123I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane single photon emission computed tomography and 123I-metaiodobenzylguanidine myocardial scintigraphy in differentiating dementia with lewy bodies from other dementias: A comparative study

Pietro Tiraboschi, Angelo Corso, Ugo P. Guerra, Flavio Nobili, A. Piccardo, Maria Lucia Calcagni, D. Volterrani, Diego Cecchin, Mauro Tettamanti, Luigi Antelmi, Simone Vidale, Leonardo Sacco, Maria Merello, Stefano Stefanini, Anna Micheli, Paola Vai, Selene Capitanio, Sara Vincenzina Gabanelli, R. Riva, Patrizia PintoAve Maria Biffi, Cristina Muscio

Research output: Contribution to journalArticle

Abstract

Objective: To compare the diagnostic value of striatal 123I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane (123I-FP-CIT) single photon emission computed tomography (SPECT) and 123I-metaiodobenzylguanidine (123I-MIBG) myocardial scintigraphy in differentiating dementia with Lewy bodies (DLB) from other dementia types. Methods: This prospective longitudinal study included 30 patients with a clinical diagnosis of DLB and 29 patients with non-DLB dementia (Alzheimer disease, n = 16; behavioral variant frontotemporal dementia, n = 13). All patients underwent 123I-FP-CIT SPECT and 123I-MIBG myocardial scintigraphy within a few weeks of clinical diagnosis. All diagnoses at each center were agreed upon by the local clinician and an independent expert, both unaware of imaging data, and re-evaluated after 12 months. Each image was visually classified as either normal or abnormal by 3 independent nuclear physicians blinded to patients' clinical data. Results: Overall, sensitivity and specificity to DLB were respectively 93% and 100% for 123I-MIBG myocardial scintigraphy, and 90% and 76% for 123I-FP-CIT SPECT. Lower specificity of striatal compared to myocardial imaging was due to decreased 123I-FP-CIT uptake in 7 non-DLB subjects (3 with concomitant parkinsonism) who had normal 123I-MIBG myocardial uptake. Notably, in our non-DLB group, myocardial imaging gave no false-positive readings even in those subjects (n = 7) with concurrent medical illnesses (diabetes and/or heart disease) supposed to potentially interfere with 123I-MIBG uptake. Interpretation: 123I-FP-CIT SPECT and 123I-MIBG myocardial scintigraphy have similar sensitivity for detecting DLB, but the latter appears to be more specific for excluding non-DLB dementias, especially when parkinsonism is the only “core feature” exhibited by the patient. Our data also indicate that the potential confounding effects of diabetes and heart disease on 123I-MIBG myocardial scintigraphy results might have been overestimated. Ann Neurol 2016;80:368–378.

Original languageEnglish
Pages (from-to)368-378
Number of pages11
JournalAnnals of Neurology
Volume80
Issue number3
DOIs
Publication statusPublished - Sep 1 2016

Fingerprint

Nortropanes
Lewy Body Disease
Myocardial Perfusion Imaging
Single-Photon Emission-Computed Tomography
Dementia
Lewy Bodies
Corpus Striatum
Parkinsonian Disorders
Heart Diseases
Frontotemporal Dementia
Longitudinal Studies
Reading
2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane
Prospective Studies
Physicians
Sensitivity and Specificity

ASJC Scopus subject areas

  • Medicine(all)
  • Neurology
  • Clinical Neurology

Cite this

123I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane single photon emission computed tomography and 123I-metaiodobenzylguanidine myocardial scintigraphy in differentiating dementia with lewy bodies from other dementias : A comparative study. / Tiraboschi, Pietro; Corso, Angelo; Guerra, Ugo P.; Nobili, Flavio; Piccardo, A.; Calcagni, Maria Lucia; Volterrani, D.; Cecchin, Diego; Tettamanti, Mauro; Antelmi, Luigi; Vidale, Simone; Sacco, Leonardo; Merello, Maria; Stefanini, Stefano; Micheli, Anna; Vai, Paola; Capitanio, Selene; Gabanelli, Sara Vincenzina; Riva, R.; Pinto, Patrizia; Biffi, Ave Maria; Muscio, Cristina.

In: Annals of Neurology, Vol. 80, No. 3, 01.09.2016, p. 368-378.

Research output: Contribution to journalArticle

Tiraboschi, P, Corso, A, Guerra, UP, Nobili, F, Piccardo, A, Calcagni, ML, Volterrani, D, Cecchin, D, Tettamanti, M, Antelmi, L, Vidale, S, Sacco, L, Merello, M, Stefanini, S, Micheli, A, Vai, P, Capitanio, S, Gabanelli, SV, Riva, R, Pinto, P, Biffi, AM & Muscio, C 2016, '123I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane single photon emission computed tomography and 123I-metaiodobenzylguanidine myocardial scintigraphy in differentiating dementia with lewy bodies from other dementias: A comparative study', Annals of Neurology, vol. 80, no. 3, pp. 368-378. https://doi.org/10.1002/ana.24717
Tiraboschi, Pietro ; Corso, Angelo ; Guerra, Ugo P. ; Nobili, Flavio ; Piccardo, A. ; Calcagni, Maria Lucia ; Volterrani, D. ; Cecchin, Diego ; Tettamanti, Mauro ; Antelmi, Luigi ; Vidale, Simone ; Sacco, Leonardo ; Merello, Maria ; Stefanini, Stefano ; Micheli, Anna ; Vai, Paola ; Capitanio, Selene ; Gabanelli, Sara Vincenzina ; Riva, R. ; Pinto, Patrizia ; Biffi, Ave Maria ; Muscio, Cristina. / 123I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane single photon emission computed tomography and 123I-metaiodobenzylguanidine myocardial scintigraphy in differentiating dementia with lewy bodies from other dementias : A comparative study. In: Annals of Neurology. 2016 ; Vol. 80, No. 3. pp. 368-378.
@article{67c8b93fde8c436688f50960d3a5ca87,
title = "123I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane single photon emission computed tomography and 123I-metaiodobenzylguanidine myocardial scintigraphy in differentiating dementia with lewy bodies from other dementias: A comparative study",
abstract = "Objective: To compare the diagnostic value of striatal 123I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane (123I-FP-CIT) single photon emission computed tomography (SPECT) and 123I-metaiodobenzylguanidine (123I-MIBG) myocardial scintigraphy in differentiating dementia with Lewy bodies (DLB) from other dementia types. Methods: This prospective longitudinal study included 30 patients with a clinical diagnosis of DLB and 29 patients with non-DLB dementia (Alzheimer disease, n = 16; behavioral variant frontotemporal dementia, n = 13). All patients underwent 123I-FP-CIT SPECT and 123I-MIBG myocardial scintigraphy within a few weeks of clinical diagnosis. All diagnoses at each center were agreed upon by the local clinician and an independent expert, both unaware of imaging data, and re-evaluated after 12 months. Each image was visually classified as either normal or abnormal by 3 independent nuclear physicians blinded to patients' clinical data. Results: Overall, sensitivity and specificity to DLB were respectively 93{\%} and 100{\%} for 123I-MIBG myocardial scintigraphy, and 90{\%} and 76{\%} for 123I-FP-CIT SPECT. Lower specificity of striatal compared to myocardial imaging was due to decreased 123I-FP-CIT uptake in 7 non-DLB subjects (3 with concomitant parkinsonism) who had normal 123I-MIBG myocardial uptake. Notably, in our non-DLB group, myocardial imaging gave no false-positive readings even in those subjects (n = 7) with concurrent medical illnesses (diabetes and/or heart disease) supposed to potentially interfere with 123I-MIBG uptake. Interpretation: 123I-FP-CIT SPECT and 123I-MIBG myocardial scintigraphy have similar sensitivity for detecting DLB, but the latter appears to be more specific for excluding non-DLB dementias, especially when parkinsonism is the only “core feature” exhibited by the patient. Our data also indicate that the potential confounding effects of diabetes and heart disease on 123I-MIBG myocardial scintigraphy results might have been overestimated. Ann Neurol 2016;80:368–378.",
author = "Pietro Tiraboschi and Angelo Corso and Guerra, {Ugo P.} and Flavio Nobili and A. Piccardo and Calcagni, {Maria Lucia} and D. Volterrani and Diego Cecchin and Mauro Tettamanti and Luigi Antelmi and Simone Vidale and Leonardo Sacco and Maria Merello and Stefano Stefanini and Anna Micheli and Paola Vai and Selene Capitanio and Gabanelli, {Sara Vincenzina} and R. Riva and Patrizia Pinto and Biffi, {Ave Maria} and Cristina Muscio",
year = "2016",
month = "9",
day = "1",
doi = "10.1002/ana.24717",
language = "English",
volume = "80",
pages = "368--378",
journal = "Annals of Neurology",
issn = "0364-5134",
publisher = "John Wiley and Sons Inc.",
number = "3",

}

TY - JOUR

T1 - 123I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane single photon emission computed tomography and 123I-metaiodobenzylguanidine myocardial scintigraphy in differentiating dementia with lewy bodies from other dementias

T2 - A comparative study

AU - Tiraboschi, Pietro

AU - Corso, Angelo

AU - Guerra, Ugo P.

AU - Nobili, Flavio

AU - Piccardo, A.

AU - Calcagni, Maria Lucia

AU - Volterrani, D.

AU - Cecchin, Diego

AU - Tettamanti, Mauro

AU - Antelmi, Luigi

AU - Vidale, Simone

AU - Sacco, Leonardo

AU - Merello, Maria

AU - Stefanini, Stefano

AU - Micheli, Anna

AU - Vai, Paola

AU - Capitanio, Selene

AU - Gabanelli, Sara Vincenzina

AU - Riva, R.

AU - Pinto, Patrizia

AU - Biffi, Ave Maria

AU - Muscio, Cristina

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Objective: To compare the diagnostic value of striatal 123I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane (123I-FP-CIT) single photon emission computed tomography (SPECT) and 123I-metaiodobenzylguanidine (123I-MIBG) myocardial scintigraphy in differentiating dementia with Lewy bodies (DLB) from other dementia types. Methods: This prospective longitudinal study included 30 patients with a clinical diagnosis of DLB and 29 patients with non-DLB dementia (Alzheimer disease, n = 16; behavioral variant frontotemporal dementia, n = 13). All patients underwent 123I-FP-CIT SPECT and 123I-MIBG myocardial scintigraphy within a few weeks of clinical diagnosis. All diagnoses at each center were agreed upon by the local clinician and an independent expert, both unaware of imaging data, and re-evaluated after 12 months. Each image was visually classified as either normal or abnormal by 3 independent nuclear physicians blinded to patients' clinical data. Results: Overall, sensitivity and specificity to DLB were respectively 93% and 100% for 123I-MIBG myocardial scintigraphy, and 90% and 76% for 123I-FP-CIT SPECT. Lower specificity of striatal compared to myocardial imaging was due to decreased 123I-FP-CIT uptake in 7 non-DLB subjects (3 with concomitant parkinsonism) who had normal 123I-MIBG myocardial uptake. Notably, in our non-DLB group, myocardial imaging gave no false-positive readings even in those subjects (n = 7) with concurrent medical illnesses (diabetes and/or heart disease) supposed to potentially interfere with 123I-MIBG uptake. Interpretation: 123I-FP-CIT SPECT and 123I-MIBG myocardial scintigraphy have similar sensitivity for detecting DLB, but the latter appears to be more specific for excluding non-DLB dementias, especially when parkinsonism is the only “core feature” exhibited by the patient. Our data also indicate that the potential confounding effects of diabetes and heart disease on 123I-MIBG myocardial scintigraphy results might have been overestimated. Ann Neurol 2016;80:368–378.

AB - Objective: To compare the diagnostic value of striatal 123I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane (123I-FP-CIT) single photon emission computed tomography (SPECT) and 123I-metaiodobenzylguanidine (123I-MIBG) myocardial scintigraphy in differentiating dementia with Lewy bodies (DLB) from other dementia types. Methods: This prospective longitudinal study included 30 patients with a clinical diagnosis of DLB and 29 patients with non-DLB dementia (Alzheimer disease, n = 16; behavioral variant frontotemporal dementia, n = 13). All patients underwent 123I-FP-CIT SPECT and 123I-MIBG myocardial scintigraphy within a few weeks of clinical diagnosis. All diagnoses at each center were agreed upon by the local clinician and an independent expert, both unaware of imaging data, and re-evaluated after 12 months. Each image was visually classified as either normal or abnormal by 3 independent nuclear physicians blinded to patients' clinical data. Results: Overall, sensitivity and specificity to DLB were respectively 93% and 100% for 123I-MIBG myocardial scintigraphy, and 90% and 76% for 123I-FP-CIT SPECT. Lower specificity of striatal compared to myocardial imaging was due to decreased 123I-FP-CIT uptake in 7 non-DLB subjects (3 with concomitant parkinsonism) who had normal 123I-MIBG myocardial uptake. Notably, in our non-DLB group, myocardial imaging gave no false-positive readings even in those subjects (n = 7) with concurrent medical illnesses (diabetes and/or heart disease) supposed to potentially interfere with 123I-MIBG uptake. Interpretation: 123I-FP-CIT SPECT and 123I-MIBG myocardial scintigraphy have similar sensitivity for detecting DLB, but the latter appears to be more specific for excluding non-DLB dementias, especially when parkinsonism is the only “core feature” exhibited by the patient. Our data also indicate that the potential confounding effects of diabetes and heart disease on 123I-MIBG myocardial scintigraphy results might have been overestimated. Ann Neurol 2016;80:368–378.

UR - http://www.scopus.com/inward/record.url?scp=84985909480&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84985909480&partnerID=8YFLogxK

U2 - 10.1002/ana.24717

DO - 10.1002/ana.24717

M3 - Article

VL - 80

SP - 368

EP - 378

JO - Annals of Neurology

JF - Annals of Neurology

SN - 0364-5134

IS - 3

ER -