study aimed to determine the validity of this method and compare the diagnostic performance of the two cameras in a larger patient cohort. Methods: We retrospectively calculated HMRs from early and late anterior-planar equivalent and planar images acquired from 173 patients in 177 studies using D-SPECT and Anger cameras, respectively. The D-SPECT HMRs were cross-calibrated to an Anger camera using conversion coefficients based on previous phantom findings, then standardized to medium-energy general-purpose collimator conditions. Relationships between HMRs before and after corrections were investigated. Late HMRs were classified into four cardiac mortality risk groups and divided into two groups using a threshold of 2.2 to verify diagnostic performance concordance. Results: Correction improved linear regression lines and differences in HMRs among the groups. The overall ratios of perfect concordance were (134 [75.7%] of 177), and higher in groups with very low (49 [80.3%] of 61) and high (51 [86.4%] of 59) HMRs when the standardized HMR was classified according to cardiac mortality risk. That between the systems was the highest (164 [92.7%] of 177) when the HMR was divided by a threshold value of 2.2. Conclusions: Phantom-based conversion can standardize HMRs between D-SPECT and Anger cameras because the standardized HMR provided comparable diagnostic performance. Our findings indicated that this conversion could be applied to multicenter studies that include both D-SPECT and Anger cameras.
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Affiliation(s)
- Shozo Yamashita
- Division of Radiology, Public Central Hospital of Matto Ishikawa, Ishikawa, Japan
| | - Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University, Ishikawa, Japan
| | - Koichi Okuda
- Department of Radiation Science, Hirosaki University Graduate School of Health Sciences, Aomori, Japan
| | - Haruki Yamamoto
- Division of Radiology, Public Central Hospital of Matto Ishikawa, Ishikawa, Japan
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Tatsuya Yoneyama
- Division of Thyroid, Public Central Hospital of Matto Ishikawa, Ishikawa, Japan
| | - Shiro Tsuji
- PET Imaging Center, Public Central Hospital of Matto Ishikawa, Ishikawa, Japan
| | - Kunihiko Yokoyama
- PET Imaging Center, Public Central Hospital of Matto Ishikawa, Ishikawa, Japan
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Lilley LM, Sanche S, Moore SC, Salemi MR, Vu D, Iyer S, Hengartner NW, Mukundan H. Methods to capture proteomic and metabolomic signatures from cerebrospinal fluid and serum of healthy individuals. Sci Rep 2022; 12:13339. [PMID: 35922450 PMCID: PMC9349260 DOI: 10.1038/s41598-022-16598-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/17/2022] [Indexed: 11/20/2022] Open
Abstract
Discovery of reliable signatures for the empirical diagnosis of neurological diseases-both infectious and non-infectious-remains unrealized. One of the primary challenges encountered in such studies is the lack of a comprehensive database representative of a signature background that exists in healthy individuals, and against which an aberrant event can be assessed. For neurological insults and injuries, it is important to understand the normal profile in the neuronal (cerebrospinal fluid) and systemic fluids (e.g., blood). Here, we present the first comparative multi-omic human database of signatures derived from a population of 30 individuals (15 males, 15 females, 23-74 years) of serum and cerebrospinal fluid. In addition to empirical signatures, we also assigned common pathways between serum and CSF. Together, our findings provide a cohort against which aberrant signature profiles in individuals with neurological injuries/disease can be assessed-providing a pathway for comprehensive diagnostics and therapeutics discovery.
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Affiliation(s)
- Laura M Lilley
- Los Alamos National Laboratory, P.O. Box 1663, Los Alamos, NM, 87545, USA
| | - Steven Sanche
- Los Alamos National Laboratory, P.O. Box 1663, Los Alamos, NM, 87545, USA
| | - Shepard C Moore
- Los Alamos National Laboratory, P.O. Box 1663, Los Alamos, NM, 87545, USA
| | - Michelle R Salemi
- Genome Center, Proteomics Core Facility, University of California, Davis, CA, 95616, USA
| | - Dung Vu
- Los Alamos National Laboratory, P.O. Box 1663, Los Alamos, NM, 87545, USA
| | - Srinivas Iyer
- Los Alamos National Laboratory, P.O. Box 1663, Los Alamos, NM, 87545, USA
| | | | - Harshini Mukundan
- Los Alamos National Laboratory, P.O. Box 1663, Los Alamos, NM, 87545, USA.
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Koyanagawa K, Naya M, Aikawa T, Manabe O, Furuya S, Kuzume M, Oyama-Manabe N, Ohira H, Tsujino I, Anzai T. The rate of myocardial perfusion recovery after steroid therapy and its implication for cardiac events in cardiac sarcoidosis and primarily preserved left ventricular ejection fraction. J Nucl Cardiol 2021; 28:1745-1756. [PMID: 31605274 DOI: 10.1007/s12350-019-01916-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/01/2019] [Accepted: 09/23/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Sarcoidosis is a multisystemic disorder of unknown cause characterized by immune granuloma formation in the involved organs. Few studies have reported on the myocardial perfusion changes by immunosuppression therapy in cardiac sarcoidosis (CS). Additionally, the relationship between myocardial perfusion changes and prognosis is unknown. Therefore, this study aimed to clarify myocardial perfusion recovery after steroid therapy and its prognostic value for major adverse cardiac events (MACE) in patients with CS. METHODS AND RESULTS Thirty-eight consecutive patients with CS {median age, 63 [interquartile range (IQR) 51-68] years; 10 men} underwent both 18F-fluorodeoxyglucose positron emission tomography/computed tomography (CT) and electrocardiography-gated single-photon emission CT (SPECT) pre- and post-steroid therapy. Patients with improved or preserved myocardial perfusion after post-therapy were defined as the recovery group and those with worsened myocardial perfusion as the non-recovery group. Twenty-six patients (68%) were categorized as the recovery group. MACE occurred in eight patients. The Kaplan-Meier curves revealed a significantly higher rate of MACE in the non-recovery group (17.4%/y vs 2.9%/y, P = 0.007). CONCLUSIONS Myocardial perfusion was recovered by steroid therapy in 61% and preserved in 8% of patients. Myocardial perfusion recovery after steroid therapy was significantly associated with a low incidence of MACE.
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Affiliation(s)
- Kazuhiro Koyanagawa
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Masanao Naya
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.
| | - Tadao Aikawa
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Osamu Manabe
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Sho Furuya
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Masato Kuzume
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Noriko Oyama-Manabe
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Hiroshi Ohira
- First Department of Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Ichizo Tsujino
- First Department of Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
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Verschure DO, Poel E, De Vincentis G, Frantellizzi V, Nakajima K, Gheysens O, de Groot JR, Verberne HJ. The relation between cardiac 123I-mIBG scintigraphy and functional response 1 year after CRT implantation. Eur Heart J Cardiovasc Imaging 2021; 22:49-57. [PMID: 32259839 PMCID: PMC7758029 DOI: 10.1093/ehjci/jeaa045] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 01/21/2020] [Accepted: 03/10/2020] [Indexed: 12/12/2022] Open
Abstract
Aims Cardiac resynchronization therapy (CRT) is a disease-modifying therapy in patients with chronic heart failure (CHF). Current guidelines ascribe CRT eligibility on three parameters only: left ventricular ejection fraction (LVEF), QRS duration, and New York Heart Association (NYHA) functional class. However, one-third of CHF patients does not benefit from CRT. This study evaluated whether 123I-meta-iodobenzylguanidine (123I-mIBG) assessed cardiac sympathetic activity could optimize CRT patient selection. Methods and results A total of 78 stable CHF subjects (age 66.8 ± 9.6 years, 73% male, LVEF 25.2 ± 6.7%, QRS duration 153 ± 23 ms, NYHA 2.2 ± 0.7) referred for CRT implantation were enrolled. Subjects underwent 123I-mIBG scintigraphy prior to implantation. Early and late heart-to-mediastinum (H/M) ratio and 123I-mIBG washout were calculated. CRT response was defined as either an increase of LVEF to >35%, any improvement in LVEF of >10%, QRS shortening to <150 ms, or improvement in NYHA class of >1 class. In 33 patients LVEF increased to >35%, QRS decreased <150 ms in 36 patients, and NYHA class decreased in 33 patients. Late H/M ratio and hypertension were independent predictors of LVEF improvement to >35% (P = 0.0014 and P = 0.0149, respectively). In addition, early H/M ratio, LVEF, and absence of diabetes mellitus (DM) were independent predictors for LVEF improvement by >10%. No independent predictors were found for QRS shortening to <150 ms or improvement in NYHA class. Conclusion Early and late H/M ratio were independent predictors of CRT response when improvement of LVEF was used as measure of response. Therefore, cardiac 123I-mIBG scintigraphy may be used as a tool to optimize selection of subjects that might benefit from CRT.
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Affiliation(s)
- D O Verschure
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location Amsterdam Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.,Department of Cardiology, Zaans Medical Center, Koningin Julianaplein 58, 1502 DV Zaandam, the Netherlands
| | - E Poel
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location Amsterdam Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - G De Vincentis
- Department of Radiological Sciences, Oncology and Anatomo-Pathology, "Sapienza" University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - V Frantellizzi
- Department of Radiological Sciences, Oncology and Anatomo-Pathology, "Sapienza" University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - K Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8640, Japan
| | - O Gheysens
- Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Hippokrateslaan 10, 1200 Brussels, Belgium
| | - J R de Groot
- Heart Center, Department of Cardiology, Amsterdam University Medical Centers, Location Amsterdam Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - H J Verberne
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location Amsterdam Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
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