Title
Diagnostic value of MIBG cardiac scintigraphy for differential dementia diagnosis Diagnostic value of MIBG cardiac scintigraphy for differential dementia diagnosis
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Faculty of Pharmaceutical, Biomedical and Veterinary Sciences . Biomedical Sciences
Publication type
article
Publication
Chichester ,
Subject
Human medicine
Source (journal)
International journal of geriatric psychiatry: a journal of the psychiatry of late life and allied sciences. - Chichester
Volume/pages
30(2015) :8 , p. 864-869
ISSN
0885-6230
ISI
000357884200010
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
Objective Iodine-123 metaiodobenzylguanidine (MIBG) cardiac scintigraphy has shown the potential to discriminate dementia with Lewy bodies (DLB) from Alzheimer's disease (AD). However, these studies did not reflect clinical practice, as patients with ischemic heart disease, heart failure, diabetes mellitus, arterial hypertension, and hyperlipidemia and patients treated with antidepressants like trazodone were excluded. Methods This study aimed to evaluate the use of MIBG cardiac scintigraphy to diagnose DLB in clinical practice. Moreover, the potential diagnostic value of MIBG cardiac scintigraphy in patients with clinically ambiguous dementia diagnosis (DLB versus AD) was tested. Eighty-five patients with a possible clinical diagnosis of DLB entered the study. MIBG uptake was determined by calculating the heart-to-mediastinum-uptake ratio (H/M). Results The average H/M ratio was 1.42 ± 0.35. The number of core features for DLB and the H/M ratio were negatively correlated (p = 0.001; r = −0.360). With an H/M ratio cutoff of 1.68 in 20 patients with clinically ambiguous dementia diagnoses (DLB versus AD) at the moment of MIBG cardiac scintigraphy, 95% (19/20) of the patients were correctly classified as compared with clinical or definite diagnosis at follow-up, with sensitivity and specificity values for diagnosing DLB of 100% (16/16) and 75% (3/4), respectively. The H/M ratio was influenced only by age (p = 0.046; r = −0.217) and gender (p = 0.024) and not by any other variable studied. Conclusions The MIBG cardiac scintigraphy H/M ratio is a possible diagnostic biomarker for DLB in routine clinical practice and might have an added diagnostic value in case of doubt between DLB and AD.
Full text (open access)
https://repository.uantwerpen.be/docman/irua/a1bda1/6101639f.pdf
https://repository.uantwerpen.be/docman/irua/7ddb4a/9261.pdf
E-info
https://repository.uantwerpen.be/docman/iruaauth/47d42d/76710498.pdf
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