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The H/M ratio reflects the ratio of the heart to the background. However, selection of the regions of interest (ROIs) may vary among institutions, and the H/M ratio is higher on medium-energy collimators than on low-energy (LE) collimators. 8 Also, even if the H/M ratio is not used for quantitative evaluations, in the presence of LBD, the cardiac uptake on early-phase planar images may be markedly decreased.

Table 3 presents the diagnostic performance of the cut-off values selected for the early and the delayed H/M ratio and the early and delayed visual scores. In ROC analysis of the diagnostic performance for LBD, the early H/M ratio yielded the highest AUC value, but the difference for AUC values among the early and delayed H/M ratio and the early and delayed visual scores was not statistically significant.

Results:

11 Schofer J , , Spielmann R , , Schuchert A , , Weber K , , Schlüter M . Iodine-123 meta-iodobenzylguanidine scintigraphy: a noninvasive method to demonstrate myocardial adrenergic nervous system disintegrity in patients with idiopathic dilated cardiomyopathy . J Am Coll Cardiol 1988 ; 12: 1252–8. doi: http://dx.doi.org/10.1016/0735-1097(88)92608-3 Crossref Medline ISI, Google Scholar

21 Müller T , , Werne B , , Fowler B , , Kuhn W . Nigral endothelial dysfunction, homocysteine, and Parkinson’s disease . Lancet 1999 ; 354: 126–7. doi: http://dx.doi.org/10.1016/S0140-6736(99)01660-8 Crossref Medline ISI, Google Scholar

The early H/M ratio exhibited the best diagnostic ability. Its overall sensitivity, specificity, accuracy, PPV and NPV were 72.2%, 93.1%, 84.3%, 88.5% and 82.2%, respectively (cut-off value 2.2 or less). However, there was no significant difference from the delayed H/M ratio or the results of visual assessment.

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