Multimodality imaging characteristics of dementia with Lewy bodies.
Dementia with Lewy bodies (DLB) is the second most common cause of neurodegenerative dementia after Alzheimer's disease (AD). Our objective was to determine whether the (11)C-Pittsburgh Compound-B (PiB) retention and regional hypometabolism on positron emission tomography (PET) and regional cortical atrophy on magnetic resonance imaging (MRI) are complementary in characterizing patients with DLB and differentiating them from AD. We studied age-, gender-, and education-matched patients with a clinical diagnosis of DLB (n = 21), AD (n = 21), and cognitively normal subjects (n = 42). Hippocampal atrophy, global cortical PiB retention and occipital lobe metabolism in combination distinguished DLB from AD better than any of the measurements alone (area under the receiver operating characteristic = 0.98). Five of the DLB and AD patients who underwent autopsy were distinguished through multimodality imaging. These data demonstrate that magnetic resonance imaging and PiB positron emission tomography contribute to characterizing the distinct pathological mechanisms in patients with AD compared with DLB. Occipital and posterior parietotemporal lobe hypometabolism is a distinguishing feature of DLB and this regional hypometabolic pattern is independent of the amyloid pathology.
Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA. kantarci.kejal@mayo.edu
Kejal
K
Kantarci
Val J
VJ
Lowe
Bradley F
BF
Boeve
Stephen D
SD
Weigand
Matthew L
ML
Senjem
Scott A
SA
Przybelski
Dennis W
DW
Dickson
Joseph E
JE
Parisi
David S
DS
Knopman
Glenn E
GE
Smith
Tanis J
TJ
Ferman
Ronald C
RC
Petersen
Clifford R
CR
Jack
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging* / Q000473:pathology*; D000814:Aniline Compounds; D001931:Brain Mapping; D016022:Case-Control Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D021621:Imaging, Three-Dimensional; D020961:Lewy Body Disease / Q000000981:diagnostic imaging* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009778:Occipital Lobe / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography; D012372:ROC Curve; D018709:Statistics, Nonparametric; D013844:Thiazoles
C475519:2-(4'-(methylamino)phenyl)-6-hydroxybenzothiazole; D000814:Aniline Compounds; D013844:Thiazoles; D019788:Fluorodeoxyglucose F18