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Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 6/2011

01.06.2011 | Original Article

Diagnostic cutoff points for 123I-MIBG myocardial scintigraphy in a Caucasian population with Parkinson’s disease

verfasst von: África Muxí, Pilar Paredes, Ignacio Navales, Francesc Valldeoriola, Carles Gaig, Francisco Lomeña, Andres de la Cerda, Oriol Solà, Beatriz Domenech, Eduardo Tolosa, Francesca Pons

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 6/2011

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Abstract

Purpose

Molecular imaging with 123I-metaiodobenzylguanidine (MIBG) has been used in Parkinson’s disease (PD), but there is no consensual index to discriminate between normal and PD patients in the Caucasian population. The purpose of this study was to determine diagnostic cutoff points in the quantification of MIBG cardiac uptake in our population of PD patients. We have also calculated the reproducibility over a range of interpretation expertise.

Methods

The study included 14 PD patients and 14 normal age- and sex-matched controls. Heart to mediastinum ratios (H/M) were calculated at 15 min (H/M15m) and 4 h (H/M4h) post-injection by three observers with different interpretation expertise, one of whom drew the regions of interest at three different times. The intraobserver and interobserver reliability was calculated (interclass correlation coefficient and coefficient of variability). Diagnosis was estimated by maximizing the Youden index for H/M and washout ratios. Discrimination ability was assessed by the area under the curve (AUC). Sensitivity and specificity were reported, using our thresholds.

Results

The parameter with the best diagnostic accuracy was the H/M4h ratio, with a major AUC (0.976 area under the receiver-operating characteristic curve). The threshold was 1.43 with a 95% confidence interval of 1.37–1.50. Using this threshold, the sensitivity and specificity were 93 and 100%. The interobserver and intraobserver variabilities measuring this ratio were 3.2 and 3.1%, respectively.

Conclusion

The diagnostic cutoff point for 123I-MIBG myocardial scintigraphy in a Caucasian population with PD was 1.43 for the H/M4h index, with a good sensitivity and specificity. The technique is easy to use, with a good reproducibility over a range of interpretation expertise.
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Metadaten
Titel
Diagnostic cutoff points for 123I-MIBG myocardial scintigraphy in a Caucasian population with Parkinson’s disease
verfasst von
África Muxí
Pilar Paredes
Ignacio Navales
Francesc Valldeoriola
Carles Gaig
Francisco Lomeña
Andres de la Cerda
Oriol Solà
Beatriz Domenech
Eduardo Tolosa
Francesca Pons
Publikationsdatum
01.06.2011
Verlag
Springer-Verlag
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 6/2011
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-011-1754-8

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