Comparative Study between the Diagnostic Effectiveness of Brain SPECT with [123I]Ioflupane and [123I]MIBG Scintigraphy in Multiple System Atrophy

Author:

Villena-Salinas Javier1ORCID,Ortega-Lozano Simeón José1,Amrani-Raissouni Tomader1,Agüera-Morales Eduardo23ORCID,Caballero-Villarraso Javier345ORCID

Affiliation:

1. Nuclear Medicine Service, Virgen de la Victoria University Hospital, 29010 Málaga, Spain

2. Neurology Service, Reina Sofia University Hospital, 14004 Cordoba, Spain

3. Maimónides Biomedical Research Institute of Córdoba (IMIBIC), 14004 Córdoba, Spain

4. Clinical Analyses Service, Reina Sofía University Hospital, 14004 Córdoba, Spain

5. Department of Biochemistry and Molecular Biology, Universidad of Córdoba, 14071 Córdoba, Spain

Abstract

Background: Multiple system atrophy (MSA) is a neurodegenerative disease. It has a fast progression, so early diagnosis is decisive. Two functional imaging tests can be involved in its diagnosis: [123I]Ioflupane SPECT and [123I]MIBG scintigraphy. Our aim is to comparatively analyze the diagnostic performance of both techniques. Methods: 46 patients (24 males and 22 females) with MSA underwent [123I]Ioflupane SPECT and [123I]MIBG scintigraphy. In each of these techniques, qualitative assessment was compared with quantitative assessment. Results: SPECT visual assessment was positive in 93.5% of subjects (S = 95.24%; PPV = 93.02%). A cut-off of 1.363 was established for overall S/O index (S = 85.7%, E = 100%). Visual assessment of scintigraphy was positive in 73.1% (S = 78.57%, PPV = 94.29%). For the delayed heart/medistinum ratio (HMR) a cut-off of 1.43 (S = 85.3, E = 100%) was obtained. For each unit increase in delayed HMR, the suspicion of MSA increased by 1.58 (OR = 1.58, p < 0.05). The quantitative assessment showed an association with the visual assessment for each technique (p < 0.05). Conclusions: Both tests are useful in MSA diagnosis. Comparatively, we did not observe a clear superiority of either. Striatal and myocardial deterioration do not evolve in parallel. Qualitative assessment is crucial in both techniques, together with the support of quantitative analysis. Delayed HMR shows a direct relationship with the risk of MSA.

Publisher

MDPI AG

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