SPECT/PET Findings in Dementia with Lewy Bodies

Abstract

Dementia with Lewy bodies (DLB) is the second most common form of degenerative dementia. However, it can be difficult to diagnose as it shares common features with both Alzheimer’s disease (AD) and Parkinson’s disease (PD). Early detection as well as accurate differentiation from other types of dementia are essential to inform management and treatment. Clinical diagnosis of DLB can be difficult, with up to 50% of cases being misdiagnosed (Walker et al., Lancet 386:1683–1697, 2015). The use of biomarkers, particularly imaging biomarkers, has greatly contributed to the accurate diagnosis of DLB. This chapter will give an overview of the contribution of PET and SPECT imaging modalities to the diagnosis of DLB and the better understanding of the underlying pathology. The areas covered include metabolic, amyloid, microglial activity, dopaminergic and cholinergic imaging in DLB. Some of these imaging methods are now well established and highly reliable at facilitating accurate diagnosis. In the future, others are likely to inform treatment or provide bases for the development of new drugs. New ligands are constantly being developed and are likely to focus on microglial activation and tau pathology in DLB.