TY - JOUR
T1 - Diagnostic accuracy of123I-meta-iodobenzylguanidine myocardial scintigraphy in dementia with lewy bodies
T2 - A multicenter study
AU - Yoshita, Mitsuhiro
AU - Arai, Heii
AU - Arai, Hiroyuki
AU - Arai, Tetsuaki
AU - Asada, Takashi
AU - Fujishiro, Hiroshige
AU - Hanyu, Haruo
AU - Iizuka, Osamu
AU - Iseki, Eizo
AU - Kashihara, Kenichi
AU - Kosaka, Kenji
AU - Maruno, Hirotaka
AU - Mizukami, Katsuyoshi
AU - Mizuno, Yoshikuni
AU - Mori, Etsuro
AU - Nakajima, Kenichi
AU - Nakamura, Hiroyuki
AU - Nakano, Seigo
AU - Nakashima, Kenji
AU - Nishio, Yoshiyuki
AU - Orimo, Satoshi
AU - Samuraki, Miharu
AU - Takahashi, Akira
AU - Taki, Junichi
AU - Tokuda, Takahiko
AU - Urakami, Katsuya
AU - Utsumi, Kumiko
AU - Wada, Kenji
AU - Washimi, Yukihiko
AU - Yamasaki, Junichi
AU - Yamashina, Shouhei
AU - Yamada, Masahito
N1 - Funding Information:
Mitsuhiro Yoshita, Kenji Wada and Seigo Nakano received honoraria for sponsored lectures from Fujifilm RI Pharma Co. Ltd. Takashi Asada and Shouhei Yamashina received honoraria for sponsored lectures and research grant from Fujifilm RI Pharma Co. Ltd. and Nihon Medi-Physics Co. Ltd. Haruo Hanyu, Junichi Taki and Takahiko Tokuda received honoraria for sponsored lectures from Nihon Medi-Physics Co. Ltd. Eizo Iseki received honoraria for consultancies, sponsored lectures, and presiding at lecture meetings from Nihon Medi-Physics Co. Ltd. Osamu Iizuka received honoraria and travel costs from Nihon Medi-Physics Co. Ltd. Kenji Kosaka received honoraria for sponsored lectures, writing, and editing from Fujifilm RI Pharma Co. Ltd., and honoraria for sponsored lectures from Nihon Medi-Physics Co. Ltd. Etsuo Mori and Katsuya Urakami received research grant from Fujifilm RI Pharma Co. Ltd., and honoraria for sponsored lectures from Nihon Medi-Physics Co. Ltd. Hirotaka Maruno received honoraria for sponsored lectures and travel costs from Fujifilm RI Pharma Co. Ltd. and Nihon Medi-Physics Co. Ltd. Kenichi Nakajima has collaborative research works with Fujifilm RI Pharma Co. Ltd., and received research funds for joint researches, honoraria for lectures and writing, and pending application for a patent on software development unrelated to this study; the title is "Image processing method and computer program” and the number is No. JP 2012–78088. Kenji Nakashima received sponsored scholarship and honoraria for presiding at lecture meetings from Fujifilm RI Pharma Co. Ltd. Satoshi Orimo received honoraria for sponsored lectures from Fujifilm RI Pharma Co. Ltd. and Nihon Medi-Physics Co. Ltd. Junichi Yamasaki received sponsored scholarship, honoraria for sponsored lectures, and travel costs from Fujifilm RI Pharma Co. Ltd., and honoraria for sponsored lectures and research grant from Nihon Medi-Physics Co. Ltd. Masahito Yamada received honoraria for sponsored lectures and research grant from Fujifilm RI Pharma Co. Ltd. Heii Arai, Hiroyuki Arai, Tetsuaki Arai, Hiroshige Fujishiro, Eizo Iseki, Kenichi Kashihara, Katsuyoshi Mizukami, Yoshikuni Mizuno, Hiroyuki Nakamura, Seigo Nakano, Yoshiyuki Nishio, Miharu Samuraki, Akira Takahashi, Kumiko Utsumi, Kenji Wada, and Yukihiko Washimi declare that they have no conflicts of interest. There are no further patents, products in development or marketed products to declare. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.
Publisher Copyright:
© 2015 Yoshita et al.
PY - 2015/3/20
Y1 - 2015/3/20
N2 - Background and Purpose: Dementia with Lewy bodies (DLB) needs to be distinguished from Alzheimer's disease (AD) because of important differences in patient management and outcome. Severe cardiac sympathetic degeneration occurs in DLB, but not in AD, offering a potential system for a biological diagnostic marker. The primary aim of this study was to investigate the diagnostic accuracy, in the ante-mortem differentiation of probable DLB from probable AD, of cardiac imaging with the ligand 123I-meta-iodobenzylguanidine (MIBG) which binds to the noradrenaline reuptake site, in the first multicenter study. Methods: We performed a multicenter study in which we used 123I-MIBG scans to assess 133 patients with clinical diagnoses of probable (n = 61) or possible (n = 26) DLB or probable AD (n = 46) established by a consensus panel. Three readers, unaware of the clinical diagnosis, classified the images as either normal or abnormal by visual inspection. The heart-to-mediastinum ratios of 123I-MIBG uptake were also calculated using an automated region-of-interest based system. Results: Using the heart-to-mediastinum ratio calculated with the automated system, the sensitivity was 68.9% and the specificity was 89.1%to differentiate probable DLB from probable AD in both early and delayed images. By visual assessment, the sensitivity and specificity were 68.9% and 87.0%, respectively. In a subpopulation of patients with mild dementia (MMSE ≥ 22, n = 47), the sensitivity and specificity were 77.4% and 93.8%, respectively, with the delayed heart-to-mediastinum ratio. Conclusions: Our first multicenter study confirmed the high correlation between abnormal cardiac sympathetic activity evaluated with 123I-MIBG myocardial scintigraphy and a clinical diagnosis of probable DLB. The diagnostic accuracy is sufficiently high for this technique to be clinically useful in distinguishing DLB from AD, especially in patients with mild dementia.
AB - Background and Purpose: Dementia with Lewy bodies (DLB) needs to be distinguished from Alzheimer's disease (AD) because of important differences in patient management and outcome. Severe cardiac sympathetic degeneration occurs in DLB, but not in AD, offering a potential system for a biological diagnostic marker. The primary aim of this study was to investigate the diagnostic accuracy, in the ante-mortem differentiation of probable DLB from probable AD, of cardiac imaging with the ligand 123I-meta-iodobenzylguanidine (MIBG) which binds to the noradrenaline reuptake site, in the first multicenter study. Methods: We performed a multicenter study in which we used 123I-MIBG scans to assess 133 patients with clinical diagnoses of probable (n = 61) or possible (n = 26) DLB or probable AD (n = 46) established by a consensus panel. Three readers, unaware of the clinical diagnosis, classified the images as either normal or abnormal by visual inspection. The heart-to-mediastinum ratios of 123I-MIBG uptake were also calculated using an automated region-of-interest based system. Results: Using the heart-to-mediastinum ratio calculated with the automated system, the sensitivity was 68.9% and the specificity was 89.1%to differentiate probable DLB from probable AD in both early and delayed images. By visual assessment, the sensitivity and specificity were 68.9% and 87.0%, respectively. In a subpopulation of patients with mild dementia (MMSE ≥ 22, n = 47), the sensitivity and specificity were 77.4% and 93.8%, respectively, with the delayed heart-to-mediastinum ratio. Conclusions: Our first multicenter study confirmed the high correlation between abnormal cardiac sympathetic activity evaluated with 123I-MIBG myocardial scintigraphy and a clinical diagnosis of probable DLB. The diagnostic accuracy is sufficiently high for this technique to be clinically useful in distinguishing DLB from AD, especially in patients with mild dementia.
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U2 - 10.1371/journal.pone.0120540
DO - 10.1371/journal.pone.0120540
M3 - Article
C2 - 25793585
AN - SCOPUS:84925607740
SN - 1932-6203
VL - 10
JO - PLoS One
JF - PLoS One
IS - 3
M1 - e0120540
ER -