<sup>123</sup>I‐2β‐carbomethoxy‐3β‐(4‐iodophenyl)‐<i>N</i>‐(3‐fluoropropyl) nortropane single photon emission computed tomography and <sup>123</sup>I‐metaiodobenzylguanidine myocardial scintigraphy in differentiating dementia with lewy bodies from other dementias: A comparative study
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- Pietro Tiraboschi
- Division of Neurology V/Neuropathology, Scientific Institute for Research, Hospitalization, and Care (IRCCS), Foundation “Carlo Besta” Neurological Institute Milan Italy
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- Angelo Corso
- Department of Nuclear Medicine Sant'Anna Hospital Como Italy
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- Ugo Paolo Guerra
- Department of Nuclear Medicine Poliambulanza Foundation Brescia Italy
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- Flavio Nobili
- Department of Neuroscience University of Genoa Genoa Italy
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- Arnoldo Piccardo
- Nuclear Medicine Unit, Department of Diagnostic Imaging E. O. Galliera Hospital Genoa Italy
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- Maria Lucia Calcagni
- Institute of Nuclear Medicine Catholic University of the Sacred Heart Rome Italy
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- Duccio Volterrani
- Nuclear Medicine Unit University Hospital of Pisa Pisa Italy
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- Diego Cecchin
- Department of Medicine University of Padua Padua Italy
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- Mauro Tettamanti
- Laboratory of Geriatric Neuropsychiatry, Institute of Hospitalization and Scientific Care Mario Negri Institute of Pharmacological Research Milan Italy
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- Luigi Antelmi
- Health Department, Institute of Hospitalization and Scientific Care Foundation Carlo Besta Neurological Institute Milan Italy
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- Simone Vidale
- Department of Neurology and Stroke Unit Sant'Anna Hospital Como Italy
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- Leonardo Sacco
- Department of Neurology and Stroke Unit Sant'Anna Hospital Como Italy
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- Maria Merello
- European Foundation for Biomedical Research, Alzheimer Center of Excellence, Briolini Hospital of Gazzaniga Bergamo Italy
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- Stefano Stefanini
- European Foundation for Biomedical Research, Alzheimer Center of Excellence, Briolini Hospital of Gazzaniga Bergamo Italy
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- Anna Micheli
- Neurology Unit, San Francesco Clinic Bergamo Italy
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- Paola Vai
- Department of Nuclear Medicine Papa Giovanni XXIII Hospital Bergamo Italy
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- Selene Capitanio
- Department of Nuclear Medicine Papa Giovanni XXIII Hospital Bergamo Italy
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- Sara Vincenzina Gabanelli
- Department of Nuclear Medicine Papa Giovanni XXIII Hospital Bergamo Italy
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- Riccardo Riva
- Department of Neurology Papa Giovanni XXIII Hospital Bergamo Italy
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- Patrizia Pinto
- Department of Neurology Papa Giovanni XXIII Hospital Bergamo Italy
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- Ave Maria Biffi
- Department of Psychology Papa Giovanni XXIII Hospital Bergamo Italy
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- Cristina Muscio
- Division of Neurology V/Neuropathology, Scientific Institute for Research, Hospitalization, and Care (IRCCS), Foundation “Carlo Besta” Neurological Institute Milan Italy
説明
<jats:sec><jats:title>Objective</jats:title><jats:p>To compare the diagnostic value of striatal <jats:sup>123</jats:sup>I‐2β‐carbomethoxy‐3β‐(4‐iodophenyl)‐<jats:italic>N</jats:italic>‐(3‐fluoropropyl) nortropane (<jats:sup>123</jats:sup>I‐FP‐CIT) single photon emission computed tomography (SPECT) and <jats:sup>123</jats:sup>I‐metaiodobenzylguanidine (<jats:sup>123</jats:sup>I‐MIBG) myocardial scintigraphy in differentiating dementia with Lewy bodies (DLB) from other dementia types.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>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 <jats:sup>123</jats:sup>I‐FP‐CIT SPECT and <jats:sup>123</jats:sup>I‐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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Overall, sensitivity and specificity to DLB were respectively 93% and 100% for <jats:sup>123</jats:sup>I‐MIBG myocardial scintigraphy, and 90% and 76% for <jats:sup>123</jats:sup>I‐FP‐CIT SPECT. Lower specificity of striatal compared to myocardial imaging was due to decreased <jats:sup>123</jats:sup>I‐FP‐CIT uptake in 7 non‐DLB subjects (3 with concomitant parkinsonism) who had normal <jats:sup>123</jats:sup>I‐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 <jats:sup>123</jats:sup>I‐MIBG uptake.</jats:p></jats:sec><jats:sec><jats:title>Interpretation</jats:title><jats:p><jats:sup>123</jats:sup>I‐FP‐CIT SPECT and <jats:sup>123</jats:sup>I‐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 <jats:sup>123</jats:sup>I‐MIBG myocardial scintigraphy results might have been overestimated. Ann Neurol 2016;80:368–378</jats:p></jats:sec>
収録刊行物
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- Annals of Neurology
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Annals of Neurology 80 (3), 368-378, 2016-08-02
Wiley