title: The usefulness of combined brain perfusion single-photon emission computed tomography, Dopamine-transporter single-photon emission computed tomography, and123I-metaiodobenzylguanidine myocardial scintigraphy for the diagnosis of dementia with Lewy bodies.
abstract: BACKGROUND
  Current diagnostic criteria recommend neuroimaging as a diagnostic support tool for the clinical diagnosis of dementia with Lewy bodies (DLB). Because DLB causes characteristic impairments and disabilities, such as neuroleptic hypersensitivity, which may significantly increase morbidity and mortality, its prompt and correct diagnosis is very important. The aim of this study was to evaluate the extent to which diagnostic accuracy can be increased by using different combinations of brain perfusion single-photon emission computed tomography (bp-SPECT),123I-metaiodobenzylguanidine myocardial scintigraphy (MIBG scintigraphy), and DAT-SPECT. Taking finances and patient burden into consideration, we compared the tests to determine priority.
  
  
  METHODS
  Thirty-four patients with probable DLB (75.0 ± 8.3 years old; 14 men, 20 women) underwent bp-SPECT, MIBG scintigraphy, and DAT-SPECT.
  
  
  RESULTS
  Our comparison of three functional imaging techniques indicated that MIBG scintigraphy (79%) and Dopamine-transporter (DAT) SPECT (79%) had better sensitivity for characteristic abnormalities in DLB than bp-SPECT (53%). The combination of the three modalities could increase sensitivity for diagnosis of DLB to 100%. Additionally, the ratio of patients with rapid eye movement sleep behaviour disorder was significantly higher in the positive finding group on MIBG scintigraphy than in the negative finding group.
  
  
  CONCLUSIONS
  In terms of stand-alone diagnostic means, priority should be placed on MIBG scintigraphy or DAT-SPECT for the diagnosis of DLB. However, our results suggest that the combination of bp-SPECT, MIBG scintigraphy, and DAT-SPECT increased the accuracy of the clinical diagnosis of DLB.
authors.affiliation: Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine , Sapporo, Japan.
authors.forename: Seiju
authors.initials: S
authors.lastname: Kobayashi
authors.affiliation: Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine , Sapporo, Japan.
authors.forename: Kanae
authors.initials: K
authors.lastname: Makino
authors.affiliation: Department of Psychiatry, Sunagawa City Medical Center, Sunagawa, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Hatakeyama
authors.affiliation: Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine , Sapporo, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Ishii
authors.affiliation: Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine , Sapporo, Japan.|Tokiwa Child Development Center, Tokiwa Hospital, Sapporo, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Tateno
authors.affiliation: Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine , Sapporo, Japan.
authors.forename: Tomo
authors.initials: T
authors.lastname: Iwamoto
authors.affiliation: Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine , Sapporo, Japan.
authors.forename: Hanako
authors.initials: H
authors.lastname: Tsujino
authors.affiliation: Department of Radiology, Sunagawa City Medical Center, Sunagawa, Japan.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Kawasaki
authors.affiliation: Department of Radiology, Sunagawa City Medical Center, Sunagawa, Japan.
authors.forename: Kouhei
authors.initials: K
authors.lastname: Mikuni
authors.affiliation: Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine , Sapporo, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Ukai
authors.affiliation: Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine , Sapporo, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Murayama
authors.affiliation: Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine , Sapporo, Japan.
authors.forename: Eri
authors.initials: E
authors.lastname: Hashimoto
authors.affiliation: Department of Psychiatry, Sunagawa City Medical Center, Sunagawa, Japan.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Utsumi
authors.affiliation: Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine , Sapporo, Japan.
authors.forename: Chiaki
authors.initials: C
authors.lastname: Kawanishi
mesh_terms: D019797:3-Iodobenzylguanidine; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation / Q000502:physiology; D050483:Dopamine Plasma Membrane Transport Proteins / Q000378:metabolism*; D005260:Female; D006801:Humans; D020961:Lewy Body Disease / Q000000981:diagnostic imaging* / Q000378:metabolism; D008297:Male; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D055420:Perfusion Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D050483:Dopamine Plasma Membrane Transport Proteins; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine
keywords: 
  Dopamine-transporter  single-photon emission computed tomography
  ; 3DSRT; dementia with Lewy bodies (DLB); ioflupane; metaiodobenzylguanidine; tomography