Clinical Autonomic Research

, Volume 22, Issue 1, pp 43–55 | Cite as

MIBG scintigraphy in differential diagnosis of Parkinsonism: a meta-analysis

  • Giorgio Treglia
  • Ernesto Cason
  • Antonella Stefanelli
  • Fabrizio Cocciolillo
  • Daniela Di Giuda
  • Giorgio Fagioli
  • Alessandro Giordano
Review Article

Abstract

Objective

Differential diagnosis between Parkinson’s disease (PD) and other Parkinsonism using clinical criteria or imaging methods is often difficult. The purpose of this study is to systematically review and meta-analyze published data about the diagnostic performance of myocardial innervation imaging using 123I-metaiodobenzylguanidine (MIBG) scintigraphy in differential diagnosis between PD and other Parkinsonism.

Methods

A comprehensive computer literature search of studies published through March 2011 regarding MIBG scintigraphy in patients with PD and other Parkinsonism was performed in PubMed/MEDLINE and Embase databases. Only studies in which MIBG scintigraphy was performed for differential diagnosis between PD and other Parkinsonism were selected. Pooled sensitivity, pooled specificity and area under the ROC curve were calculated to measure the accuracy of MIBG scintigraphy in differential diagnosis between PD and other Parkinsonism.

Results

Nineteen studies comprising 1,972 patients (1,076 patients with PD, 117 patients with other Lewy body diseases and 779 patients with other diseases) were included in this meta-analysis. The pooled sensitivity of MIBG scintigraphy in detecting PD was 88% (95% CI 86–90%); the pooled specificity of MIBG scintigraphy in discriminating between PD and other Parkinsonism was 85% (95% CI 81–88%). The area under the ROC curve was 0.93.

Conclusions

In patients with clinically suspected PD, myocardial innervation imaging demonstrated high sensitivity and specificity. MIBG scintigraphy is an accurate test in this setting. Nevertheless, possible causes of false-negative and false-positive results should be kept in mind when interpreting the scintigraphic results.

Keywords

MIBG Metaiodobenzylguanidine Parkinson’s disease Parkinsonism Differential diagnosis 

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Giorgio Treglia
    • 1
  • Ernesto Cason
    • 2
  • Antonella Stefanelli
    • 1
  • Fabrizio Cocciolillo
    • 1
  • Daniela Di Giuda
    • 1
  • Giorgio Fagioli
    • 2
  • Alessandro Giordano
    • 1
  1. 1.Institute of Nuclear Medicine, Policlinico GemelliCatholic University of the Sacred HeartRomeItaly
  2. 2.Nuclear Medicine UnitMaggiore HospitalBolognaItaly

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