{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T01:56:34Z","timestamp":1774403794967,"version":"3.50.1"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100018502","name":"Kanazawa University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100018502","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nucl Med Mol Imaging"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      We previously proposed that a probability-based sympathetic\n                      <jats:sup>123<\/jats:sup>\n                      I-\n                      <jats:italic>meta<\/jats:italic>\n                      -iodobenzylguanidine (\n                      <jats:italic>m<\/jats:italic>\n                      IBG) index (SMILe) could distinguish the presence or absence of Lewy body disease (LBD) based on findings at a single center. However, whether the model would be useful in the real world remained uncertain. Therefore, we updated and evaluated its performance at five Japanese and three European institutions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We compared data from 967 patients with suspected LBD with 62 controls from a normal database (NDB). Of 815 patients with guideline-based diagnoses, 483 had LBD (Parkinson disease [PD] or dementia with Lewy bodies [DLB]) and 332 did not have LBD. Heart-to-mediastinum (H\/M) ratios were standardized using a phantom-based method. Logistic regression models included early and late H\/M ratios, age, sex, and comorbidities. We assessed diagnostic performance using ROC analysis and cross-validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The updated model discriminated LBD from other diseases (AUC for early and late H\/M, 0.880 0.899, respectively). Age correction of H\/M ratios based on the NDB did not improve accuracy. Median early H\/M ratios [SMILe probability] were 3.09 [12.8%] for NDB, 2.57 [37.5%] for Alzheimer disease, 1.76 [84.7%] for PD, and 1.62 [89.0%] for DLB, with significantly lower H\/M ratios and higher probabilities in PD and DLB compared with controls (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Late-phase imaging added value mainly in intermediate borderline (30%\u201370%) situations. Coronary artery disease attenuated the diagnostic performance of SMILe.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The probability-based\n                      <jats:sup>123<\/jats:sup>\n                      I-\n                      <jats:italic>m<\/jats:italic>\n                      IBG model reliably differentiated LBD from other diseases. Standardization among sites supports global applicability and reflects real-world clinical practice.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-025-07706-0","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T05:28:21Z","timestamp":1768368501000},"page":"3481-3494","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multicenter development and validation of a probability-based model to diagnose Lewy body disease using \u00b9\u00b2\u00b3I-meta-iodobenzylguanidine"],"prefix":"10.1007","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7188-8746","authenticated-orcid":false,"given":"Kenichi","family":"Nakajima","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junji","family":"Komatsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Matsumura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Orimo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuhiro","family":"Yoshita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viviana","family":"Frantellizzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Silvia","family":"De Feo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gemma","family":"Greenfinch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Assante","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wanda","family":"Acampa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Shirasaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunihiko","family":"Yokoyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Wakabayashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moeko","family":"Noguchi-Shinohara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenjiro","family":"Ono","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seigo","family":"Kinuya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"7706_CR1","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1016\/j.arr.2016.01.001","volume":"30","author":"S Orimo","year":"2016","unstructured":"Orimo S, Yogo M, Nakamura T, Suzuki M, Watanabe H. 123I-meta-iodobenzylguanidine (MIBG) cardiac scintigraphy in alpha-synucleinopathies. 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The Ethics Committee at Kanazawa University approved this retrospective study (Approval no: 2024\u2009\u2212\u2009143, 114645) Participation in this multicenter study was approved by the ethics committees at each institution or followed comparable guidelines.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The Ethics Committee at Kanazawa University waived the need for patients to provide written, informed consent to participate as the study investigated innominate data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"K. Nakajima belonged to a department endowed by PDRadiopharma (Tokyo, Japan), Nihon Medi-Physics (Tokyo, Japan), and Siemens Healthcare Japan (Tokyo, Japan), and has a collaborative research agreement with PDRadiopharma, Inc. (Tokyo, Japan), which markets\n                      123\n                      I-\n                      m\n                      IBG (myoMIBG\u2122) in Japan.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}