Abstract for presentation at 38th Annual Scientific Meeting of the Australian and New Zealand Society of Nuclear Medicine 2008

Initial Experience with Lodine-123 MIBG Scanning to Differentiate Idiopathic Parkinsons Disease (IPD) from Multisystem Atrophy (MSA)

  • Natalie Humphreys, Sydney West Area Health Service, Australia
  • Mr Khang Le, Australia
  • Dr Robert Mansberg, Australia
  • Dr Mohamed Shaffi, Australia
  • Dr Diep Nguyen, Australia
  • Dr Chuong Bui, Bankstown/Lidcombe Hospital, Australia
  • Dr Leo Ha, Australia

    • OBJECTIVE: To aid the clinical differential diagnosis between patients with MSA and IPD using scintigraphy. Some patients initially treated for IPD are subsequently diagnosed with alternative diseases such as MSA, despite the application of stringent diagnostic criteria. This differentiation is particularly difficult if patients with IPD also show symptoms of autonomic failure. In IPD, autonomic failure is caused by damage of the postganglionic part of the autonomic nervous system, whereas in MSA, degeneration of preganglionic and central autonomic neurons is revealed histopathologically.

    METHOD: Scintigraphy with Iodine-123 (I123) metaiodobenzylguanidine (MIBG) enables the quantification of postganglionic sympathetic cardiac innervation. Scintigraphy with technetium-99m (Tc99m) Sestamibi was also performed to allow assessment of viable myocardium. In patients with IPD, the heart-mediastinum (H/M) ratio of MIBG uptake is pathologically impaired, patients with MSA have a regular H/M ratio.

    RESULTS: The results of the initial patients will be presented.

    CONCLUSION: I123 MIBG scintigraphy improves the differential diagnosis between MSA and IPD which allows appropriate treatment of IPD and avoids the inappropriate treatment of MSA and possible side effects.

    Conference Organiser - ICMS Pty Ltd