RT Journal Article
SR Electronic
T1 Evaluation of Probable or Possible Dementia with Lewy Bodies Using <sup>123</sup>I-IMP Brain Perfusion SPECT, <sup>123</sup>I-MIBG, and <sup>99m</sup>Tc-MIBI Myocardial SPECT
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1641
OP 1650
DO 10.2967/jnumed.107.042143
VO 48
IS 10
A1 Yoshitaka Inui
A1 Hiroshi Toyama
A1 Yuta Manabe
A1 Takahisa Sato
A1 Masayoshi Sarai
A1 Kenji Kosaka
A1 Nakao Iwata
A1 Kazuhiro Katada
YR 2007
UL http://jnm.snmjournals.org/content/48/10/1641.abstract
AB We evaluated the diagnostic usefulness of combination studies with a statistical mapping method in N-isopropyl-p-123I-iodoamphetamine (123I-IMP) brain perfusion SPECT, cardiac sympathetic nerve function by 123I-metaiodobenzylguanidine (123I-MIBG), and myocardial function by electrocardiographically gated 99mTc-sestamibi (99mTc-MIBI) SPECT for patients with probable or possible dementia with Lewy bodies (DLB). Methods: Twelve patients with probable DLB (7 male, 5 female; mean age ± SD, 72.3 ± 5.63 y; range, 65–82 y) and 9 patients with possible DLB (3 male, 6 female; mean age ± SD, 73.1 ± 9.23 y; range, 59–88 y) were enrolled in this study. 123I-IMP SPECT images were analyzed with 3-dimensional stereotactic surface projections (3D-SSP) and the severity of ischemia was classified objectively using quantitatively analytic and display software; stereotactic extraction estimation (SEE) methods were compared with a normal database. In addition, we evaluated 123I-MIBG heart-to-mediastinum (H/M) uptake ratios. Moreover, we performed 99mTc-MIBI SPECT to evaluate myocardial perfusion and the left ventricular ejection fraction (LVEF) compared with a normal database. Results: 3D-SSP images of group comparison with healthy control subjects showed significantly decreased perfusion in the parietotemporal, occipital cortex, posterior cingulated, and precuneus regions in the probable DLB group but no significant reduction in the possible DLB group. Mean H/M ratios in the probable DLB group were significantly lower than those of the possible DLB group and the control group, respectively. Ten of 12 patients (83.3%) with probable DLB and 1 of 9 patients (11.1%) with possible DLB showed severe reduction in the bilateral occipital lobe and also a low 123I-MIBG uptake. One patient (8.3%) with probable DLB and 2 patients (22.2%) with possible DLB showed no bilateral occipital hypoperfusion but showed low 123I-MIBG uptake. One patient (8.3%) with probable DLB and 6 patients (66.7%) with possible DLB showed no occipital hypoperfusion and normal 123I-MIBG uptake. 99mTc-MIBI gated SPECT did not indicate any wall motion abnormality in any subjects. Conclusion: These results suggest that combined examination of cerebral blood flow with 3D-SSP and SEE analysis, and cardiac sympathetic nerve function with 123I-MIBG, would be a useful supporting diagnostic method in patients with DLB—particularly, in possible DLB and when cerebral blood flow does not indicate occipital hypoperfusion.