Value of multi-parameter 123I-MIBG scintigraphy in the differential diagnosis of Parkinson’s disease
Abstract Background 123I-MIBG scintigraphy plays a significant role in diagnosing Parkinson's disease (PD), with most studies primarily targeting cardiac uptake and relying on traditional ratio-based parameters for assessment. However, due to variations in scanning conditions and image processi...
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SpringerOpen
2025-01-01
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| Online Access: | https://doi.org/10.1186/s13550-025-01197-8 |
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| author | Teng Xue Ying Cui Ying Kan Guanyun Wang Jigang Yang |
| author_facet | Teng Xue Ying Cui Ying Kan Guanyun Wang Jigang Yang |
| author_sort | Teng Xue |
| collection | DOAJ |
| description | Abstract Background 123I-MIBG scintigraphy plays a significant role in diagnosing Parkinson's disease (PD), with most studies primarily targeting cardiac uptake and relying on traditional ratio-based parameters for assessment. However, due to variations in scanning conditions and image processing methodologies, the clinical utility of different parameters remains a subject of debate. This study aims to evaluate the diagnostic accuracy of multi-parameter 123I-3-Iodobenzylguanidine (MIBG) scintigraphy and to identify the most reliable metrics for distinguishing PD from Parkinson-plus syndromes. Result We recruited 56 PD patients and 44 non-PD controls, who underwent 123I-MIBG scintigraphy and clinical evaluation. MIBG uptake and washout rates (WR) for the heart, salivary glands, and thyroid were assessed, with semi-quantitative methods used to calculate heart-to-mediastinum (H/M) and gland-to-background (P/B, S/B, T/B) ratios. Diagnostic efficacy was evaluated using receiver operating characteristic (ROC) curves. The H/M ratio and cardiac WR parameters scintigraphy exhibited excellent diagnostic efficacy for PD and PPS. The 4 h H/M ratio showed superior diagnostic performance with an area under the ROC curve (AUC) of 0.980. Background and time decay correction improved cardiac WR diagnostic performance (AUC = 0.963). Although P/B, S/B, and T/B ratios showed no significant differences for differential diagnosis, the WR values of the parotid and thyroid glands exhibited moderate diagnostic efficacy with AUCs of 0.648 and 0.638, respectively. Conclusion The heart H/M ratio and cardiac WR in 123I-MIBG scintigraphy show high diagnostic efficacy for both diagnosing and differentiating PD. Including cardiac WR in routine assessments is recommended. The diagnostic potential of WR in the parotid and thyroid glands also holds promise for PD diagnosis. Incorporating these parameters could enhance the accuracy of PD diagnosis, particularly in clinical scenarios where concurrent cardiac disease may confound the diagnosis. |
| format | Article |
| id | doaj-art-fd39b132e0de4cf3be10d868f7c9a425 |
| institution | Kabale University |
| issn | 2191-219X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SpringerOpen |
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| series | EJNMMI Research |
| spelling | doaj-art-fd39b132e0de4cf3be10d868f7c9a4252025-02-02T12:42:18ZengSpringerOpenEJNMMI Research2191-219X2025-01-0115111210.1186/s13550-025-01197-8Value of multi-parameter 123I-MIBG scintigraphy in the differential diagnosis of Parkinson’s diseaseTeng Xue0Ying Cui1Ying Kan2Guanyun Wang3Jigang Yang4Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical UniversityDepartment of Neurology, Beijing Friendship Hospital, Capital Medical UniversityDepartment of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical UniversityDepartment of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical UniversityDepartment of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical UniversityAbstract Background 123I-MIBG scintigraphy plays a significant role in diagnosing Parkinson's disease (PD), with most studies primarily targeting cardiac uptake and relying on traditional ratio-based parameters for assessment. However, due to variations in scanning conditions and image processing methodologies, the clinical utility of different parameters remains a subject of debate. This study aims to evaluate the diagnostic accuracy of multi-parameter 123I-3-Iodobenzylguanidine (MIBG) scintigraphy and to identify the most reliable metrics for distinguishing PD from Parkinson-plus syndromes. Result We recruited 56 PD patients and 44 non-PD controls, who underwent 123I-MIBG scintigraphy and clinical evaluation. MIBG uptake and washout rates (WR) for the heart, salivary glands, and thyroid were assessed, with semi-quantitative methods used to calculate heart-to-mediastinum (H/M) and gland-to-background (P/B, S/B, T/B) ratios. Diagnostic efficacy was evaluated using receiver operating characteristic (ROC) curves. The H/M ratio and cardiac WR parameters scintigraphy exhibited excellent diagnostic efficacy for PD and PPS. The 4 h H/M ratio showed superior diagnostic performance with an area under the ROC curve (AUC) of 0.980. Background and time decay correction improved cardiac WR diagnostic performance (AUC = 0.963). Although P/B, S/B, and T/B ratios showed no significant differences for differential diagnosis, the WR values of the parotid and thyroid glands exhibited moderate diagnostic efficacy with AUCs of 0.648 and 0.638, respectively. Conclusion The heart H/M ratio and cardiac WR in 123I-MIBG scintigraphy show high diagnostic efficacy for both diagnosing and differentiating PD. Including cardiac WR in routine assessments is recommended. The diagnostic potential of WR in the parotid and thyroid glands also holds promise for PD diagnosis. Incorporating these parameters could enhance the accuracy of PD diagnosis, particularly in clinical scenarios where concurrent cardiac disease may confound the diagnosis.https://doi.org/10.1186/s13550-025-01197-8Parkinson diseaseParkinsonism-plus syndrome3-IodobenzylguanidineSalivary glandsThyroid gland |
| spellingShingle | Teng Xue Ying Cui Ying Kan Guanyun Wang Jigang Yang Value of multi-parameter 123I-MIBG scintigraphy in the differential diagnosis of Parkinson’s disease EJNMMI Research Parkinson disease Parkinsonism-plus syndrome 3-Iodobenzylguanidine Salivary glands Thyroid gland |
| title | Value of multi-parameter 123I-MIBG scintigraphy in the differential diagnosis of Parkinson’s disease |
| title_full | Value of multi-parameter 123I-MIBG scintigraphy in the differential diagnosis of Parkinson’s disease |
| title_fullStr | Value of multi-parameter 123I-MIBG scintigraphy in the differential diagnosis of Parkinson’s disease |
| title_full_unstemmed | Value of multi-parameter 123I-MIBG scintigraphy in the differential diagnosis of Parkinson’s disease |
| title_short | Value of multi-parameter 123I-MIBG scintigraphy in the differential diagnosis of Parkinson’s disease |
| title_sort | value of multi parameter 123i mibg scintigraphy in the differential diagnosis of parkinson s disease |
| topic | Parkinson disease Parkinsonism-plus syndrome 3-Iodobenzylguanidine Salivary glands Thyroid gland |
| url | https://doi.org/10.1186/s13550-025-01197-8 |
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