¹²³I-MIBG myocardial scintigraphy for the diagnosis of DLB: a multicentre 3-year follow-up study

Abstract

UMIN00003419.

What does diagnostic threshold mean? Deterministic and probabilistic considerations

“…C and D show UK and Japanese patients with AD (n = 15 and 31, respectively) as well as DLB (n = 17 and 30, respectively). 4,7 The H/M ratio for DLB did not differ between UK and Japanese databases, whereas that of AD was higher in the Japanese database. Original UK data were provided by Dr. Gemma Roberts (Newcastle University, UK).…”

“…B Probability of DLB calculated by logistic function based on Japanese and UK databases. 4,7 Thresholds of 2.5 for early H/M and 2.2 for delayed H/M are shown in blue unfilled and filled circles, and those of 1.8 and 1.65, respectively are shown in red unfilled and filled circles. Corresponding probabilities of DLB and AD can be estimated using these curves.…”

“…Prediction of the optimal point can be viewed from probability analysis based on logistic curves. The possibility of diagnosing DLB is schematically displayed in the UK and Japanese studies cited above 4,7 using the logistic function shown in Figure 2B. The thresholds of early and delayed H/M ratios in the UK study were 1.8 (1.77-1.80) and 1.65 (1.61-1.70), respectively, that corresponded to 67% and 72% probabilities of DLB respectively.…”

“…The H/M ratios were corrected using a phantom-based method to overcome differences in camera-collimator variations. 5,6 The UK threshold to discriminate AD and DLB was lower than that in a Japanese multicenter study, 7 and suggested that the threshold might be even lower in the USA, than in the UK. Several factors are involved in establishing appropriate thresholds, such as the demographics of patients including background, age, and comorbidity; therefore, how to understand whether or not a threshold is ''appropriate'' is addressed here.…”

Dementia with Lewy Bodies and Parkinson's Disease-Dementia: Current Perspectives

“…Cardiac neuroimaging using 123 I-metaiodobenzylguanidine (MIBG) as marker of postganglionic sympathetic innervation, shows reduced MIBG uptake in both DLB and PDD and allows no differentiation between the two disorders [39]. Its diagnostic usefulness in early stages of DLB was suggested [40].…”