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European Journal of Nuclear Medicine and Molecular Imaging

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01-07-2020 | Alzheimer's Disease | Review Article

Diagnostic accuracy of DAT-SPECT and MIBG scintigraphy for dementia with Lewy bodies: an updated systematic review and Bayesian latent class model meta-analysis

Authors: Takashi Nihashi, Kengo Ito, Teruhiko Terasawa

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 8/2020

Abstract

Purpose

Imperfect clinical reference standards can preclude accurately estimating the diagnostic accuracy of DAT-SPECT and MIBG myocardial scintigraphy for diagnosing DLB. To investigate the validity of unadjusted accuracy, we updated our previous meta-analysis.

Methods

Literature search was updated to March 18, 2018. We also examined published systematic review reports. Two investigators extracted data and rated study validity using the QUADAS-2 tool. We performed a Bayesian latent class model meta-analysis accounting for imperfect reference standards.

Results

We evaluated 27 studies including 2236 patients. With the exception of two DAT-SPECT studies that involved postmortem neuropathological verification, studies were susceptible to bias from imperfect reference standards. Compared with the unadjusted accuracy estimates, the adjusted sensitivity values were similar, whereas the adjusted specificity values were generally lower for detecting α-synuclein pathology in the brain. The adjusted summary sensitivity and specificity were 0.86 (95% credible interval [CrI], 0.76–0.95) and 0.81 (CrI, 0.70–0.92), and 0.93 (CrI, 0.74–1.00) and 0.75 (CI, 0.47–0.94) for visual and semi-quantitative assessments of DAT-SPECT, respectively; 0.92 (CrI, 0.81–0.99) and 0.80 (CrI, 0.67–0.93), and 0.87 (CrI, 0.74–0.98) and 0.80 (CrI, 0.69–0.93), for delayed- and early-phase scans of MIBG scintigraphy, respectively. When diagnosing the typical clinical syndrome, the adjusted accuracy values were similar to the unadjusted estimates. The adjusted sensitivity and specificity were 0.89 (CrI, 0.75–0.98) and 0.87 (CrI, 0.72–0.97), and 0.97 (CrI, 0.78–1.0) and 0.70 (CrI, 0.43–0.92) for visual and semi-quantitative assessments of DAT-SPECT, respectively; and 0.93 (CrI, 0.81–0.98) and 0.90 (CrI, 0.73–0.97), and 0.85 (CrI, 0.66–0.96) and 0.96 (95% CI, 0.83–1.0) for delayed- and early-phase scans of MIBG scintigraphy, respectively.

Conclusions

In our adjusted analyses, both imaging biomarkers had high diagnostic accuracy for detecting the hallmark pathology in the brain and for diagnosing the typical clinical syndrome.

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Title: Diagnostic accuracy of DAT-SPECT and MIBG scintigraphy for dementia with Lewy bodies: an updated systematic review and Bayesian latent class model meta-analysis
Authors: Takashi Nihashi
Kengo Ito
Teruhiko Terasawa
Publication date: 01-07-2020
Publisher: Springer Berlin Heidelberg
Keywords: Alzheimer's Disease
Dementia
Alzheimer's Disease
Pathology
Dementia
Scintigraphy
Biomarkers
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 8/2020
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-019-04480-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Diagnostic accuracy of DAT-SPECT and MIBG scintigraphy for dementia with Lewy bodies: an updated systematic review and Bayesian latent class model meta-analysis

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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