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Master Thesis

Cardiac dual isotope (123Iodine-metaiodobenzylguanidine/99mTechnetium-tetrofosmin) CZT (cadmiumzinc-telluride) imaging in parkinsonian syndromes: diagnostic value and reproducibility

Abstract : Introduction: We evaluated the diagnostic value and reproducibility of cardiac dual isotope CZT imaging with simultaneous acquisition of 123I-MIBG and 99mTc-tetrofosmin in parkinsonian syndromes. Materials and methods: From November 2016 to July 2018, we prospectively included all patients referred to our unit of Nuclear Medicine for a cardiac dual isotope CZT scintigraphy to characterize a clinical parkinsonian syndrome. Two neurologists evaluated all patients a year after the scintigraphy. The HMR was calculated by two different nuclear medicine physicians. The LVEF was also evaluated and a cardiologist systematically reviewed perfusion images. Results: Forty-one patients were included (20 females and 21 males): 18 (44%) patients were finally diagnosed LBD+ and 18 (44%) were diagnosed LBD– . The mean LVEF was 65 ± 0.9 %. Seven patients (17%) presented with perfusion abnormalities. The mean HMR in LBD+ patients was significantly lower than in LBD− patients (1.14 ± 0.04 vs 1.58 ± 0.32, p = 0.0002). According to the ROC curves analysis, the optimal HMR cut-off value to discriminate LBD+ from LBD− was 1.24 and led to sensitivity, specificity, positive predictive value and negative predictive value equal to of 72.2%, 94.4%, 92.9% and 77.3 %, respectively. Agreement between readers in discriminating between LBD+ and LBD- patients using the 1.24 HMR cut-off value was almost perfect (kappa = 0.942). Conclusion: Dual isotope CZT cardiac imaging can diagnose LBD in patients with parkinsonian syndromes with excellent specificity and positive predictive value and almost perfect reproducibility when applying a specific HMR cut-off value set 1.24.
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Master Thesis
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Laure-Eugénie Tainturier. Cardiac dual isotope (123Iodine-metaiodobenzylguanidine/99mTechnetium-tetrofosmin) CZT (cadmiumzinc-telluride) imaging in parkinsonian syndromes: diagnostic value and reproducibility. Human health and pathology. 2019. ⟨dumas-02481390⟩

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