Skip to main content

Advertisement

SpringerLink
Log in

Validation of cardiac 123I-MIBG scintigraphy in patients with Parkinson’s disease who were diagnosed with dopamine PET

  • Original Article
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

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).

Methods

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.

Results

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.

Conclusion

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. 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.

    Article  CAS  PubMed  Google Scholar 

  2. 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.

    CAS  PubMed  Google Scholar 

  3. 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. taki@med.kanazawa-u.ac.jp. Eur J Nucl Med 2000;27:566–73.

    Article  CAS  PubMed  Google Scholar 

  4. 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.

    CAS  PubMed  Google Scholar 

  5. 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.

    Article  CAS  PubMed  Google Scholar 

  6. 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.

    Article  CAS  PubMed  Google Scholar 

  7. 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.

    CAS  PubMed  Google Scholar 

  8. 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.

    CAS  PubMed  Google Scholar 

  9. Rajput AH, Rozdilsky B, Rajput A. Accuracy of clinical diagnosis in parkinsonism–a prospective study. Can J Neurol Sci 1991;18:275–8.

    CAS  PubMed  Google Scholar 

  10. 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.

    Article  CAS  PubMed  Google Scholar 

  11. 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.

    Article  CAS  PubMed  Google Scholar 

  12. Hughes AJ, Daniel SE, Lees AJ. Improved accuracy of clinical diagnosis of Lewy body Parkinson’s disease. Neurology 2001;57:1497–9.

    CAS  PubMed  Google Scholar 

  13. 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.

    Article  CAS  PubMed  Google Scholar 

  14. 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.

    Article  CAS  PubMed  Google Scholar 

  15. 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.

    Article  CAS  PubMed  Google Scholar 

  16. 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.

    Article  CAS  PubMed  Google Scholar 

  17. 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.

    CAS  PubMed  Google Scholar 

  18. 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.

    CAS  PubMed  Google Scholar 

  19. 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.

    Article  CAS  PubMed  Google Scholar 

  20. 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.

    Article  CAS  PubMed  Google Scholar 

  21. 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.

    Article  CAS  PubMed  Google Scholar 

  22. 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.

    Article  CAS  PubMed  Google Scholar 

  23. 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.

    Article  CAS  PubMed  Google Scholar 

  24. 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.

    Article  PubMed  Google Scholar 

  25. 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.

    Article  CAS  PubMed  Google Scholar 

  26. 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.

    Article  CAS  PubMed  Google Scholar 

  27. 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.

    Article  CAS  PubMed  Google Scholar 

  28. 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.

    Article  CAS  PubMed  Google Scholar 

  29. 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.

    Article  Google Scholar 

  30. 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.

    Article  CAS  PubMed  Google Scholar 

  31. 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.

    CAS  PubMed  Google Scholar 

  32. 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.

    Article  CAS  PubMed  Google Scholar 

  33. 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.

    CAS  PubMed  Google Scholar 

  34. 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.

    CAS  PubMed  Google Scholar 

  35. Li ST, Dendi R, Holmes C, Goldstein DS. Progressive loss of cardiac sympathetic innervation in Parkinson’s disease. Ann Neurol 2002;52:220–3.

    Article  PubMed  Google Scholar 

  36. Braune S. The role of cardiac metaiodobenzylguanidine uptake in the differential diagnosis of parkinsonian syndromes. Clin Auton Res 2001;11:351–5.

    Article  CAS  PubMed  Google Scholar 

  37. 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.

    Article  PubMed  Google Scholar 

  38. Fearnley JM, Lees AJ. Ageing and Parkinson’s disease: substantia nigra regional selectivity. Brain 1991;114(Pt 5):2283–301.

    Article  PubMed  Google Scholar 

  39. 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.

    Article  CAS  PubMed  Google Scholar 

  40. 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.

    Article  CAS  PubMed  Google Scholar 

  41. 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.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank Mr. Keiichi Kawasaki, Dr. Masaya Hashimoto, and Ms. Hiroko Tsukinari for their technical assistance and useful discussions. This work was supported by grant-in-aid for Scientific Research (B) No. 20390334 (Ki.I.) from the Japan Society for the Promotion of Science and a grant (06-46) (Ki.I.) from the Program for Promotion of Fundamental Studies in Health Sciences of the National Institute of Biomedical Innovation of Japan, and a grant-in-aid for Neurological and Psychiatric Research (S.M., Y.S., and Ke.I.), and Research fo Longevity (S.M., Y.S., and Ke.I.) from the Ministry of Health, Labor, and Welfare of Japan, a grant-in-aid for Long-Term Comprehensive Research on Age-associated Dementia from the Tokyo Metropolitan Institute of Gerontology (K.K., S.M., and Ke.I.).

Author information

Authors and Affiliations

  1. Department of Neurology and Neurological Science, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan

    Kenji Ishibashi & Hidehiro Mizusawa

  2. Positron Medical Center, Tokyo Metropolitan Institute of Gerontology, 1-1 Nakacho, Itabashi-ku, Tokyo, 173-0022, Japan

    Kenji Ishibashi, Keiichi Oda, Kiichi Ishiwata & Kenji Ishii

  3. Department of Pathology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan

    Yuko Saito

  4. Department of Neuropathology, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan

    Yuko Saito & Shigeo Murayama

  5. Department of Neurology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan

    Kazutomi Kanemaru

Authors
  1. Kenji Ishibashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yuko Saito
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shigeo Murayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kazutomi Kanemaru
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Keiichi Oda
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kiichi Ishiwata
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hidehiro Mizusawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kenji Ishii
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kenji Ishii.

Additional information

An Editorial Commentary on this paper is available at http://dx.doi.org/10.1007/s00259-009-1215-9.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ishibashi, K., Saito, Y., Murayama, S. et al. Validation of cardiac 123I-MIBG scintigraphy in patients with Parkinson’s disease who were diagnosed with dopamine PET. Eur J Nucl Med Mol Imaging 37, 3–11 (2010). https://doi.org/10.1007/s00259-009-1202-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-009-1202-1

Keywords

Search

Navigation