title: Iodine-123 metaiodobenzylguanidine scintigraphy and iodine-123 ioflupane single photon emission computed tomography in Lewy body diseases: complementary or alternative techniques?
abstract: OBJECTIVE
  To compare myocardial sympathetic imaging using (123)I-Metaiodobenzylguanidine (MIBG) scintigraphy and striatal dopaminergic imaging using (123)I-Ioflupane (FP-CIT) single photon emission computed tomography (SPECT) in patients with suspected Lewy body diseases (LBD).
  
  
  METHODS
  Ninety-nine patients who performed both methods within 2 months for differential diagnosis between Parkinson's disease (PD) and other parkinsonism (n = 68) or between dementia with Lewy bodies (DLB) and other dementia (n = 31) were enrolled. Sensitivity, specificity, accuracy, positive and negative predictive values of both methods were calculated.
  
  
  RESULTS
  For (123) I-MIBG scintigraphy, the overall sensitivity, specificity, accuracy, positive and negative predictive values in LBD were 83%, 79%, 82%, 86%, and 76%, respectively. For (123)I-FP-CIT SPECT, the overall sensitivity, specificity, accuracy, positive and negative predictive values in LBD were 93%, 41%, 73%, 71%, and 80%, respectively. There was a statistically significant difference between these two methods in patients without LBD, but not in patients with LBD.
  
  
  CONCLUSIONS
  LBD usually present both myocardial sympathetic and striatal dopaminergic impairments. (123)I-FP-CIT SPECT presents high sensitivity in the diagnosis of LBD; (123)I-MIBG scintigraphy may have a complementary role in differential diagnosis between PD and other parkinsonism. These scintigraphic methods showed similar diagnostic accuracy in differential diagnosis between DLB and other dementia.
authors.affiliation: Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Treglia
authors.forename: Ernesto
authors.initials: E
authors.lastname: Cason
authors.forename: Pietro
authors.initials: P
authors.lastname: Cortelli
authors.forename: Anna
authors.initials: A
authors.lastname: Gabellini
authors.forename: Rocco
authors.initials: R
authors.lastname: Liguori
authors.forename: Antonio
authors.initials: A
authors.lastname: Bagnato
authors.forename: Alessandro
authors.initials: A
authors.lastname: Giordano
authors.forename: Giorgio
authors.initials: G
authors.lastname: Fagioli
mesh_terms: D019797:3-Iodobenzylguanidine; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D020961:Lewy Body Disease / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014326:Tropanes
chemical_list: D019275:Radiopharmaceuticals; D014326:Tropanes; C087552:2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane; D019797:3-Iodobenzylguanidine