Annals of Nuclear Medicine

, Volume 22, Issue 7, pp 557–564 | Cite as

Usefulness of rCBF analysis in diagnosing Parkinson’s disease: supplemental role with MIBG myocardial scintigraphy

  • Shigeki Nagamachi
  • Hideyuki Wakamatsu
  • Shogo Kiyohara
  • Seigo Fujita
  • Shigemi Futami
  • Shozo Tamura
  • Masamitsu Nakazato
  • Syuichi Yamashita
  • Hideo Arita
  • Ryuichi Nishii
  • Keiichi Kawai
Original Article

Abstract

Abstract

123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy is a useful tool for differentiating idiopathic Parkinson’s disease (PD) from parkinsonism (PS) caused by other disorders. However, cardiac MIBG uptake is affected by various causes. Alternatively, hypoperfusion in the occipital lobe of PD is reported recently.

Objective

The objective is to clarify the correlation between regional cerebral blood flow (rCBF) alteration and cardiac MIBG uptake in PD. In addition, we examined whether additional brain perfusion analysis improved the differential diagnostic ability for PD from PS when compared with MIBG scintigraphy alone.

Methods

Forty-nine patients with PD (27 mild groups: Hoehn and Yahr stages I, II; 22 severe groups: Hoehn and Yahr stages III, IV) and 28 patients with PS participated. We compared absolute rCBF values between PD and PS. In addition, we determined correlation between MIBG parameters and each rCBF value. Finally, we compared the diagnostic ability for the differentiation of PD from PS between two diagnostic criteria, each MIBG index abnormality alone [heart-to-mediastinum ratio, H/M (E) < 1.9, H/E (D) < 1.7, washout rate > 40%] and each MIBG index abnormality or occipital lobe hypoperfusion (<36 ml/100 g per min).

Results

Absolute rCBF value of occipital lobe was significantly lower in severe PD as compared with PS or mild PD. In the correlation analysis, rCBF of occipital lobe correlated positively with MIBG parameters (H/M). Regarding the diagnostic ability, sensitivity improved by accounting for occipital hypoperfusion as compared with MIBG indices alone. In contrast, neither specificity nor accuracy improved by adding occipital lobe analysis.

Conclusions

MIBG parameters (H/M) correlated positively with occipital hypoperfusion in PD. In the differential diagnosis between PD and PS, although its usefulness might be limited, analysis of rCBF in the occipital lobe added to 123I-MIBG myocardial imaging can be recommended.

Keywords

123I-MIBG 99mTc-HMPAO 3D-SSP 3D-SRT Parkinson’s disease 

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Copyright information

© The Japanese Society of Nuclear Medicine 2008

Authors and Affiliations

  • Shigeki Nagamachi
    • 1
  • Hideyuki Wakamatsu
    • 1
  • Shogo Kiyohara
    • 1
  • Seigo Fujita
    • 1
  • Shigemi Futami
    • 1
  • Shozo Tamura
    • 1
  • Masamitsu Nakazato
    • 2
  • Syuichi Yamashita
    • 2
  • Hideo Arita
    • 1
  • Ryuichi Nishii
    • 3
  • Keiichi Kawai
    • 4
  1. 1.Department of RadiologyMiyazaki Medical CollegeMiyazakiJapan
  2. 2.Department of 3rd Internal MedicineMiyazaki Medical CollegeMiyazakiJapan
  3. 3.Shiga Medical Center for AdultsShigaJapan
  4. 4.Faculty of Health Science, School of MedicineKanazawa UniversityIshikawaJapan

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