Utility of early imaging of myocardial innervation scintigraphy in the diagnosis of Lewy Body Dementia

The importance of accurate and early diagnosis of dementia with Lewy bodies (DLB) lies in its pharmacological management. Delayed imaging of cardiac I-123-MIBG scintigraphy allows differentiation between DLB and other neurodegenerative diseases with cognitive impairment. The aim of this study was to assess the utility of early imaging of cardiac I-123-MIBG scintigraphy for differentiating DLB from others neurodegenerative disease with cognitive impairment. Material and methods: We assess retrospectively 106 patients (51 men, mean age 78 years) with cognitive impairment that underwent a cardiac I-123-MIBG study. Planar images were acquired in anterior view of the thorax 15 min (early) and 4 h (delayed) after tracer administration. The heart-to-mediastinum ratios (HMR) at 15 m (HMR15m) and at 4 h (HMR4h) were obtained. Results: After four years, 52 patients were diagnosed of DLB.HMR15m and HMR4h were significantly inferior in DLB respect to the others neurodegenerative diseases (1,27 +/- 0,15 vs 1,76 +/- 0,15,p < 0,05) and (1,14 +/- 0,13 vs 1,68 +/- 0,19,p < 0.01), respectively. The ROC analysis showed a HMR15m cut off point of 1.56 to differentiated DLB from the other dementias with a sensitivity and a specificity of 98%. Conclusions: Early imaging of cardiac I-123-MIBG scintigraphy can help to differentiate DLB from other neurodegenerative diseases with cognitive impairment. (c) 2012 Elsevier Espana, S.L. and SEMNIM. All rights reserved.