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

• Published in: Parkinsonism & related disorders 2012-03, Vol.18 (3), p.225-229
• Main Authors: Papathanasiou, Nikolaos D., Boutsiadis, Anastasios, Dickson, John, Bomanji, Jamshed B.
• Format: Article
• Language: English
• Subjects: 123I-FP-CIT; DaTSCAN; Dopamine Plasma Membrane Transport Proteins - analysis; Dopamine transporter; Humans; Lewy body dementia; Lewy Body Disease - diagnostic imaging; Meta-analysis; Positron-Emission Tomography - methods; Radiopharmaceuticals; Sensitivity and Specificity; Tropanes
• ISSN: 1353-8020; 1873-5126
• DOI: 10.1016/j.parkreldis.2011.09.015

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). 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. 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. 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.