title: MIBG scintigraphy in differential diagnosis of Parkinsonism: a meta-analysis.
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 (123)I-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.
authors.affiliation: Institute of Nuclear Medicine, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy. giorgiomednuc@libero.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Treglia
authors.forename: Ernesto
authors.initials: E
authors.lastname: Cason
authors.forename: Antonella
authors.initials: A
authors.lastname: Stefanelli
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Cocciolillo
authors.forename: Daniela
authors.initials: D
authors.lastname: Di Giuda
authors.forename: Giorgio
authors.initials: G
authors.lastname: Fagioli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Giordano
mesh_terms: D019797:3-Iodobenzylguanidine; D003937:Diagnosis, Differential; D005188:False Negative Reactions; D005189:False Positive Reactions; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D020961:Lewy Body Disease / Q000000981:diagnostic imaging; D010300:Parkinson Disease / Q000000981:diagnostic imaging*; D020734:Parkinsonian Disorders / Q000175:diagnosis; D012372:ROC Curve; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results
chemical_list: D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine