title: Diagnostic accuracy of ¹²³I-FP-CIT (DaTSCAN) in dementia with Lewy bodies: a meta-analysis of published studies.
abstract: OBJECTIVE
  A systematic meta-analysis of published studies on the diagnostic accuracy of presynaptic dopaminergic imaging with ¹²³I-FP-CIT (DaTSCAN) in dementia with Lewy bodies (DLB).
  
  
  METHODS
  We included (a) studies in which DaTSCAN was performed in cases of diagnostic uncertainty to differentiate between DLB and non-DLB dementia and (b) studies of patients with already established diagnoses of DLB, non-DLB dementia, or normalcy, against which the diagnostic accuracy of DaTSCAN was tested. We applied fixed-effects Mantel-Haenszel and hierarchical logistic regression models for meta-analysis of the diagnostic test's accuracy. The pooled sensitivity, specificity and diagnostic odds ratio (DOR) were estimated. Heterogeneity among studies was estimated by calculating the corresponding I² statistic. We tested for publication or other bias by creating the respective funnel plot.
  
  
  RESULTS
  Four studies, with a total of 419 subjects, were judged to be suitable for meta-analysis. According to hierarchical models, the estimated pooled sensitivity of DaTSCAN in differentiating DLB versus no DLB was 86.5% [95% Confidence Intervals (CI): 72-94.1%], the specificity was 93.6% (95% CI: 88.5-96.6%), and the DOR was 94.2 (95% CI: 25.7-345). The Mantel-Haenszel estimate of overall DOR was calculated at 48.95 (95% CI: 26.16-91.59). There was some heterogeneity among studies (I² = 45%), but this was not found statistically significant (χ² test for heterogeneity p value = 0.142). Funnel plot analysis showed no significant bias.
  
  
  CONCLUSIONS
  Allowing for the small number of studies in the meta-analysis, our results showed high diagnostic accuracy of DaTSCAN in DLB diagnosis, especially in terms of specificity.
authors.affiliation: Institute of Nuclear Medicine, University College Hospital, 235 Euston Road, London NW1 2BU, UK.
authors.forename: Nikolaos D
authors.initials: ND
authors.lastname: Papathanasiou
authors.forename: Anastasios
authors.initials: A
authors.lastname: Boutsiadis
authors.forename: John
authors.initials: J
authors.lastname: Dickson
authors.forename: Jamshed B
authors.initials: JB
authors.lastname: Bomanji
mesh_terms: D050483:Dopamine Plasma Membrane Transport Proteins / Q000032:analysis; D006801:Humans; D020961:Lewy Body Disease / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014326:Tropanes
chemical_list: D050483:Dopamine Plasma Membrane Transport Proteins; D019275:Radiopharmaceuticals; D014326:Tropanes; C087552:2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane