Utility of the Combination of DAT SPECT and MIBG Myocardial Scintigraphy in Differentiating Dementia with Lewy Bodies from Alzheimer's Disease

Overview

Journal Eur J Nucl Med Mol Imaging

Specialties Biophysics
Nuclear Medicine
Radiology

Date 2015 Aug 3

PMID 26233438

Citations 26

Authors

Soichiro Shimizu

Kentaro Hirao

Hidekazu Kanetaka

Nayuta Namioka

Hirokuni Hatanaka

Daisuke Hirose

Raita Fukasawa

Takahiko Umahara

Hirohumi Sakurai

Haruo Hanyu

Affiliations

Soon will be listed here.

Abstract

Purpose: (123)I-2β-Carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane ((123)I-FP-CIT) dopamine transporter single photon emission computed tomography (DAT SPECT) and (123)I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy can be used to assist in the diagnosis of patients with dementia with Lewy bodies (DLB). We compared the diagnostic value of these two methods in differentiating DLB from Alzheimer's disease (AD). Furthermore, we evaluated whether a combination of DAT SPECT and MIBG myocardial scintigraphy would provide a more useful means of differentiating between DLB and AD.

Methods: Patients with AD (n = 57) and patients with DLB (n = 76) who underwent both DAT SPECT and MIBG myocardial scintigraphy were enrolled. The sensitivity, specificity, and accuracy of both methods as well as their combination for differentiating DLB from AD were calculated. Moreover, we examined whether symptoms of the patients with DLB were associated with the patterns of the abnormalities displayed on DAT SPECT and MIBG myocardial scintigraphy.

Results: The sensitivity and specificity of differentiating DLB from AD were 72.4 and 94.4 % by the heart to mediastinum ratio of MIBG uptake, 88.2 and 88.9 % by the specific binding ratio on DAT SPECT, and 96.1 and 90.7 % by their combination, respectively. The combined use of DAT SPECT and MIBG myocardial scintigraphy enabled more accurate differentiation between DLB and AD compared with either DAT SPECT or MIBG myocardial scintigraphy alone. There was a significantly higher frequency of parkinsonism in the abnormal DAT SPECT group than the normal DAT SPECT group. On the other hand, there was a higher frequency of the appearance of rapid eye movement (REM) sleep behavior disorder in the abnormal MIBG uptake group than the normal MIBG uptake group.

Conclusion: These results suggested that using a combination of these scintigraphic methods is a useful and practical approach to differentiate DLB from AD.

Citing Articles

Diagnostic Sensitivity and Symptomatic Relevance of Dopamine Transporter Imaging and Myocardial Sympathetic Scintigraphy in Patients with Dementia with Lewy Bodies.

Tang Z, Hirano S, Koizumi Y, Izumi M, Kitayama Y, Yamagishi K J Alzheimers Dis. 2024; 100(1):127-137.

PMID: 38848178 PMC: 11307094. DOI: 10.3233/JAD-231395.

Harmonizing multisite data with the ComBat method for enhanced Parkinson's disease diagnosis via DAT-SPECT.

Wakasugi N, Takano H, Abe M, Sawamoto N, Murai T, Mizuno T Front Neurol. 2024; 15:1306546.

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Two distinct degenerative types of nigrostriatal dopaminergic neuron in the early stage of parkinsonian disorders.

Kawazoe T, Sugaya K, Nakata Y, Okitsu M, Takahashi K Clin Park Relat Disord. 2024; 10:100242.

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[Dementia with Lewy bodies: old and new knowledge - Part 1: clinical aspects and diagnostics].

Dodel R, Berg D, Duning T, Kalbe E, Meyer P, Ramirez A Nervenarzt. 2023; 95(4):353-361.

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The diagnostic performance of functional dopaminergic scintigraphic imaging in the diagnosis of dementia with Lewy bodies: an updated systematic review.

Jreige M, Kurian G, Perriraz J, Potheegadoo J, Bernasconi F, Stampacchia S Eur J Nucl Med Mol Imaging. 2023; 50(7):1988-2035.

PMID: 36920494 PMC: 10199865. DOI: 10.1007/s00259-023-06154-y.

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