Diagnostic accuracy of cardiac metaiodobenzylguanidine scintigraphy in Parkinson disease
Identifieur interne : 000003 ( Main/Corpus ); précédent : 000002; suivant : 000004Diagnostic accuracy of cardiac metaiodobenzylguanidine scintigraphy in Parkinson disease
Auteurs : H. Sawada ; T. Oeda ; K. Yamamoto ; N. Kitagawa ; E. Mizuta ; R. Hosokawa ; M. Ohba ; R. Nishio ; K. Yamakawa ; H. Takeuchi ; S. Shimohama ; R. Takahashi ; T. KawamuraSource :
- European Journal of Neurology [ 1351-5101 ] ; 2009-02.
English descriptors
Abstract
Background and purpose: To estimate the diagnostic accuracy of cardiac 123I‐metaiodobenzylguanidine (MIBG) scintigram for detection of Parkinson disease. Methods: A cross‐sectional study with index test of MIBG scintigram and reference standard of U.K. Parkinson’s Disease Brain Bank Criteria was performed in 403 patients. Ratio of cardiac‐to‐mediastinum MIBG accumulation was determined at 20 min (early H/M) and 4 h (late H/M). Area under the receiver‐operator characteristic (ROC) curve, sensitivity and specificity in detecting Parkinson disease were analyzed. Accuracy was analyzed in a subgroup of patients with disease duration of 3 years or less. Results: Area under the ROC curve was 0.89 using either early or late H/M as a diagnostic marker (95% CI 0.85–0.92 for early H/M and 0.86–0.93 for late H/M). Sensitivity and specificity were 81.3% (76.1–85.8%) and 85.0% (77.7–90.6%) for early H/M and 84.3% (79.3–88.4%) and 89.5% (83.01–94.1%) for late H/M. In the subgroup with duration of 3 years or less, the ROC curve area, sensitivity, and specificity were 0.86 (0.79–0.92), 76.0% (64.8–85.1%), and 83.9% (71.7–92.4%) for early H/M and 0.85 (0.78–0.92), 73.3% (61.9–82.9%), and 87.5% (75.9–94.8%) for late H/M. Conclusion: Although diagnostic accuracy of cardiac MIBG scintigram is high, it is limited because of insufficient sensitivity in patients with short duration.
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DOI: 10.1111/j.1468-1331.2008.02372.x
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Yamakawa</name><affiliation><mods:affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</mods:affiliation></affiliation></author><author><name sortKey="Takeuchi, H" sort="Takeuchi, H" uniqKey="Takeuchi H" first="H." last="Takeuchi">H. Takeuchi</name><affiliation><mods:affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</mods:affiliation></affiliation></author><author><name sortKey="Shimohama, S" sort="Shimohama, S" uniqKey="Shimohama S" first="S." last="Shimohama">S. Shimohama</name><affiliation><mods:affiliation>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</mods:affiliation></affiliation></author><author><name sortKey="Takahashi, R" sort="Takahashi, R" uniqKey="Takahashi R" first="R." last="Takahashi">R. Takahashi</name><affiliation><mods:affiliation>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</mods:affiliation></affiliation></author><author><name sortKey="Kawamura, T" sort="Kawamura, T" uniqKey="Kawamura T" first="T." last="Kawamura">T. 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Sawada</name><affiliation><mods:affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</mods:affiliation></affiliation><affiliation><mods:affiliation>Center for Parkinson Disease and Related Disorders, Utano National Hospital, Kyoto, Japan</mods:affiliation></affiliation></author><author><name sortKey="Oeda, T" sort="Oeda, T" uniqKey="Oeda T" first="T." last="Oeda">T. Oeda</name><affiliation><mods:affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</mods:affiliation></affiliation><affiliation><mods:affiliation>Center for Parkinson Disease and Related Disorders, Utano National Hospital, Kyoto, Japan</mods:affiliation></affiliation></author><author><name sortKey="Yamamoto, K" sort="Yamamoto, K" uniqKey="Yamamoto K" first="K." last="Yamamoto">K. Yamamoto</name><affiliation><mods:affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</mods:affiliation></affiliation><affiliation><mods:affiliation>Center for Parkinson Disease and Related Disorders, Utano National Hospital, Kyoto, Japan</mods:affiliation></affiliation></author><author><name sortKey="Kitagawa, N" sort="Kitagawa, N" uniqKey="Kitagawa N" first="N." last="Kitagawa">N. Kitagawa</name><affiliation><mods:affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</mods:affiliation></affiliation><affiliation><mods:affiliation>Center for Parkinson Disease and Related Disorders, Utano National Hospital, Kyoto, Japan</mods:affiliation></affiliation></author><author><name sortKey="Mizuta, E" sort="Mizuta, E" uniqKey="Mizuta E" first="E." last="Mizuta">E. Mizuta</name><affiliation><mods:affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</mods:affiliation></affiliation><affiliation><mods:affiliation>Center for Parkinson Disease and Related Disorders, Utano National Hospital, Kyoto, Japan</mods:affiliation></affiliation></author><author><name sortKey="Hosokawa, R" sort="Hosokawa, R" uniqKey="Hosokawa R" first="R." last="Hosokawa">R. Hosokawa</name><affiliation><mods:affiliation>Department of Cardiology, Kyoto University Hospital, Kyoto, Japan</mods:affiliation></affiliation></author><author><name sortKey="Ohba, M" sort="Ohba, M" uniqKey="Ohba M" first="M." last="Ohba">M. Ohba</name><affiliation><mods:affiliation>Department of Cardiology, Kyoto University Hospital, Kyoto, Japan</mods:affiliation></affiliation></author><author><name sortKey="Nishio, R" sort="Nishio, R" uniqKey="Nishio R" first="R." last="Nishio">R. Nishio</name><affiliation><mods:affiliation>Department of Cardiology, Kyoto University Hospital, Kyoto, Japan</mods:affiliation></affiliation></author><author><name sortKey="Yamakawa, K" sort="Yamakawa, K" uniqKey="Yamakawa K" first="K." last="Yamakawa">K. Yamakawa</name><affiliation><mods:affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</mods:affiliation></affiliation></author><author><name sortKey="Takeuchi, H" sort="Takeuchi, H" uniqKey="Takeuchi H" first="H." last="Takeuchi">H. Takeuchi</name><affiliation><mods:affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</mods:affiliation></affiliation></author><author><name sortKey="Shimohama, S" sort="Shimohama, S" uniqKey="Shimohama S" first="S." last="Shimohama">S. Shimohama</name><affiliation><mods:affiliation>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</mods:affiliation></affiliation></author><author><name sortKey="Takahashi, R" sort="Takahashi, R" uniqKey="Takahashi R" first="R." last="Takahashi">R. Takahashi</name><affiliation><mods:affiliation>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</mods:affiliation></affiliation></author><author><name sortKey="Kawamura, T" sort="Kawamura, T" uniqKey="Kawamura T" first="T." last="Kawamura">T. Kawamura</name><affiliation><mods:affiliation>Kyoto University Health Service, Kyoto, Japan</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">European Journal of Neurology</title><idno type="ISSN">1351-5101</idno><idno type="eISSN">1468-1331</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2009-02">2009-02</date><biblScope unit="volume">16</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="174">174</biblScope><biblScope unit="page" to="182">182</biblScope></imprint><idno type="ISSN">1351-5101</idno></series><idno type="istex">6007A81B42533B7429ED913064F247CFC39008D1</idno><idno type="DOI">10.1111/j.1468-1331.2008.02372.x</idno><idno type="ArticleID">ENE2372</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1351-5101</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>ROC curve</term><term>norepinephrine</term><term>preclinical diagnosis</term><term>sympathetic nerve</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background and purpose: To estimate the diagnostic accuracy of cardiac 123I‐metaiodobenzylguanidine (MIBG) scintigram for detection of Parkinson disease. Methods: A cross‐sectional study with index test of MIBG scintigram and reference standard of U.K. Parkinson’s Disease Brain Bank Criteria was performed in 403 patients. Ratio of cardiac‐to‐mediastinum MIBG accumulation was determined at 20 min (early H/M) and 4 h (late H/M). Area under the receiver‐operator characteristic (ROC) curve, sensitivity and specificity in detecting Parkinson disease were analyzed. Accuracy was analyzed in a subgroup of patients with disease duration of 3 years or less. Results: Area under the ROC curve was 0.89 using either early or late H/M as a diagnostic marker (95% CI 0.85–0.92 for early H/M and 0.86–0.93 for late H/M). Sensitivity and specificity were 81.3% (76.1–85.8%) and 85.0% (77.7–90.6%) for early H/M and 84.3% (79.3–88.4%) and 89.5% (83.01–94.1%) for late H/M. In the subgroup with duration of 3 years or less, the ROC curve area, sensitivity, and specificity were 0.86 (0.79–0.92), 76.0% (64.8–85.1%), and 83.9% (71.7–92.4%) for early H/M and 0.85 (0.78–0.92), 73.3% (61.9–82.9%), and 87.5% (75.9–94.8%) for late H/M. Conclusion: Although diagnostic accuracy of cardiac MIBG scintigram is high, it is limited because of insufficient sensitivity in patients with short duration.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>H. Sawada</name><affiliations><json:string>Clinical Research Center, Utano National Hospital, Kyoto, Japan</json:string><json:string>Center for Parkinson Disease and Related Disorders, Utano National Hospital, Kyoto, Japan</json:string></affiliations></json:item><json:item><name>T. Oeda</name><affiliations><json:string>Clinical Research Center, Utano National Hospital, Kyoto, Japan</json:string><json:string>Center for Parkinson Disease and Related Disorders, Utano National Hospital, Kyoto, Japan</json:string></affiliations></json:item><json:item><name>K. Yamamoto</name><affiliations><json:string>Clinical Research Center, Utano National Hospital, Kyoto, Japan</json:string><json:string>Center for Parkinson Disease and Related Disorders, Utano National Hospital, Kyoto, Japan</json:string></affiliations></json:item><json:item><name>N. Kitagawa</name><affiliations><json:string>Clinical Research Center, Utano National Hospital, Kyoto, Japan</json:string><json:string>Center for Parkinson Disease and Related Disorders, Utano National Hospital, Kyoto, Japan</json:string></affiliations></json:item><json:item><name>E. Mizuta</name><affiliations><json:string>Clinical Research Center, Utano National Hospital, Kyoto, Japan</json:string><json:string>Center for Parkinson Disease and Related Disorders, Utano National Hospital, Kyoto, Japan</json:string></affiliations></json:item><json:item><name>R. Hosokawa</name><affiliations><json:string>Department of Cardiology, Kyoto University Hospital, Kyoto, Japan</json:string></affiliations></json:item><json:item><name>M. Ohba</name><affiliations><json:string>Department of Cardiology, Kyoto University Hospital, Kyoto, Japan</json:string></affiliations></json:item><json:item><name>R. Nishio</name><affiliations><json:string>Department of Cardiology, Kyoto University Hospital, Kyoto, Japan</json:string></affiliations></json:item><json:item><name>K. Yamakawa</name><affiliations><json:string>Clinical Research Center, Utano National Hospital, Kyoto, Japan</json:string><json:string>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</json:string></affiliations></json:item><json:item><name>H. Takeuchi</name><affiliations><json:string>Clinical Research Center, Utano National Hospital, Kyoto, Japan</json:string><json:string>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</json:string></affiliations></json:item><json:item><name>S. Shimohama</name><affiliations><json:string>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</json:string></affiliations></json:item><json:item><name>R. Takahashi</name><affiliations><json:string>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</json:string></affiliations></json:item><json:item><name>T. Kawamura</name><affiliations><json:string>Kyoto University Health Service, Kyoto, Japan</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>norepinephrine</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>preclinical diagnosis</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>ROC curve</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>sympathetic nerve</value></json:item></subject><articleId><json:string>ENE2372</json:string></articleId><language><json:string>eng</json:string></language><abstract>Background and purpose: To estimate the diagnostic accuracy of cardiac 123I‐metaiodobenzylguanidine (MIBG) scintigram for detection of Parkinson disease. Methods: A cross‐sectional study with index test of MIBG scintigram and reference standard of U.K. Parkinson’s Disease Brain Bank Criteria was performed in 403 patients. Ratio of cardiac‐to‐mediastinum MIBG accumulation was determined at 20 min (early H/M) and 4 h (late H/M). Area under the receiver‐operator characteristic (ROC) curve, sensitivity and specificity in detecting Parkinson disease were analyzed. Accuracy was analyzed in a subgroup of patients with disease duration of 3 years or less. Results: Area under the ROC curve was 0.89 using either early or late H/M as a diagnostic marker (95% CI 0.85–0.92 for early H/M and 0.86–0.93 for late H/M). Sensitivity and specificity were 81.3% (76.1–85.8%) and 85.0% (77.7–90.6%) for early H/M and 84.3% (79.3–88.4%) and 89.5% (83.01–94.1%) for late H/M. In the subgroup with duration of 3 years or less, the ROC curve area, sensitivity, and specificity were 0.86 (0.79–0.92), 76.0% (64.8–85.1%), and 83.9% (71.7–92.4%) for early H/M and 0.85 (0.78–0.92), 73.3% (61.9–82.9%), and 87.5% (75.9–94.8%) for late H/M. Conclusion: Although diagnostic accuracy of cardiac MIBG scintigram is high, it is limited because of insufficient sensitivity in patients with short duration.</abstract><qualityIndicators><score>6.422</score><pdfVersion>1.3</pdfVersion><pdfPageSize>595.276 x 782.362 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>4</keywordCount><abstractCharCount>1385</abstractCharCount><pdfWordCount>4034</pdfWordCount><pdfCharCount>26285</pdfCharCount><pdfPageCount>9</pdfPageCount><abstractWordCount>199</abstractWordCount></qualityIndicators><title>Diagnostic accuracy of cardiac metaiodobenzylguanidine scintigraphy in Parkinson 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Japan</affiliation></author><author><persName><forename type="first">K.</forename><surname>Yamamoto</surname></persName><affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</affiliation><affiliation>Center for Parkinson Disease and Related Disorders, Utano National Hospital, Kyoto, Japan</affiliation></author><author><persName><forename type="first">N.</forename><surname>Kitagawa</surname></persName><affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</affiliation><affiliation>Center for Parkinson Disease and Related Disorders, Utano National Hospital, Kyoto, Japan</affiliation></author><author><persName><forename type="first">E.</forename><surname>Mizuta</surname></persName><affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</affiliation><affiliation>Center for Parkinson Disease and Related Disorders, Utano National Hospital, Kyoto, Japan</affiliation></author><author><persName><forename type="first">R.</forename><surname>Hosokawa</surname></persName><affiliation>Department of Cardiology, Kyoto University Hospital, Kyoto, Japan</affiliation></author><author><persName><forename type="first">M.</forename><surname>Ohba</surname></persName><affiliation>Department of Cardiology, Kyoto University Hospital, Kyoto, Japan</affiliation></author><author><persName><forename type="first">R.</forename><surname>Nishio</surname></persName><affiliation>Department of Cardiology, Kyoto University Hospital, Kyoto, Japan</affiliation></author><author><persName><forename type="first">K.</forename><surname>Yamakawa</surname></persName><affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</affiliation><affiliation>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</affiliation></author><author><persName><forename type="first">H.</forename><surname>Takeuchi</surname></persName><affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</affiliation><affiliation>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</affiliation></author><author><persName><forename type="first">S.</forename><surname>Shimohama</surname></persName><affiliation>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</affiliation></author><author><persName><forename type="first">R.</forename><surname>Takahashi</surname></persName><affiliation>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</affiliation></author><author><persName><forename type="first">T.</forename><surname>Kawamura</surname></persName><note type="biography">Statistical analysis was conducted by Takashi Kawamura.</note><affiliation>Statistical analysis was conducted by Takashi Kawamura.</affiliation><affiliation>Kyoto University Health Service, Kyoto, Japan</affiliation></author></analytic><monogr><title level="j">European Journal of Neurology</title><idno type="pISSN">1351-5101</idno><idno type="eISSN">1468-1331</idno><idno type="DOI">10.1111/(ISSN)1468-1331</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2009-02"></date><biblScope unit="volume">16</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="174">174</biblScope><biblScope unit="page" to="182">182</biblScope></imprint></monogr><idno type="istex">6007A81B42533B7429ED913064F247CFC39008D1</idno><idno type="DOI">10.1111/j.1468-1331.2008.02372.x</idno><idno type="ArticleID">ENE2372</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2009</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Background and purpose: To estimate the diagnostic accuracy of cardiac 123I‐metaiodobenzylguanidine (MIBG) scintigram for detection of Parkinson disease. Methods: A cross‐sectional study with index test of MIBG scintigram and reference standard of U.K. Parkinson’s Disease Brain Bank Criteria was performed in 403 patients. Ratio of cardiac‐to‐mediastinum MIBG accumulation was determined at 20 min (early H/M) and 4 h (late H/M). Area under the receiver‐operator characteristic (ROC) curve, sensitivity and specificity in detecting Parkinson disease were analyzed. Accuracy was analyzed in a subgroup of patients with disease duration of 3 years or less. Results: Area under the ROC curve was 0.89 using either early or late H/M as a diagnostic marker (95% CI 0.85–0.92 for early H/M and 0.86–0.93 for late H/M). Sensitivity and specificity were 81.3% (76.1–85.8%) and 85.0% (77.7–90.6%) for early H/M and 84.3% (79.3–88.4%) and 89.5% (83.01–94.1%) for late H/M. In the subgroup with duration of 3 years or less, the ROC curve area, sensitivity, and specificity were 0.86 (0.79–0.92), 76.0% (64.8–85.1%), and 83.9% (71.7–92.4%) for early H/M and 0.85 (0.78–0.92), 73.3% (61.9–82.9%), and 87.5% (75.9–94.8%) for late H/M. Conclusion: Although diagnostic accuracy of cardiac MIBG scintigram is high, it is limited because of insufficient sensitivity in patients with short duration.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>norepinephrine</term></item><item><term>preclinical diagnosis</term></item><item><term>ROC curve</term></item><item><term>sympathetic nerve</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2009-02">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/6007A81B42533B7429ED913064F247CFC39008D1/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1468-1331</doi><issn type="print">1351-5101</issn><issn type="electronic">1468-1331</issn><idGroup><id type="product" value="ENE"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="EUROPEAN JOURNAL OF NEUROLOGY">European Journal of Neurology</title></titleGroup></publicationMeta><publicationMeta level="part" position="02002"><doi origin="wiley">10.1111/ene.2009.16.issue-2</doi><numberingGroup><numbering type="journalVolume" number="16">16</numbering><numbering type="journalIssue" number="2">2</numbering></numberingGroup><coverDate startDate="2009-02">February 2009</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="6" status="forIssue"><doi origin="wiley">10.1111/j.1468-1331.2008.02372.x</doi><idGroup><id type="unit" value="ENE2372"></id></idGroup><countGroup><count type="pageTotal" number="9"></count></countGroup><titleGroup><title type="tocHeading1">Original Articles</title></titleGroup><copyright>© 2008 The Author(s). Journal compilation © 2008 EFNS</copyright><eventGroup><event type="firstOnline" date="2008-12-23"></event><event type="publishedOnlineFinalForm" date="2009-01-14"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.2 mode:FullText source:FullText result:FullText" date="2010-03-06"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-24"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-16"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="174">174</numbering><numbering type="pageLast" number="182">182</numbering></numberingGroup><correspondenceTo>Dr Hideyuki Sawada, Clinical Research Center, Utano National Hospital, 8 Ondoyamacho, Ukyoku, Kyoto, Japan (tel.: +81‐75‐461‐5121; fax: +81‐75‐464‐0021; e‐mail: <email>sawada@unh.hosp.go.jp</email>). </correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:ENE.ENE2372.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Received 16 August 2008 Accepted 17 October 2008</unparsedEditorialHistory><countGroup><count type="figureTotal" number="6"></count><count type="tableTotal" number="3"></count></countGroup><titleGroup><title type="main">Diagnostic accuracy of cardiac metaiodobenzylguanidine scintigraphy in Parkinson disease</title><title type="shortAuthors">H. Sawada <i>et al.</i></title><title type="short">Diagnostic accuracy of cardiac MIBG</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1 #a2"><personName><givenNames>H.</givenNames><familyName>Sawada</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1 #a2"><personName><givenNames>T.</givenNames><familyName>Oeda</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a1 #a2"><personName><givenNames>K.</givenNames><familyName>Yamamoto</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a1 #a2"><personName><givenNames>N.</givenNames><familyName>Kitagawa</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a1 #a2"><personName><givenNames>E.</givenNames><familyName>Mizuta</familyName></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a3"><personName><givenNames>R.</givenNames><familyName>Hosokawa</familyName></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a3"><personName><givenNames>M.</givenNames><familyName>Ohba</familyName></personName></creator><creator creatorRole="author" xml:id="cr8" affiliationRef="#a3"><personName><givenNames>R.</givenNames><familyName>Nishio</familyName></personName></creator><creator creatorRole="author" xml:id="cr9" affiliationRef="#a1 #a4"><personName><givenNames>K.</givenNames><familyName>Yamakawa</familyName></personName></creator><creator creatorRole="author" xml:id="cr10" affiliationRef="#a1 #a4"><personName><givenNames>H.</givenNames><familyName>Takeuchi</familyName></personName></creator><creator creatorRole="author" xml:id="cr11" affiliationRef="#a4"><personName><givenNames>S.</givenNames><familyName>Shimohama</familyName></personName></creator><creator creatorRole="author" xml:id="cr12" affiliationRef="#a4"><personName><givenNames>R.</givenNames><familyName>Takahashi</familyName></personName></creator><creator creatorRole="author" xml:id="cr13" affiliationRef="#a5" noteRef="#fn1"><personName><givenNames>T.</givenNames><familyName>Kawamura</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="JP"><unparsedAffiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="JP"><unparsedAffiliation>Center for Parkinson Disease and Related Disorders, Utano National Hospital, Kyoto, Japan</unparsedAffiliation></affiliation><affiliation xml:id="a3" countryCode="JP"><unparsedAffiliation>Department of Cardiology, Kyoto University Hospital, Kyoto, Japan</unparsedAffiliation></affiliation><affiliation xml:id="a4" countryCode="JP"><unparsedAffiliation>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</unparsedAffiliation></affiliation><affiliation xml:id="a5" countryCode="JP"><unparsedAffiliation>Kyoto University Health Service, Kyoto, Japan</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">norepinephrine</keyword><keyword xml:id="k2">preclinical diagnosis</keyword><keyword xml:id="k3">ROC curve</keyword><keyword xml:id="k4">sympathetic nerve</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><p><b>Background and purpose: </b> To estimate the diagnostic accuracy of cardiac <sup>123</sup>I‐metaiodobenzylguanidine (MIBG) scintigram for detection of Parkinson disease.</p><p><b>Methods: </b> A cross‐sectional study with index test of MIBG scintigram and reference standard of U.K. Parkinson’s Disease Brain Bank Criteria was performed in 403 patients. Ratio of cardiac‐to‐mediastinum MIBG accumulation was determined at 20 min (early H/M) and 4 h (late H/M). Area under the receiver‐operator characteristic (ROC) curve, sensitivity and specificity in detecting Parkinson disease were analyzed. Accuracy was analyzed in a subgroup of patients with disease duration of 3 years or less.</p><p><b>Results: </b> Area under the ROC curve was 0.89 using either early or late H/M as a diagnostic marker (95% CI 0.85–0.92 for early H/M and 0.86–0.93 for late H/M). Sensitivity and specificity were 81.3% (76.1–85.8%) and 85.0% (77.7–90.6%) for early H/M and 84.3% (79.3–88.4%) and 89.5% (83.01–94.1%) for late H/M. In the subgroup with duration of 3 years or less, the ROC curve area, sensitivity, and specificity were 0.86 (0.79–0.92), 76.0% (64.8–85.1%), and 83.9% (71.7–92.4%) for early H/M and 0.85 (0.78–0.92), 73.3% (61.9–82.9%), and 87.5% (75.9–94.8%) for late H/M.</p><p><b>Conclusion: </b> Although diagnostic accuracy of cardiac MIBG scintigram is high, it is limited because of insufficient sensitivity in patients with short duration.</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><label>1</label><p> Statistical analysis was conducted by Takashi Kawamura.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Diagnostic accuracy of cardiac metaiodobenzylguanidine scintigraphy in Parkinson disease</title></titleInfo><titleInfo type="abbreviated"><title>Diagnostic accuracy of cardiac MIBG</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Diagnostic accuracy of cardiac metaiodobenzylguanidine scintigraphy in Parkinson disease</title></titleInfo><name type="personal"><namePart type="given">H.</namePart><namePart type="family">Sawada</namePart><affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</affiliation><affiliation>Center for Parkinson Disease and Related Disorders, Utano National Hospital, Kyoto, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">T.</namePart><namePart type="family">Oeda</namePart><affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</affiliation><affiliation>Center for Parkinson Disease and Related Disorders, Utano National Hospital, Kyoto, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">K.</namePart><namePart type="family">Yamamoto</namePart><affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</affiliation><affiliation>Center for Parkinson Disease and Related Disorders, Utano National Hospital, Kyoto, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">N.</namePart><namePart type="family">Kitagawa</namePart><affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</affiliation><affiliation>Center for Parkinson Disease and Related Disorders, Utano National Hospital, Kyoto, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">E.</namePart><namePart type="family">Mizuta</namePart><affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</affiliation><affiliation>Center for Parkinson Disease and Related Disorders, Utano National Hospital, Kyoto, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">R.</namePart><namePart type="family">Hosokawa</namePart><affiliation>Department of Cardiology, Kyoto University Hospital, Kyoto, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M.</namePart><namePart type="family">Ohba</namePart><affiliation>Department of Cardiology, Kyoto University Hospital, Kyoto, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">R.</namePart><namePart type="family">Nishio</namePart><affiliation>Department of Cardiology, Kyoto University Hospital, Kyoto, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">K.</namePart><namePart type="family">Yamakawa</namePart><affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</affiliation><affiliation>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">H.</namePart><namePart type="family">Takeuchi</namePart><affiliation>Clinical Research Center, Utano National Hospital, Kyoto, Japan</affiliation><affiliation>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S.</namePart><namePart type="family">Shimohama</namePart><affiliation>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">R.</namePart><namePart type="family">Takahashi</namePart><affiliation>Department of Neurology, Kyoto University Hospital, Kyoto, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">T.</namePart><namePart type="family">Kawamura</namePart><affiliation>Kyoto University Health Service, Kyoto, Japan</affiliation><description>Statistical analysis was conducted by Takashi Kawamura.</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2009-02</dateIssued><edition>Received 16 August 2008 Accepted 17 October 2008</edition><copyrightDate encoding="w3cdtf">2009</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">6</extent><extent unit="tables">3</extent></physicalDescription><abstract lang="en">Background and purpose: To estimate the diagnostic accuracy of cardiac 123I‐metaiodobenzylguanidine (MIBG) scintigram for detection of Parkinson disease. Methods: A cross‐sectional study with index test of MIBG scintigram and reference standard of U.K. Parkinson’s Disease Brain Bank Criteria was performed in 403 patients. Ratio of cardiac‐to‐mediastinum MIBG accumulation was determined at 20 min (early H/M) and 4 h (late H/M). Area under the receiver‐operator characteristic (ROC) curve, sensitivity and specificity in detecting Parkinson disease were analyzed. Accuracy was analyzed in a subgroup of patients with disease duration of 3 years or less. Results: Area under the ROC curve was 0.89 using either early or late H/M as a diagnostic marker (95% CI 0.85–0.92 for early H/M and 0.86–0.93 for late H/M). Sensitivity and specificity were 81.3% (76.1–85.8%) and 85.0% (77.7–90.6%) for early H/M and 84.3% (79.3–88.4%) and 89.5% (83.01–94.1%) for late H/M. In the subgroup with duration of 3 years or less, the ROC curve area, sensitivity, and specificity were 0.86 (0.79–0.92), 76.0% (64.8–85.1%), and 83.9% (71.7–92.4%) for early H/M and 0.85 (0.78–0.92), 73.3% (61.9–82.9%), and 87.5% (75.9–94.8%) for late H/M. Conclusion: Although diagnostic accuracy of cardiac MIBG scintigram is high, it is limited because of insufficient sensitivity in patients with short duration.</abstract><subject lang="en"><genre>Keywords</genre><topic>norepinephrine</topic><topic>preclinical diagnosis</topic><topic>ROC curve</topic><topic>sympathetic nerve</topic></subject><relatedItem type="host"><titleInfo><title>European Journal of Neurology</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">1351-5101</identifier><identifier type="eISSN">1468-1331</identifier><identifier type="DOI">10.1111/(ISSN)1468-1331</identifier><identifier type="PublisherID">ENE</identifier><part><date>2009</date><detail type="volume"><caption>vol.</caption><number>16</number></detail><detail type="issue"><caption>no.</caption><number>2</number></detail><extent unit="pages"><start>174</start><end>182</end><total>9</total></extent></part></relatedItem><identifier type="istex">6007A81B42533B7429ED913064F247CFC39008D1</identifier><identifier type="DOI">10.1111/j.1468-1331.2008.02372.x</identifier><identifier type="ArticleID">ENE2372</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2008 The Author(s). 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