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

Abstract The importance of accurate and early diagnosis of dementia with Lewy bodies (DLB) lies in its pharmacological management. Delayed imaging of cardiac 123 I-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 123 I-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 123 I-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 (HMR 15 m ) and at 4 h (HMR 4 h ) were obtained. Results After four years, 52 patients were diagnosed of DLB.HMR 15 m and HMR 4 h were significantly inferior in DLB respect to the others neurodegenerative diseases (1.27 ± 0.15 vs 1.76 ± 0.15, p p 15 m 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 123 I-MIBG scintigraphy can help to differentiate DLB from other neurodegenerative diseases with cognitive impairment.