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Li S, Yue L, Chen S, Wu Z, Zhang J, Hong R, Xie L, Peng K, Wang C, Lin A, Jin L, Guan Q. High clinical diagnostic accuracy of combined salivary gland and myocardial metaiodobenzylguanidine scintigraphy in the diagnosis of Parkinson's disease. Front Aging Neurosci 2023; 14:1066331. [PMID: 36711204 PMCID: PMC9875016 DOI: 10.3389/fnagi.2022.1066331] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/22/2022] [Indexed: 01/13/2023] Open
Abstract
Background Decreased myocardial uptake of 131I-metaiodobenzylguanidine (MIBG) is known to be an important feature to diagnose Parkinson's disease (PD). However, the diagnosis accuracy of myocardial MIBG scintigraphy alone is often unsatisfying. Recent studies have found that the MIBG uptake of the major salivary glands was reduced in PD patients as well. Purpose To evaluate the diagnostic value of major salivary gland MIBG scintigraphy in PD, and explore the potential role of myocardial MIBG scintigraphy combined with salivary gland MIBG scintigraphy in distinguishing PD from non-PD (NPD). Methods Thirty-seven subjects were performed with 131I-MIBG scintigraphy. They were classified into the PD group (N = 18) and the NPD group (N = 19), based on clinical diagnostic criteria, DAT PET and 18F-FDG PET imaging findings. Images of salivary glands and myocardium were outlined to calculated the MIBG uptake ratios. Results The combination of left parotid and left submandibular gland early images had a good performance in distinguishing PD from NPD, with sensitivity, specificity, and accuracy of 50.00, 94.74, and 72.37%, respectively. Combining the major salivary gland and myocardial scintigraphy results in the early period showed a good diagnostic value with AUC, sensitivity and specificity of 0.877, 77.78, and 94.74%, respectively. Meanwhile, in the delayed period yield an excellent diagnostic value with AUC, sensitivity and specificity of 0.904, 88.89, and 84.21%, respectively. Conclusion 131I-MIBG salivary gland scintigraphy assisted in the diagnosis and differential diagnosis of PD. The combination of major salivary gland and myocardial 131I-MIBG scintigraphy further increased the accuracy of PD diagnosis.
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Affiliation(s)
- Shuangfang Li
- Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China,Department of Neurology and Neurological Rehabilitation, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Lei Yue
- Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shuzhen Chen
- Department of Nuclear Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhuang Wu
- Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jingxing Zhang
- Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Ronghua Hong
- Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Ludi Xie
- Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Kangwen Peng
- Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Chenghong Wang
- Department of Nuclear Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Ao Lin
- Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Lingjing Jin
- Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China,Department of Neurology and Neurological Rehabilitation, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China,Shanghai Clinical Research Center for Aging and Medicine, Shanghai, China,Lingjing Jin,
| | - Qiang Guan
- Neurotoxin Research Center of Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China,*Correspondence: Qiang Guan,
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Shafie M, Mayeli M, Saeidi S, Mirsepassi Z, Abbasi M, Shafeghat M, Aghamollaii V. The potential role of the cardiac MIBG scan in differentiating the drug-induced Parkinsonism from Parkinson’s disease. Clin Park Relat Disord 2022; 6:100130. [PMID: 35146407 PMCID: PMC8802054 DOI: 10.1016/j.prdoa.2022.100130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/04/2021] [Accepted: 12/27/2021] [Indexed: 11/01/2022] Open
Abstract
MIBG scan is more positive in the PD group than the DIP. There is a significant difference in MIBG uptake between the PD and DIP groups. MIBG scan can be used to determine the prognosis of DIP. MIBG scan is 84.4% sensitive and 86.36% specific in diagnosing PD. MIBG scan is useful in better referring the patients to related centers.
Introduction Methods Results Conclusion
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Catalan M, Dore F, Polverino P, Bertolotti C, Sartori A, Antonutti L, Cucca A, Furlanis G, Capitanio S, Manganotti P. 123I-Metaiodobenzylguanidine Myocardial Scintigraphy in Discriminating Degenerative Parkinsonisms. Mov Disord Clin Pract 2021; 8:717-724. [PMID: 34295947 PMCID: PMC8287155 DOI: 10.1002/mdc3.13227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 03/30/2021] [Accepted: 04/07/2021] [Indexed: 11/08/2022] Open
Abstract
Background 123I-Metaiodobenzylguanidine (123I-MIBG) myocardial scintigraphy is a useful technique to differentiate Parkinson's disease (PD) from atypical parkinsonisms, since it is generally abnormal in PD and normal in the latter. Reduction of myocardial MIBG uptake is a supportive feature in the latest PD diagnostic criteria. Objectives To explore the clinical contribution of myocardial scintigraphy in discriminating different forms of parkinsonisms, especially when atypical features are present. Methods Forty-one patients with parkinsonism underwent a 123I-MIBG myocardial scintigraphy in our Movement Disorders Center. Disease evolution was reviewed by applying the latest disease criteria for PD, multiple system atrophy (MSA), progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS), as appropriate. Three diagnostic times were defined: T1 (before scintigraphy execution), T2 (immediately after the exam) and T3 (two years later). Early and delayed heart/mediastinum (H/M) ratios and washout rate (WR) were analyzed. Results Myocardial scintigraphy showed impaired MIBG uptake in 12 out of 15 patients with a definite PD diagnosis, while normal uptake was found in 20 of 26 patients with no-PD. Early and delayed H/M ratios were significantly lower in PD compared to overall no-PD patients and MSA patients. 123I-MIBG myocardial scintigraphy was abnormal in all PD patients with dysautonomia. After 123I-MIBG myocardial scintigraphy (T2), in 9 patients (22%) an improvement of diagnostic accuracy was reached. Conclusions Diagnostic accuracy of myocardial scintigraphy in distinguishing PD from atypical parkinsonism was suboptimal. Nevertheless, this study confirmed the relevance of 123I-MIBG myocardial scintigraphy for the discrimination of PD from atypical parkinsonism, especially when dysautonomic symptoms are present.
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Affiliation(s)
- Mauro Catalan
- Clinical Unit of Neurology, Department of Medical Sciences University Hospital and Health Services of Trieste, University of Trieste Trieste Italy
| | - Franca Dore
- Nuclear Medicine, Imaging Diagnostic Department University Hospital and Health Services of Trieste, University of Trieste Trieste Italy
| | - Paola Polverino
- Clinical Unit of Neurology, Department of Medical Sciences University Hospital and Health Services of Trieste, University of Trieste Trieste Italy
| | - Claudio Bertolotti
- Clinical Unit of Neurology, Department of Medical Sciences University Hospital and Health Services of Trieste, University of Trieste Trieste Italy
| | - Arianna Sartori
- Clinical Unit of Neurology, Department of Medical Sciences University Hospital and Health Services of Trieste, University of Trieste Trieste Italy
| | - Lucia Antonutti
- Clinical Unit of Neurology, Department of Medical Sciences University Hospital and Health Services of Trieste, University of Trieste Trieste Italy
| | - Alberto Cucca
- Department of Life Sciences University of Trieste Trieste Italy.,The Marlene and Paolo Fresco Institute for Parkinson's and Movement Disorders, Department of Neurology NYU School of Medicine New York New York USA.,Department of Rehabilitation Medicine Villa Margherita Fresco Parkinson Center Vicenza Italy
| | - Giovanni Furlanis
- Clinical Unit of Neurology, Department of Medical Sciences University Hospital and Health Services of Trieste, University of Trieste Trieste Italy
| | - Selene Capitanio
- Nuclear Medicine, Imaging Diagnostic Department University Hospital and Health Services of Trieste, University of Trieste Trieste Italy.,Nuclear Medicine, IRCCS Ospedale Policlinico San Martino Genoa Italy.,Department of Nuclear Medicine ASST, Grande Ospedale Metropolitano Niguarda Milan Italy
| | - Paolo Manganotti
- Clinical Unit of Neurology, Department of Medical Sciences University Hospital and Health Services of Trieste, University of Trieste Trieste Italy
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