Diagnostic accuracy of ¹²³I-FP-CIT (DaTSCAN) in dementia with Lewy bodies: a meta-analysis of published studies.

Abstract

PURPOSE:

A systematic meta-analysis of published studies on the diagnostic accuracy of presynaptic dopaminergic imaging with ¹²³I-FP-CIT (DaTSCAN) in dementia with Lewy bodies (DLB).

METHODS:

We included (a) studies in which DaTSCAN was performed in cases of diagnostic uncertainty to differentiate between DLB and non-DLB dementia and (b) studies of patients with already established diagnoses of DLB, non-DLB dementia, or normalcy, against which the diagnostic accuracy of DaTSCAN was tested. We applied fixed-effects Mantel-Haenszel and hierarchical logistic regression models for meta-analysis of the diagnostic test's accuracy. The pooled sensitivity, specificity and diagnostic odds ratio (DOR) were estimated. Heterogeneity among studies was estimated by calculating the corresponding I² statistic. We tested for publication or other bias by creating the respective funnel plot.

RESULTS:

Four studies, with a total of 419 subjects, were judged to be suitable for meta-analysis. According to hierarchical models, the estimated pooled sensitivity of DaTSCAN in differentiating DLB versus no DLB was 86.5% [95% Confidence Intervals (CI): 72-94.1%], the specificity was 93.6% (95% CI: 88.5-96.6%), and the DOR was 94.2 (95% CI: 25.7-345). The Mantel-Haenszel estimate of overall DOR was calculated at 48.95 (95% CI: 26.16-91.59). There was some heterogeneity among studies (I² = 45%), but this was not found statistically significant (χ² test for heterogeneity p value = 0.142). Funnel plot analysis showed no significant bias.

CONCLUSION:

Allowing for the small number of studies in the meta-analysis, our results showed high diagnostic accuracy of DaTSCAN in DLB diagnosis, especially in terms of specificity.

• Authors: Nikolaos D Papathanasiou, Anastasios Boutsiadis, John Dickson, Jamshed B Bomanji
• Journal: Parkinsonism & related disorders (Parkinsonism Relat Disord) Vol. 18 Issue 3 Pg. 225-9 (Mar 2012) ISSN: 1873-5126 [Electronic] England
• PMID: 21975260 (Publication Type: Journal Article, Meta-Analysis, Review)
• Copyright: Copyright © 2011 Elsevier Ltd. All rights reserved.

Chemical References

• Dopamine Plasma Membrane Transport Proteins
• Radiopharmaceuticals
• Tropanes
• 2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane

Topics

• Dopamine Plasma Membrane Transport Proteins (analysis)
• Humans
• Lewy Body Disease (diagnostic imaging)
• Positron-Emission Tomography (methods)
• Radiopharmaceuticals
• Sensitivity and Specificity
• Tropanes