Validation of cardiac 123I-MIBG scintigraphy in patients with Parkinson’s disease who were diagnosed with dopamine PET
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
The aim of this study was to evaluate the diagnostic potential of cardiac 123I-labelled metaiodobenzylguanidine (123I-MIBG) scintigraphy in idiopathic Parkinson’s disease (PD). The diagnosis was confirmed by positron emission tomography (PET) imaging with 11C-labelled 2β-carbomethoxy-3β-(4-fluorophenyl)-tropane (11C-CFT) and 11C-raclopride (together designated as dopamine PET).
Cardiac 123I-MIBG scintigraphy and dopamine PET were performed for 39 parkinsonian patients. To estimate the cardiac 123I-MIBG uptake, heart to mediastinum (H/M) ratios in early and delayed images were calculated. On the basis of established clinical criteria and our dopamine PET findings, 24 patients were classified into the PD group and 15 into the non-PD (NPD) group.
Both early and delayed images showed that the H/M ratios were significantly lower in the PD group than in the NPD group. When the optimal cut-off levels of the H/M ratio were set at 1.95 and 1.60 in the early and delayed images, respectively, by receiver-operating characteristic analysis, the sensitivity of cardiac 123I-MIBG scintigraphy for the diagnosis of PD was 79.2 and 70.8% and the specificity was 93.3 and 93.3% in the early and delayed images, respectively. In the Hoehn and Yahr 1 and 2 PD patients, the sensitivity decreased by 69.2 and 53.8% in the early and delayed images, respectively.
In early PD cases, cardiac 123I-MIBG scintigraphy is of limited value in the diagnosis, because of its relatively lower sensitivity. However, because of its high specificity for the overall cases, cardiac 123I-MIBG scintigraphy may assist in the diagnosis of PD in a complementary role with the dopaminergic neuroimaging.
- Orimo S, Ozawa E, Nakade S, Sugimoto T, Mizusawa H. (123)I-metaiodobenzylguanidine myocardial scintigraphy in Parkinson’s disease. J Neurol Neurosurg Psychiatry 1999;67:189–94. CrossRef
- Satoh A, Serita T, Seto M, Tomita I, Satoh H, Iwanaga K, et al. Loss of 123I-MIBG uptake by the heart in Parkinson’s disease: assessment of cardiac sympathetic denervation and diagnostic value. J Nucl Med 1999;40:371–5.
- Taki J, Nakajima K, Hwang EH, Matsunari I, Komai K, Yoshita M, et al. Peripheral sympathetic dysfunction in patients with Parkinson’s disease without autonomic failure is heart selective and disease specific. firstname.lastname@example.org. Eur J Nucl Med 2000;27:566–73. CrossRef
- Takatsu H, Nishida H, Matsuo H, Watanabe S, Nagashima K, Wada H, et al. Cardiac sympathetic denervation from the early stage of Parkinson’s disease: clinical and experimental studies with radiolabeled MIBG. J Nucl Med 2000;41:71–7.
- Nagayama H, Hamamoto M, Ueda M, Nagashima J, Katayama Y. Reliability of MIBG myocardial scintigraphy in the diagnosis of Parkinson’s disease. J Neurol Neurosurg Psychiatry 2005;76:249–51. CrossRef
- Hamada K, Hirayama M, Watanabe H, Kobayashi R, Ito H, Ieda T, et al. Onset age and severity of motor impairment are associated with reduction of myocardial 123I-MIBG uptake in Parkinson’s disease. J Neurol Neurosurg Psychiatry 2003;74:423–6. CrossRef
- Braune S, Reinhardt M, Schnitzer R, Riedel A, Lucking CH. Cardiac uptake of [123I]MIBG separates Parkinson’s disease from multiple system atrophy. Neurology 1999;53:1020–5.
- Raffel DM, Koeppe RA, Little R, Wang CN, Liu S, Junck L, et al. PET measurement of cardiac and nigrostriatal denervation in Parkinsonian syndromes. J Nucl Med 2006;47:1769–77.
- Rajput AH, Rozdilsky B, Rajput A. Accuracy of clinical diagnosis in parkinsonism–a prospective study. Can J Neurol Sci 1991;18:275–8.
- Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 1992;55:181–4. CrossRef
- Jankovic J, Rajput AH, McDermott MP, Perl DP. The evolution of diagnosis in early Parkinson disease. Parkinson Study Group. Arch Neurol 2000;57:369–72. CrossRef
- Hughes AJ, Daniel SE, Lees AJ. Improved accuracy of clinical diagnosis of Lewy body Parkinson’s disease. Neurology 2001;57:1497–9.
- Plotkin M, Amthauer H, Klaffke S, Kuhn A, Ludemann L, Arnold G, et al. Combined 123I-FP-CIT and 123I-IBZM SPECT for the diagnosis of parkinsonian syndromes: study on 72 patients. J Neural Transm 2005;112:677–92. CrossRef
- Nurmi E, Bergman J, Eskola O, Solin O, Vahlberg T, Sonninen P, et al. Progression of dopaminergic hypofunction in striatal subregions in Parkinson’s disease using [18F]CFT PET. Synapse 2003;48:109–15. CrossRef
- Frost JJ, Rosier AJ, Reich SG, Smith JS, Ehlers MD, Snyder SH, et al. Positron emission tomographic imaging of the dopamine transporter with 11C-WIN 35,428 reveals marked declines in mild Parkinson’s disease. Ann Neurol 1993;34:423–31. CrossRef
- Rinne JO, Ruottinen H, Bergman J, Haaparanta M, Sonninen P, Solin O. Usefulness of a dopamine transporter PET ligand [(18)F]beta-CFT in assessing disability in Parkinson’s disease. J Neurol Neurosurg Psychiatry 1999;67:737–41. CrossRef
- Antonini A, Schwarz J, Oertel WH, Beer HF, Madeja UD, Leenders KL. [11C]raclopride and positron emission tomography in previously untreated patients with Parkinson’s disease: influence of L-dopa and lisuride therapy on striatal dopamine D2-receptors. Neurology 1994;44:1325–9.
- Kaasinen V, Ruottinen HM, Någren K, Lehikoinen P, Oikonen V, Rinne JO. Upregulation of putaminal dopamine D2 receptors in early Parkinson’s disease: a comparative PET study with [11C] raclopride and [11C]N-methylspiperone. J Nucl Med 2000;41:65–70.
- Rinne JO, Laihinen A, Rinne UK, Någren K, Bergman J, Ruotsalainen U. PET study on striatal dopamine D2 receptor changes during the progression of early Parkinson’s disease. Mov Disord 1993;8:134–8. CrossRef
- Dentresangle C, Veyre L, Le Bars D, Pierre C, Lavenne F, Pollak P, et al. Striatal D2 dopamine receptor status in Parkinson’s disease: an [18F]dopa and [11C]raclopride PET study. Mov Disord 1999;14:1025–30. CrossRef
- Antonini A, Schwarz J, Oertel WH, Pogarell O, Leenders KL. Long-term changes of striatal dopamine D2 receptors in patients with Parkinson’s disease: a study with positron emission tomography and [11C]raclopride. Mov Disord 1997;12:33–8. CrossRef
- Wang J, Zuo CT, Jiang YP, Guan YH, Chen ZP, Xiang JD, et al. 18F-FP-CIT PET imaging and SPM analysis of dopamine transporters in Parkinson’s disease in various Hoehn & Yahr stages. J Neurol 2007;254:185–90. CrossRef
- Knudsen GM, Karlsborg M, Thomsen G, Krabbe K, Regeur L, Nygaard T, et al. Imaging of dopamine transporters and D2 receptors in patients with Parkinson’s disease and multiple system atrophy. Eur J Nucl Med Mol Imaging 2004;31:1631–8. CrossRef
- Kim YJ, Ichise M, Ballinger JR, Vines D, Erami SS, Tatschida T, et al. Combination of dopamine transporter and D2 receptor SPECT in the diagnostic evaluation of PD, MSA, and PSP. Mov Disord 2002;17:303–12. CrossRef
- Verstappen CC, Bloem BR, Haaxma CA, Oyen WJ, Horstink MW. Diagnostic value of asymmetric striatal D2 receptor upregulation in Parkinson’s disease: an [123I]IBZM and [123I]FP-CIT SPECT study. Eur J Nucl Med Mol Imaging 2007;34:502–7. CrossRef
- Fujiwara T, Watanuki S, Yamamoto S, Miyake M, Seo S, Itoh M, et al. Performance evaluation of a large axial field-of-view PET scanner: SET-2400W. Ann Nucl Med 1997;11:307–13. CrossRef
- Hashimoto M, Kawasaki K, Suzuki M, Mitani K, Murayama S, Mishina M, et al. Presynaptic and postsynaptic nigrostriatal dopaminergic functions in multiple system atrophy. Neuroreport 2008;19:145–50. CrossRef
- Ishibashi K, Ishii K, Oda K, Kawasaki K, Mizusawa H, Ishiwata K. Regional analysis of age-related decline in dopamine transporters and dopamine D2-like receptors in human striatum. Synapse 2009;63:282–90. CrossRef
- NK LO, Dolle F, Lundkvist C, Sandell J, Swahn CG, Vaufrey F, et al. Precursor synthesis and radiolabelling of the dopamine D2 receptor ligand [11C]raclopride from [11C]methyl triflate. J Labelled Compd Radiopharm 1999;42:1183–93. CrossRef
- Kawamura K, Oda K, Ishiwata K. Age-related changes of the [11C]CFT binding to the striatal dopamine transporters in the Fischer 344 rats: a PET study. Ann Nucl Med 2003;17:249–53. CrossRef
- Antonini A, Leenders KL, Reist H, Thomann R, Beer HF, Locher J. Effect of age on D2 dopamine receptors in normal human brain measured by positron emission tomography and 11C-raclopride. Arch Neurol 1993;50:474–80.
- Nakajima K, Taki J, Tonami N, Hisada K. Decreased 123I-MIBG uptake and increased clearance in various cardiac diseases. Nucl Med Commun 1994;15:317–23. CrossRef
- Gilman S, Low PA, Quinn N, Albanese A, Ben-Shlomo Y, Fowler CJ, et al. Consensus statement on the diagnosis of multiple system atrophy. J Auton Nerv Syst 1998;74:189–92.
- Litvan I, Agid Y, Calne D, Campbell G, Dubois B, Duvoisin RC, et al. Clinical research criteria for the diagnosis of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome): report of the NINDS-SPSP international workshop. Neurology 1996;47:1–9.
- Li ST, Dendi R, Holmes C, Goldstein DS. Progressive loss of cardiac sympathetic innervation in Parkinson’s disease. Ann Neurol 2002;52:220–3. CrossRef
- Braune S. The role of cardiac metaiodobenzylguanidine uptake in the differential diagnosis of parkinsonian syndromes. Clin Auton Res 2001;11:351–5. CrossRef
- Spiegel J, Mollers MO, Jost WH, Fuss G, Samnick S, Dillmann U, et al. FP-CIT and MIBG scintigraphy in early Parkinson’s disease. Mov Disord 2005;20:552–61. CrossRef
- Fearnley JM, Lees AJ. Ageing and Parkinson’s disease: substantia nigra regional selectivity. Brain 1991;114(Pt 5):2283–301. CrossRef
- Guttman M, Seeman P, Reynolds GP, Riederer P, Jellinger K, Tourtellotte WW. Dopamine D2 receptor density remains constant in treated Parkinson’s disease. Ann Neurol 1986;19:487–92. CrossRef
- Bokobza B, Ruberg M, Scatton B, Javoy-Agid F, Agid Y. [3H]spiperone binding, dopamine and HVA concentrations in Parkinson’s disease and supranuclear palsy. Eur J Pharmacol 1984;99:167–75. CrossRef
- Kish SJ, Shannak K, Hornykiewicz O. Uneven pattern of dopamine loss in the striatum of patients with idiopathic Parkinson’s disease. Pathophysiologic and clinical implications. N Engl J Med 1988;318:876–80.
- Validation of cardiac 123I-MIBG scintigraphy in patients with Parkinson’s disease who were diagnosed with dopamine PET
European Journal of Nuclear Medicine and Molecular Imaging
Volume 37, Issue 1 , pp 3-11
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Positron emission tomography
- Parkinson’s disease
- Industry Sectors
- Author Affiliations
- 1. Department of Neurology and Neurological Science, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
- 2. Positron Medical Center, Tokyo Metropolitan Institute of Gerontology, 1-1 Nakacho, Itabashi-ku, Tokyo, 173-0022, Japan
- 3. Department of Pathology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
- 4. Department of Neuropathology, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
- 5. Department of Neurology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan