J P M Kane1, G Roberts2, G S Petrides3, J J Lloyd4, J T O'Brien5, A J Thomas6. 1. Institute of Neuroscience, Newcastle University, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, United Kingdom. Electronic address: j.kane2@newcastle.ac.uk. 2. Institute of Neuroscience, Newcastle University, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, United Kingdom; Nuclear Medicine Department, Royal Victoria Infirmary, Newcastle upon Tyne NHS Foundation Hospitals Trust, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, United Kingdom. Electronic address: gemma.roberts@newcastle.ac.uk. 3. Nuclear Medicine Department, Royal Victoria Infirmary, Newcastle upon Tyne NHS Foundation Hospitals Trust, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, United Kingdom. Electronic address: george.petrides@nuth.nhs.uk. 4. Institute of Neuroscience, Newcastle University, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, United Kingdom; Nuclear Medicine Department, Royal Victoria Infirmary, Newcastle upon Tyne NHS Foundation Hospitals Trust, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, United Kingdom. Electronic address: j.j.lloyd@newcastle.ac.uk. 5. Institute of Neuroscience, Newcastle University, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, United Kingdom; Department of Psychiatry, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, CB2 0SP, United Kingdom. Electronic address: john.obrien@medschl.cam.ac.uk. 6. Institute of Neuroscience, Newcastle University, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, United Kingdom. Electronic address: alan.thomas@newcastle.ac.uk.
Abstract
OBJECTIVE: To determine the utility of 123I-metaiodobenzylguanidine cardiac scintigraphy (MIBG), and optimum heart: mediastinum ratio (HMR) for differentiating dementia with Lewy bodies (DLB) from Alzheimer's disease (AD) in a clinically representative population, comparing findings with those of 123I-2β -carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane (FP-CIT) SPECT. METHODS: We recruited subjects with probable DLB (n = 17) and probable AD (n = 16) from clinical services. Each participant underwent clinical examination, cardiac MIBG scintigraphy and FP-CIT SPECT. Diagnosis was made on the basis of clinical symptoms using validated criteria. Cardiac MIBG uptake was measured by the planar HMR, blind to clinical diagnosis, with values below a cut-off taken from a previous study (<2.2 at four hours) defining scans as abnormal. FP-CIT scans were blindly rated according to a visual rating scale. RESULTS: MIBG had a sensitivity, specificity and overall accuracy of 71%, 81% and 76% for distinguishing DLB from AD. FP-CIT demonstrated a sensitivity, specificity and accuracy of 82%, 88% and 85%. Using a lower HMR cut-off to distinguish between abnormal and normal MIBG scans improved the accuracy of MIBG, raising specificity (100%) and overall accuracy (85%) without compromising sensitivity (71%). Neither prescription of potentially interfering medications, nor a history of myocardial infarction (MI), had a significant effect on HMR. CONCLUSION: We found that MIBG did not demonstrate superior sensitivity and overall accuracy to FP-CIT. HMR cut-off influences biomarker utility, and clinical and Caucasian populations may require a lower cut-off than those reported elsewhere. Future MIBG studies should include clinically representative cohorts as neither medications nor previous MI appear to influence HMR. Crown
OBJECTIVE: To determine the utility of 123I-metaiodobenzylguanidine cardiac scintigraphy (MIBG), and optimum heart: mediastinum ratio (HMR) for differentiating dementia with Lewy bodies (DLB) from Alzheimer's disease (AD) in a clinically representative population, comparing findings with those of 123I-2β -carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane (FP-CIT) SPECT. METHODS: We recruited subjects with probable DLB (n = 17) and probable AD (n = 16) from clinical services. Each participant underwent clinical examination, cardiac MIBG scintigraphy and FP-CIT SPECT. Diagnosis was made on the basis of clinical symptoms using validated criteria. Cardiac MIBG uptake was measured by the planar HMR, blind to clinical diagnosis, with values below a cut-off taken from a previous study (<2.2 at four hours) defining scans as abnormal. FP-CIT scans were blindly rated according to a visual rating scale. RESULTS:MIBG had a sensitivity, specificity and overall accuracy of 71%, 81% and 76% for distinguishing DLB from AD. FP-CIT demonstrated a sensitivity, specificity and accuracy of 82%, 88% and 85%. Using a lower HMR cut-off to distinguish between abnormal and normal MIBG scans improved the accuracy of MIBG, raising specificity (100%) and overall accuracy (85%) without compromising sensitivity (71%). Neither prescription of potentially interfering medications, nor a history of myocardial infarction (MI), had a significant effect on HMR. CONCLUSION: We found that MIBG did not demonstrate superior sensitivity and overall accuracy to FP-CIT. HMR cut-off influences biomarker utility, and clinical and Caucasian populations may require a lower cut-off than those reported elsewhere. Future MIBG studies should include clinically representative cohorts as neither medications nor previous MI appear to influence HMR. Crown
Authors: Gemma Roberts; Joseph P M Kane; Jim Lloyd; Michael Firbank; Paul Christopher Donaghy; George S Petrides; John-Paul Taylor; John O'Brien; Alan J Thomas Journal: Nucl Med Commun Date: 2022-05-20 Impact factor: 1.698
Authors: Leonidas Chouliaras; Alan Thomas; Maura Malpetti; Paul Donaghy; Joseph Kane; Elijah Mak; George Savulich; Maria A Prats-Sedano; Amanda J Heslegrave; Henrik Zetterberg; Li Su; James Benedict Rowe; John Tiernan O'Brien Journal: J Neurol Neurosurg Psychiatry Date: 2022-01-25 Impact factor: 13.654
Authors: Calum A Hamilton; James Frith; Paul C Donaghy; Sally A H Barker; Rory Durcan; Sarah Lawley; Nicola Barnett; Michael Firbank; Gemma Roberts; John-Paul Taylor; Louise M Allan; John O'Brien; Alison J Yarnall; Alan J Thomas Journal: Int J Geriatr Psychiatry Date: 2022-04-02 Impact factor: 3.850
Authors: G Roberts; J J Lloyd; J P M Kane; R Durcan; S Lawley; K Howe; G S Petrides; J T O'Brien; A J Thomas Journal: J Nucl Cardiol Date: 2019-09-16 Impact factor: 5.952
Authors: Gemma Roberts; Rory Durcan; Paul C Donaghy; Sarah Lawley; Joanna Ciafone; Calum A Hamilton; Sean J Colloby; Michael J Firbank; Louise Allan; Nicola Barnett; Sally Barker; Kim Howe; Tamir Ali; George S Petrides; Jim Lloyd; John-Paul Taylor; John O'Brien; Alan J Thomas Journal: Neurology Date: 2021-04-21 Impact factor: 9.910
Authors: Michael J Firbank; John T O'Brien; Rory Durcan; Louise M Allan; Sally Barker; Joanna Ciafone; Paul C Donaghy; Calum A Hamilton; Sarah Lawley; Jim Lloyd; Gemma Roberts; John-Paul Taylor; Alan J Thomas Journal: J Neurol Date: 2020-10-21 Impact factor: 4.849
Authors: Gemma Roberts; Jim J Lloyd; Elizabeth Jefferson; Joseph P M Kane; Rory Durcan; Sarah Lawley; George S Petrides; Kim Howe; Iftikhar Haq; John T O'Brien; Alan J Thomas Journal: J Nucl Cardiol Date: 2019-12-09 Impact factor: 5.952