123I-metaiodobenzylguanidine myocardial scintigraphy with early images alone is useful for the differential diagnosis of dementia with Lewy bodies.
123I-metaiodobenzylguanidine cardiac scintigraphy (MIBG) is a useful imaging technique for the diagnosis of dementia with Lewy bodies (DLB). However, MIBG has a serious disadvantage in that it demands a long examination time. The objective of this study was to evaluate statistically the usefulness of the heart/mediastinum ratio (H/M) from the early phase of MIBG for the differential diagnosis of DLB. In total, 113 patients were examined, including 32 non-DLB (19 with Alzheimer's dementia) and 79 DLB patients. The mean early-H/M ratio was 2.83 in the non-DLB group and 1.95 in the DLB group. The mean delayed-H/M ratio was 3.0 in the non-DLB group and 1.76 in the DLB group. With a cutoff point of 2.27 on early images, the sensitivity, specificity, and diagnostic accuracy were 65%, 94%, and 73%, respectively, and the area under the curve was 0.82, indicating moderate accuracy. This analysis indicates that images from the early phase of MIBG alone are sufficient for the differential diagnosis of Alzheimer's disease and DLB.
Dementia Diagnostic Center, Department of Internal Medicine, Yokohama Shintoshi Neurosurgical Hospital, 433 Edacho, Aobaku, Yokohama-shi, 225-0013 Kanagawa, Japan; Fujita Health University Hospital, Department of Emergency and General Internal Medicine, 1-98 Dengakugakubo, Kutukakecho, Toyoake-shi, 470-1192 Aichi, Japan; Clinic Ian Center Minami, 40-3 Chigasakichuou, Tuzuki-ku, Yokohama-shi, 224-0032 Kanagawa, Japan. Electronic address: manabe.epikuros@gmail.com.
Yuta
Y
Manabe
Fujita Health University Hospital, Department of Radiology, 1-98 Dengakugakubo, Kutukakecho, Toyoake-shi, 470-1192 Aichi, Japan.
Yoshitaka
Y
Inui
Fujita Health University Hospital, Department of Radiology, 1-98 Dengakugakubo, Kutukakecho, Toyoake-shi, 470-1192 Aichi, Japan.
Hiroshi
H
Toyama
Clinic Ian Center Minami, 40-3 Chigasakichuou, Tuzuki-ku, Yokohama-shi, 224-0032 Kanagawa, Japan.
Kenji
K
Kosaka
D019797:3-Iodobenzylguanidine; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D020961:Lewy Body Disease / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity
D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine
Alzheimer-type dementia; Dementia with Lewy bodies; Heart/mediastinum ratio; Lewy body disease; Parkinson's disease; Parkinson's disease with dementia