Nucl Med Mol Imaging.
2015 Dec;49(4):298-302. 10.1007/s13139-015-0354-0.
The Utility of Segmental Analysis in Cardiac I-123MIBG SPECT in Parkinson's Disease
- Affiliations
-
- 1Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon 443-380, Republic of Korea. aysays77@naver.com
- 2Department of Neurology, Ajou University School of Medicine, Suwon, South Korea.
- KMID: 2132235
- DOI: http://doi.org/10.1007/s13139-015-0354-0
Abstract
- PURPOSE
Cardiac images using I-123 metaiodobenzylguanidine (MIBG) are widely used to evaluate cardiac sympathetic denervation in Parkinson's disease (PD). The aim of this study was to evaluate the utility of segmental analysis on cardiac MIBG SPECT in PD patients.
MATERIALS AND METHODS
In total, 36 patients with PD (n=26) or essential tremor (ET, n=10) who underwent MIBG cardiac SPECTwere enrolled. The heart-to-mediastinum (H/M) ratios of MIBG uptake were acquired on planar images. For the segmental analysis of SPECT images, we evaluated the summed defect score (SDS) using a 17-segment model. The diagnostic abilities of H/Mratios and segmental parameters on MIBG SPECT were assessed by ROC curve analysis.
RESULTS
The H/Mratios were significantly lower in PD than in ET patients (p<0.05). On segmental analysis, SDS was significantly higher in PD patients than in the ET group (7.04+/- 4.09 vs. 2.90+/-2.80; p=0.006). The defect score of the anteroseptal region showed a significant difference between the groups (p=0.002). The ROC analysis suggested only SDS (AUC=0.785, p=0.0003) and defect scores in the anteroseptal (AUC=0.800, p<0.0001) and inferior (AUC=0.667, p=0.013) regions showed significant diagnostic ability to differentiate PD from ET.
CONCLUSIONS
Segmental parameters from cardiac MIBG SPECT images can provide additional information to differentiate PD from ET patients. Beyond H/M ratios from planar images, we recommend an MIBG SPECT study to evaluate sympathetic denervation in PD.
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