Nörolojide 123I-metaiodobenzylguanidin SPECT-CT kullanılarak sempatik sinir aktivitesinin mutlak niceliği

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Abstract Objective The ability of 123I- metaiodobenzylguanidine (MIBG) sympathetic nerve imaging with three-dimensional (3D) quantitation to clinically diagnose neurological disorders has not been evaluated. This study compared absolute heart counts calculated as mean standardized uptake values (SUVmean) with conventional planar image-based quantitation and assessed the contribution of 123I-MIBG single-photon emission computed tomography (SPECT)-CT to the diagnosis of neurological diseases. Methods Seventy-two patients with neurological diseases were consecutively assessed using early and delayed 123I-MIBG SPECT-CT and planar imaging. Left ventricles were manually segmented in both early and delayed SPECT-CT images, and SUVmean and washout rates (WRs) were calculated. Heart-to-mediastinum ratios (HMRs) and WRs on planar images were conventionally computed. We investigated correlations between planar HMRs and SPECT-CT SUVmeans and between WRs obtained from planar and SPECT-CT images. The cutoff for SPECT-CT WR was defined by linear regression together with normal values of planar WR from a database, and the classification was compared with neurological diagnoses of the patients. We classified the patients according to clinical diagnoses of neurological diseases as follows: controls (n = 6), multiple system atrophy (MSA, n = 7), progressive supranuclear palsy (PSP, n = 17), and Parkinson’s disease or dementia with Lewy bodies (PD/DLB, n = 19), then compared SPECT-CT and planar image parameters among them. Results We found significant correlations between SPECT-CT SUVmean and planar HMR on early and delayed images (R2 = 0.69 and 0.82, p 2 = 0.79, p mean in patients with PSP and MSA tended more towards significance than planar HMR. This trend was similar for SPECT-CT WRs in patients with PSP. Conclusions Absolute heart counts and SUVmean determined using 123I-MIBG SPECT-CT correlated with findings of conventional planar images in patients with neurological diseases. Three-dimensional quantitation with 123I-MIBG SPECT-CT imaging might differentiate patients with PSP and MSA from controls.

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