{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T06:04:08Z","timestamp":1768802648186,"version":"3.49.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,12,2]],"date-time":"2022-12-02T00:00:00Z","timestamp":1669939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002803","name":"Fondazione Cariplo","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002803","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study investigates the effects of manual and semi-automatic methods for assessing MIBG semi-quantitative indices in a clinical setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>We included <jats:sup>123<\/jats:sup>I-MIBG scans obtained in 35 patients with idiopathic Parkinson\u2019s Disease. Early and late heart-to-mediastinum (H\/M) ratios were calculated from <jats:sup>123<\/jats:sup>I-MIBG images using regions of interest (ROIs) placed over the heart and the mediastinum. The ROIs were derived using two approaches: (i) manually drawn and (ii) semi-automatic fixed-size ROIs using anatomical landmarks. Expert, moderate-expert, and not expert raters applied the ROIs procedures and interpreted the <jats:sup>123<\/jats:sup>I-MIBG images. We evaluated the inter and intra-rater agreements in assessing <jats:sup>123<\/jats:sup>I-MIBG H\/M ratios.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A moderate agreement in the raters\u2019 classification of pathological and non-pathological scores emerged regarding early and late H\/M ratio values (\u03ba = 0.45 and 0.69 respectively), applying the manual method, while the early and late H\/M ratios obtained with the semi-automatic method reached a good agreement among observers (\u03ba = 0.78). Cohen-Kappa values revealed that the semi-automatic method improved the agreement between expert and inexpert raters: the agreement improved from a minimum of 0.29 (fair, for early H\/M) and 0.69 (substantial, in late H\/M) with the manual method, to 0.90 (perfect, in early H\/M) and 0.87 (perfect, in late H\/M) with the semi-automatic method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of the semi-automatic method improves the agreement among raters in classifying\u2019 H\/M ratios as pathological or non-pathological, namely for inexpert readers. These results have important implications for semi-quantitative assessment of <jats:sup>123<\/jats:sup>I-MIBG images in clinical routine.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.1073720","type":"journal-article","created":{"date-parts":[[2022,12,2]],"date-time":"2022-12-02T05:36:45Z","timestamp":1669959405000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Manual and semi-automated approaches to MIBG myocardial scintigraphy in patients with Parkinson\u2019s disease"],"prefix":"10.3389","volume":"9","author":[{"given":"Cecilia","family":"Boccalini","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Carli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilia Giovanna","family":"Vanoli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoniangela","family":"Cocco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Albanese","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Garibotto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Perani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,12,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1264","DOI":"10.1002\/mds.27115","article-title":"Past, present, and future of Parkinson\u2019s disease: a special essay on the 200th Anniversary of the Shaking Palsy.","volume":"32","author":"Obeso","year":"2017","journal-title":"Mov Disord."},{"key":"B2","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1002\/mds.27138","article-title":"How does parkinson\u2019s disease begin? Perspectives on neuroanatomical pathways, prions, and histology.","volume":"33","author":"Borghammer","year":"2018","journal-title":"Mov Disord."},{"key":"B3","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1007\/s00441-018-2851-9","article-title":"Peripheral and central autonomic nervous system: does the sympathetic or parasympathetic nervous system bear the brunt of the pathology during the course of sporadic PD?","volume":"373","author":"Orimo","year":"2018","journal-title":"Cell Tissue Res."},{"key":"B4","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1007\/s11910-018-0889-4","article-title":"Imaging the Autonomic Nervous System in Parkinson\u2019s Disease.","volume":"18","author":"Knudsen","year":"2018","journal-title":"Curr Neurol Neurosci Rep."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1591","DOI":"10.1002\/mds.26424","article-title":"MDS clinical diagnostic criteria for Parkinson\u2019s disease.","volume":"30","author":"Postuma","year":"2015","journal-title":"Mov Disord."},{"key":"B6","first-page":"22","article-title":"Myocardial imaging with a radioiodinated norepinephrine storage analog.","volume":"22","author":"Wieland","year":"1981","journal-title":"J Nucl Med."},{"key":"B7","first-page":"96","article-title":"Radiolabeled meta-iodobenzylguanidine: pharmacology and clinical studies.","volume":"1","author":"Sisson","year":"1986","journal-title":"Am J Physiol Imaging."},{"key":"B8","first-page":"1062","article-title":"Cardiac neurotransmission imaging.","volume":"42","author":"Carri\u00f3","year":"2001","journal-title":"J Nucl Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1016\/j.parkreldis.2012.01.009","article-title":"123I-MIBG myocardial scintigraphy for differentiating Parkinson\u2019s disease from other neurodegenerative parkinsonism: a systematic review and meta-analysis.","volume":"18","author":"Orimo","year":"2012","journal-title":"Parkinsonism Relat Disord."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1218","DOI":"10.1002\/mds.23659","article-title":"Meta-analysis of 123I-MIBG cardiac scintigraphy for the diagnosis of Lewy body\u2013related disorders.","volume":"26","author":"King","year":"2011","journal-title":"Mov Disord."},{"key":"B11","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1007\/s11307-019-01406-6","article-title":"[123I] Metaiodobenzylguanidine (MIBG) cardiac scintigraphy and automated classification techniques in parkinsonian disorders.","volume":"22","author":"Nuvoli","year":"2019","journal-title":"Mol Imaging Biol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1097\/MNM.0000000000001024","article-title":"A comparison of visual and semiquantitative analysis methods for planar cardiac 123I-MIBG scintigraphy in dementia with Lewy bodies.","volume":"40","author":"Roberts","year":"2019","journal-title":"Nucl Med Commun."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1599","DOI":"10.1007\/s00259-012-2180-2","article-title":"Reproducibility of planar 123I-meta-iodobenzylguanidine (MIBG) myocardial scintigraphy in patients with heart failure.","volume":"39","author":"Veltman","year":"2012","journal-title":"Eur J Nucl Med Mol Imaging."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1802","DOI":"10.1007\/s00259-010-1491-4","article-title":"Proposal for standardisation of 123 I-metaiodobenzylguanidine (MIBG) cardiac sympathetic imaging by the EANM Cardiovascular Committee and the European Council of Nuclear Cardiology.","volume":"37","author":"Flotats","year":"2010","journal-title":"Eur J Nucl Med Mol Imaging."},{"key":"B15","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","article-title":"A guideline of selecting and reporting intraclass correlation coefficients for reliability research.","volume":"15","author":"Koo","year":"2016","journal-title":"J Chiropr Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1007\/s12149-008-0156-x","article-title":"Usefulness of rCBF analysis in diagnosing Parkinson\u2019s disease: supplemental role with MIBG myocardial scintigraphy.","volume":"22","author":"Nagamachi","year":"2008","journal-title":"Ann Nucl Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1037\/h0031619","article-title":"Measuring nominal scale agreement among many raters.","volume":"76","author":"Fleiss","year":"1971","journal-title":"Psychol Bull."},{"key":"B18","author":"Fleiss","year":"2013","journal-title":"Statistical Methods for Rates and Proportions."},{"key":"B19","doi-asserted-by":"publisher","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data.","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics."},{"key":"B20","doi-asserted-by":"publisher","first-page":"276","DOI":"10.11613\/BM.2012.031","article-title":"Interrater reliability: the kappa statistic.","volume":"22","author":"McHugh","year":"2012","journal-title":"Biochem Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1097\/MNM.0b013e328337a99b","article-title":"Mathematical methods to determine quantitative parameters of myocardial 123I-MIBG studies: a review of the literature.","volume":"31","author":"van der Veen","year":"2010","journal-title":"Nucl Med Commun."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.1007\/s00702-015-1409-1","article-title":"Comparison of I-123 MIBG planar imaging and SPECT for the detection of decreased heart uptake in Parkinson disease.","volume":"122","author":"Oh","year":"2015","journal-title":"J Neural Trans."},{"key":"B23","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1007\/s12350-012-9539-4","article-title":"Assessment of global cardiac I-123 MIBG uptake and washout using volumetric quantification of SPECT acquisitions.","volume":"19","author":"van der Veen","year":"2012","journal-title":"J Nucl Cardiol."}],"updated-by":[{"DOI":"10.3389\/fmed.2023.1171820","type":"erratum","label":"Erratum","source":"publisher","updated":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T00:00:00Z","timestamp":1677801600000}}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.1073720\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T15:34:46Z","timestamp":1677857686000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.1073720\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,2]]},"references-count":23,"alternative-id":["10.3389\/fmed.2022.1073720"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2022.1073720","relation":{"erratum":[{"id-type":"doi","id":"10.3389\/fmed.2023.1171820","asserted-by":"object"}]},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,2]]},"article-number":"1073720"}}