A COMPARISON OF THE DIAGNOSTIC ACCURACY OF MIBG, ECD AND FP-CIT SPECT FOR DETECTING LEWY BODY DISEASE IN A MEMORY CLINIC

Abstract

99mTc-ethyl cysteinate dimer (ECD) cerebral blood flow single photon emission computed tomography (SPECT), 123I-2β-Carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane (123I-FP-CIT) dopamine transporter (DAT) SPECT and 123I-metaiodobenzylguanidine (MIBG) myocardial SPECT can be used to assist in the diagnosis of patients with Lewy bodies disease (LBD). We compared the diagnostic value of these three SPECT methods in differentiating LBD from non-LBD. Patients with no-LBD (n=48) and patients with LBD (n=17) who underwent ECD SPECT, DAT SPECT and MIBG myocardial scintigraphy were enrolled. Patients with LBD consisted of dementia with Lewy bodies (n=33), Parkinson disease (n=7), Parkinson disease with dementia (n=4), and REM sleep behavior disorder (n=4). Patients with non-LBD consisted of Alzheimer disease (n=9), progressive supranuclear palsy (n=2), multiple system atrophy (n=1), corticobasal degeneration (n=1), vascular dementia (n=1), essential tremor (n=1), sleep apnea syndrome (n=1), and normal (n=1). The sensitivity, specificity, and accuracy of those methods were calculated. The sensitivity and specificity of differentiating LBD from non-LBD were 73.0 and 100 % by the MIBG heart uptake, 64.0 and 82.0 % by the striatum uptake on DAT SPECT, and 76.0 and 53.0 % by ECD SPECT, respectively. These results suggested that using these methods is a useful and practical approach to differentiate LBD from non-LBD.