Neuroimaging for diagnosing dementia with Lewy bodies: What is the best neuroimaging technique in discriminating dementia with Lewy bodies from Alzheimer's disease?

Aim: We compared the diagnostic value of four neuroimaging techniques, namely, ¹²³ I-2β-Carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane (¹²³ I-FP-CIT) dopamine transporter single-photon emission computed tomography (DAT-SPECT), magnetic resonance imaging, perfusion SPECT and ¹²³ I-metaiodobenzyl-guanidine myocardial scintigraphy in differentiating dementia with Lewy bodies (DLB) from Alzheimer's disease (AD).

Methods: A total of 32 patients with probable AD and 32 patients with probable DLB were enrolled in the present study. For the comparison study, we used the specific binding ratio for DAT-SPECT, the heart-to-mediastinum ratio in the delay phase for ¹²³ I-metaiodobenzyl-guanidine myocardial scintigraphy, z-scores in the medial occipital lobe for perfusion SPECT and z-scores of hippocampal atrophy using a voxel-based specific regional analysis system for AD for magnetic resonance imaging.

Results: DAT-SPECT enabled more accurate differentiation of DLB from AD than other methods. ¹²³ I-metaiodobenzyl-guanidine myocardial scintigraphy enabled more accurate differentiation of DLB from AD than magnetic resonance imaging and perfusion SPECT.

Conclusions: In agreement with the recent consensus clinical diagnostic criteria for DLB, we confirmed that the diagnostic accuracy of DAT-SPECT imaging is significantly higher than other neuroimaging techniques. Geriatr Gerontol Int 2017; 17: 819-824.