The clinical value of <sup>123</sup>I-metaiodobenzylguanidine myocardial imaging in the diagnosis of dementia with Lewy bodies_Journal of Biomedical Engineering

Authors：

LIU Weiting , YAO Xilan ,  OU Xiaohong

Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

Keywords：

¹²³I-metaiodobenzylguanidine; Dementia with Lewy bodies; Myocardial imaging; Diagnostic biomarkers

DOI：

10.7507/1001-5515.202204082

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Metaiodobenzylguanidine (MIBG) is an analog of norepinephrine that accumulates in sympathetic nerve endings soon after intravenous administration. The degree of accumulation reflects the uptake, storage and release of transmitters by noradrenergic neurons. Myocardial imaging with ¹²³I labeled MIBG (¹²³I-MIBG) can be used to estimate the extent of local myocardial sympathetic nerve damage, which has been widely used in the diagnosis and treatment of various heart diseases. In recent years, numerous studies have been carried out on the application of ¹²³I-MIBG in the diagnosis of degenerative diseases of the nervous system (such as Parkinson's disease and dementia of Lewy body), and have made some achievements. The purpose of this review is to summarize the current clinical application of ¹²³I-MIBG myocardial imaging in the diagnosis of dementia with Lewy bodies, the problems in imaging technology and the possible research directions in the future, so as to provide valuable reference information for clinicians to reasonably and accurately apply this technology in the early diagnosis and discrimination of dementia.

Citation： LIU Weiting, YAO Xilan, OU Xiaohong. The clinical value of ¹²³I-metaiodobenzylguanidine myocardial imaging in the diagnosis of dementia with Lewy bodies. Journal of Biomedical Engineering, 2023, 40(3): 595-601. doi: 10.7507/1001-5515.202204082 Copy

1.	Carrasquillo J A, Chen C C, Jha A, et al. Imaging of pheochromocytoma and paraganglioma. Journal of Nuclear Medicine, 2021, 62(8): 1033-1042.
2.	Duignan J A, Haughey A, Kinsella J A, et al. Molecular and anatomical imaging of dementia with Lewy bodies and frontotemporal lobar degeneration. Seminars in Nuclear Medicine, 2021, 51(3): 264-274.
3.	Iwabuchi Y, Kameyama M, Matsusaka Y, et al. A diagnostic strategy for Parkinsonian syndromes using quantitative indices of DAT SPECT and MIBG scintigraphy: an investigation using the classification and regression tree analysis. European Journal of Nuclear Medicine and Molecular Imaging, 2021, 48(6): 1833-1841.
4.	Giannoccaro M P, Donadio V, Giannini G, et al. Comparison of ¹²³I-MIBG scintigraphy and phosphorylated α-synuclein skin deposits in synucleinopathies. Parkinsonism & Related Disorders, 2020, 81: 48-53.
5.	Marshall K, Hale D. Lewy body dementia. Home Healthcare Now, 2021, 39(2): 107-108.
6.	Jia L, Du Y, Chu L, et al. Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: a cross-sectional study. The Lancet Public Health, 2020, 5(12): e661-e671.
7.	Capouch S D, Farlow M R, Brosch J R. A Review of dementia with Lewy bodies’ impact, diagnostic criteria and treatment. Neurology and Therapy, 2018, 7(2): 249-263.
8.	Varanese S, Perfetti B, Monaco D, et al. Fluctuating cognition and different cognitive and behavioural profiles in Parkinson’s disease with dementia: comparison of dementia with Lewy bodies and Alzheimer’s disease. Journal of Neurology, 2010, 257(6): 1004-1011.
9.	Goldman J G, Forsberg L K, Boeve B F, et al. Challenges and opportunities for improving the landscape for Lewy body dementia clinical trials. Alzheimer's Research & Therapy, 2020, 12(1): 137.
10.	Rizzo G, Arcuti S, Copetti M, et al. Accuracy of clinical diagnosis of dementia with Lewy bodies: a systematic review and meta-analysis. Journal of Neurology, Neurosurgery & Psychiatry, 2018, 89(4): 358-366.
11.	Nihashi T, Ito K, Terasawa T. Diagnostic accuracy of DAT-SPECT and MIBG scintigraphy for dementia with Lewy bodies: an updated systematic review and Bayesian latent class model meta-analysis. European Journal of Nuclear Medicine and Molecular Imaging, 2020, 47(8): 1984-1997.
12.	McKeith I G, Boeve B F, Dickson D W, et al. Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB Consortium. Neurology, 2017, 89(1): 88-100.
13.	中国微循环学会神经变性病专业委员会. 中国路易体痴呆诊断与治疗指南. 中华老年医学杂志, 2021, 40(12): 1473-1484.
14.	Kane J P M, Roberts G, Petrides G S, et al. 123I-MIBG scintigraphy utility and cut-off value in a clinically representative dementia cohort. Parkinsonism & Related Disorders, 2019, 62: 79-84.
15.	Hamilton C A, Matthews F E, Donaghy P C, et al. Cognitive decline in mild cognitive impairment with Lewy bodies or Alzheimer disease: a prospective cohort study. The American Journal of Geriatric Psychiatry, 2021, 29(3): 272-284.
16.	Tsamakis K, Mueller C. Challenges in predicting cognitive decline in dementia with Lewy bodies. Dementia and Geriatric Cognitive Disorders, 2021, 50(1): 1-8.
17.	Roberts G, Durcan R, Donaghy P C, et al. Accuracy of cardiac innervation scintigraphy for mild cognitive impairment with Lewy bodies. Neurology, 2021, 96(23): e2801-e2811.
18.	Komatsu J, Samuraki M, Nakajima K, et al. ¹²³I-MIBG myocardial scintigraphy for the diagnosis of DLB: a multicentre 3-year follow-up study. Journal of Neurology, Neurosurgery & Psychiatry, 2018, 89(11): 1167-1173.
19.	Yoshita M, Arai H, Arai H, et al. Diagnostic accuracy of ¹²³I-meta-iodobenzylguanidine myocardial scintigraphy in dementia with Lewy bodies: a multicenter study. PLoS One, 2015, 10(3): e0120540.
20.	Fujishiro H, Ota K, Yamagata M, et al. Early diagnosis of prodromal dementia with Lewy bodies using clinical history of probable REM sleep behaviour disorder and cardiac ¹²³I-MIBG scintigraphy in memory clinics. Psychogeriatrics, 2021, 21(3): 288-295.
21.	Roberts G, Lloyd J J, Jefferson E, et al. Uniformity of cardiac ¹²³I-MIBG uptake on SPECT images in older adults with normal cognition and patients with dementia. Journal of Nuclear Cardiology, 2021, 28(5): 2151-2163.
22.	Fujishiro H, Okuda M, Iwamoto K, et al. Early diagnosis of Lewy body disease in patients with late-onset psychiatric disorders using clinical history of rapid eye movement sleep behavior disorder and [¹²³I]-metaiodobenzylguanidine cardiac scintigraphy. Psychiatry and Clinical Neurosciences, 2018, 72(6): 423-434.
23.	Nemoto K, Sakaguchi H, Kasai W, et al. Differentiating dementia with Lewy bodies and Alzheimer's disease by deep learning to structural MRI. Journal of Neuroimaging, 2021, 31(3): 579-587.
24.	Isonaka R, Sullivan P, Jinsmaa Y, et al. Spectrum of abnormalities of sympathetic tyrosine hydroxylase and alpha-synuclein in chronic autonomic failure. Clinical Autonomic Research, 2018, 28(2): 223-230.
25.	Yoshita M, Taki J, Yokoyama K, et al. Value of ¹²³I-MIBG radioactivity in the differential diagnosis of DLB from AD. Neurology, 2006, 66(12): 1850-1854.
26.	Sonni I, Ratib O, Boccardi M, et al. Clinical validity of presynaptic dopaminergic imaging with ¹²³I-ioflupane and noradrenergic imaging with ¹²³I-MIBG in the differential diagnosis between Alzheimer's disease and dementia with Lewy bodies in the context of a structured 5-phase development framework. Neurobiology of Aging, 2017, 52: 228-242.
27.	Outeiro T F, Koss D J, Erskine D, et al. Dementia with Lewy bodies: an update and outlook. Molecular Neurodegeneration, 2019, 14(1): 5.
28.	Stathaki M, Koukouraki S, Simos P, et al. Is There any clinical value of adding ¹²³I-metaiodobenzylguanidine myocardial scintigraphy to ¹²³I-ioflupane (DaTscan) in the differential diagnosis of Parkinsonism?. Clinical Nuclear Medicine, 2020, 45(8): 588-593.
29.	Hansen D, Ling H, Lashley T, et al. Novel clinicopathological characteristics differentiate dementia with Lewy bodies from Parkinson’s disease dementia. Neuropathology and Applied Neurobiology, 2021, 47(1): 143-156.
30.	Lebasnier A, Lamotte G, Manrique A, et al. Potential diagnostic value of regional myocardial adrenergic imaging using ¹²³I-MIBG SPECT to identify patients with Lewy body diseases. European Journal of Nuclear Medicine and Molecular Imaging, 2015, 42(7): 1043-1051.
31.	Okuda K, Nakajima K, Kitamura C, et al. Calibrated scintigraphic imaging procedures improve quantitative assessment of the cardiac sympathetic nerve activity. Scientific Reports, 2020, 10(1): 21834.
32.	Roberts G, Kane J P M, Lloyd J J, et al. A comparison of visual and semiquantitative analysis methods for planar cardiac ¹²³I-MIBG scintigraphy in dementia with Lewy bodies. Nuclear Medicine Communications, 2019, 40(7): 734-743.
33.	Kumakura Y, Shimizu Y, Hariu M, et al. Dynamic planar scintigraphy for the rapid kinetic measurement of myocardial ¹²³I-MIBG turnover can identify Lewy body disease. EJNMMI Research, 2021, 11(1): 122.

1. Carrasquillo J A, Chen C C, Jha A, et al. Imaging of pheochromocytoma and paraganglioma. Journal of Nuclear Medicine, 2021, 62(8): 1033-1042.
2. Duignan J A, Haughey A, Kinsella J A, et al. Molecular and anatomical imaging of dementia with Lewy bodies and frontotemporal lobar degeneration. Seminars in Nuclear Medicine, 2021, 51(3): 264-274.
3. Iwabuchi Y, Kameyama M, Matsusaka Y, et al. A diagnostic strategy for Parkinsonian syndromes using quantitative indices of DAT SPECT and MIBG scintigraphy: an investigation using the classification and regression tree analysis. European Journal of Nuclear Medicine and Molecular Imaging, 2021, 48(6): 1833-1841.
4. Giannoccaro M P, Donadio V, Giannini G, et al. Comparison of ¹²³I-MIBG scintigraphy and phosphorylated α-synuclein skin deposits in synucleinopathies. Parkinsonism & Related Disorders, 2020, 81: 48-53.
5. Marshall K, Hale D. Lewy body dementia. Home Healthcare Now, 2021, 39(2): 107-108.
6. Jia L, Du Y, Chu L, et al. Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: a cross-sectional study. The Lancet Public Health, 2020, 5(12): e661-e671.
7. Capouch S D, Farlow M R, Brosch J R. A Review of dementia with Lewy bodies’ impact, diagnostic criteria and treatment. Neurology and Therapy, 2018, 7(2): 249-263.
8. Varanese S, Perfetti B, Monaco D, et al. Fluctuating cognition and different cognitive and behavioural profiles in Parkinson’s disease with dementia: comparison of dementia with Lewy bodies and Alzheimer’s disease. Journal of Neurology, 2010, 257(6): 1004-1011.
9. Goldman J G, Forsberg L K, Boeve B F, et al. Challenges and opportunities for improving the landscape for Lewy body dementia clinical trials. Alzheimer's Research & Therapy, 2020, 12(1): 137.
10. Rizzo G, Arcuti S, Copetti M, et al. Accuracy of clinical diagnosis of dementia with Lewy bodies: a systematic review and meta-analysis. Journal of Neurology, Neurosurgery & Psychiatry, 2018, 89(4): 358-366.
11. Nihashi T, Ito K, Terasawa T. Diagnostic accuracy of DAT-SPECT and MIBG scintigraphy for dementia with Lewy bodies: an updated systematic review and Bayesian latent class model meta-analysis. European Journal of Nuclear Medicine and Molecular Imaging, 2020, 47(8): 1984-1997.
12. McKeith I G, Boeve B F, Dickson D W, et al. Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB Consortium. Neurology, 2017, 89(1): 88-100.
13. 中国微循环学会神经变性病专业委员会. 中国路易体痴呆诊断与治疗指南. 中华老年医学杂志, 2021, 40(12): 1473-1484.
14. Kane J P M, Roberts G, Petrides G S, et al. 123I-MIBG scintigraphy utility and cut-off value in a clinically representative dementia cohort. Parkinsonism & Related Disorders, 2019, 62: 79-84.
15. Hamilton C A, Matthews F E, Donaghy P C, et al. Cognitive decline in mild cognitive impairment with Lewy bodies or Alzheimer disease: a prospective cohort study. The American Journal of Geriatric Psychiatry, 2021, 29(3): 272-284.
16. Tsamakis K, Mueller C. Challenges in predicting cognitive decline in dementia with Lewy bodies. Dementia and Geriatric Cognitive Disorders, 2021, 50(1): 1-8.
17. Roberts G, Durcan R, Donaghy P C, et al. Accuracy of cardiac innervation scintigraphy for mild cognitive impairment with Lewy bodies. Neurology, 2021, 96(23): e2801-e2811.
18. Komatsu J, Samuraki M, Nakajima K, et al. ¹²³I-MIBG myocardial scintigraphy for the diagnosis of DLB: a multicentre 3-year follow-up study. Journal of Neurology, Neurosurgery & Psychiatry, 2018, 89(11): 1167-1173.
19. Yoshita M, Arai H, Arai H, et al. Diagnostic accuracy of ¹²³I-meta-iodobenzylguanidine myocardial scintigraphy in dementia with Lewy bodies: a multicenter study. PLoS One, 2015, 10(3): e0120540.
20. Fujishiro H, Ota K, Yamagata M, et al. Early diagnosis of prodromal dementia with Lewy bodies using clinical history of probable REM sleep behaviour disorder and cardiac ¹²³I-MIBG scintigraphy in memory clinics. Psychogeriatrics, 2021, 21(3): 288-295.
21. Roberts G, Lloyd J J, Jefferson E, et al. Uniformity of cardiac ¹²³I-MIBG uptake on SPECT images in older adults with normal cognition and patients with dementia. Journal of Nuclear Cardiology, 2021, 28(5): 2151-2163.
22. Fujishiro H, Okuda M, Iwamoto K, et al. Early diagnosis of Lewy body disease in patients with late-onset psychiatric disorders using clinical history of rapid eye movement sleep behavior disorder and [¹²³I]-metaiodobenzylguanidine cardiac scintigraphy. Psychiatry and Clinical Neurosciences, 2018, 72(6): 423-434.
23. Nemoto K, Sakaguchi H, Kasai W, et al. Differentiating dementia with Lewy bodies and Alzheimer's disease by deep learning to structural MRI. Journal of Neuroimaging, 2021, 31(3): 579-587.
24. Isonaka R, Sullivan P, Jinsmaa Y, et al. Spectrum of abnormalities of sympathetic tyrosine hydroxylase and alpha-synuclein in chronic autonomic failure. Clinical Autonomic Research, 2018, 28(2): 223-230.
25. Yoshita M, Taki J, Yokoyama K, et al. Value of ¹²³I-MIBG radioactivity in the differential diagnosis of DLB from AD. Neurology, 2006, 66(12): 1850-1854.
26. Sonni I, Ratib O, Boccardi M, et al. Clinical validity of presynaptic dopaminergic imaging with ¹²³I-ioflupane and noradrenergic imaging with ¹²³I-MIBG in the differential diagnosis between Alzheimer's disease and dementia with Lewy bodies in the context of a structured 5-phase development framework. Neurobiology of Aging, 2017, 52: 228-242.
27. Outeiro T F, Koss D J, Erskine D, et al. Dementia with Lewy bodies: an update and outlook. Molecular Neurodegeneration, 2019, 14(1): 5.
28. Stathaki M, Koukouraki S, Simos P, et al. Is There any clinical value of adding ¹²³I-metaiodobenzylguanidine myocardial scintigraphy to ¹²³I-ioflupane (DaTscan) in the differential diagnosis of Parkinsonism?. Clinical Nuclear Medicine, 2020, 45(8): 588-593.
29. Hansen D, Ling H, Lashley T, et al. Novel clinicopathological characteristics differentiate dementia with Lewy bodies from Parkinson’s disease dementia. Neuropathology and Applied Neurobiology, 2021, 47(1): 143-156.
30. Lebasnier A, Lamotte G, Manrique A, et al. Potential diagnostic value of regional myocardial adrenergic imaging using ¹²³I-MIBG SPECT to identify patients with Lewy body diseases. European Journal of Nuclear Medicine and Molecular Imaging, 2015, 42(7): 1043-1051.
31. Okuda K, Nakajima K, Kitamura C, et al. Calibrated scintigraphic imaging procedures improve quantitative assessment of the cardiac sympathetic nerve activity. Scientific Reports, 2020, 10(1): 21834.
32. Roberts G, Kane J P M, Lloyd J J, et al. A comparison of visual and semiquantitative analysis methods for planar cardiac ¹²³I-MIBG scintigraphy in dementia with Lewy bodies. Nuclear Medicine Communications, 2019, 40(7): 734-743.
33. Kumakura Y, Shimizu Y, Hariu M, et al. Dynamic planar scintigraphy for the rapid kinetic measurement of myocardial ¹²³I-MIBG turnover can identify Lewy body disease. EJNMMI Research, 2021, 11(1): 122.

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The clinical value of ¹²³I-metaiodobenzylguanidine myocardial imaging in the diagnosis of dementia with Lewy bodies