title: Comparison of the usefulness of brain perfusion SPECT and MIBG myocardial scintigraphy for the diagnosis of dementia with Lewy bodies.
abstract: BACKGROUND
  Supportive features in the diagnostic criteria for dementia with Lewy bodies (DLB) include occipital hypoperfusion and decreased cardiac uptake of (123)I-metaiodobenzylguanidine (MIBG). In this study, we performed both brain perfusion single photon emission computed tomography (SPECT) and MIBG myocardial scintigraphy in the same subjects and evaluated their sensitivity to detect the characteristic features of DLB.
  
  
  METHODS
  Twenty-five patients with probable DLB (76.8 +/- 5.1 years old, 10 male) underwent (99m)Tc-ethylcysteinate dimer brain perfusion SPECT and (123)I-MIBG myocardial scintigraphy. The results of SPECT were analyzed using a qualitative analysis program, easy Z score imaging system (eZIS), and an automated quantitative analysis program, 3DSRT.
  
  
  RESULTS
  Qualitative analysis using eZIS demonstrated occipital hypoperfusion in 17 subjects (68%). The quantified mean blood perfusion in the occipital segment on the 3DSRT template was 40.7 +/- 5.03 ml/100 g/min (right) and 40.5 +/- 5.38 ml/100 g/min (left), and in 19 DLB patients these values were below the normal limit. Twenty-four of 25 subjects (96%) had decreased cardiac MIBG uptake in the delayed image.
  
  
  CONCLUSIONS
  MIBG myocardial scintigraphy was superior to brain perfusion SPECT in detecting a characteristic feature of DLB. Our results suggest that combining SPECT and MIBG scintigraphy could increase the accuracy of clinical diagnosis of DLB.
authors.affiliation: Department of Neuropsychiatry, Sapporo Medical University, Chuo-ku, Sapporo, Japan. tatema@sapmed.ac.jp
authors.forename: Masaru
authors.initials: M
authors.lastname: Tateno
authors.forename: Seiju
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Shirasaka
authors.forename: Yoshimori
authors.initials: Y
authors.lastname: Furukawa
authors.forename: Kazuki
authors.initials: K
authors.lastname: Fujii
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Morii
authors.forename: Shuichi
authors.initials: S
authors.lastname: Yasumura
authors.forename: Kumiko
authors.initials: K
authors.lastname: Utsumi
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Saito
mesh_terms: D019797:3-Iodobenzylguanidine; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000000981:diagnostic imaging; D001921:Brain / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003545:Cysteine / Q000031:analogs & derivatives; D003937:Diagnosis, Differential; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D020961:Lewy Body Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D008297:Male; D009778:Occipital Lobe / Q000098:blood supply; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine; C059659:technetium Tc 99m bicisate; D003545:Cysteine