Clinical Implication of SPECT in Dementia with Lewy Bodies

Abstract

Dementia with Lewy bodies (DLB) is highly prevalent dementia disorder in elder population, after Alzheimerʼs disease. DLB has multiple involvement of neurotransmitter systems with non-specific structural changes. Clinical symptoms as well as SPECT imaging is effective diagnostic marker which is incorporated in the diagnostic criteria of DLB. Since DLB is treatable, early recognition and diagnosis is pivotal in clinical practice. In this review dopamine transporter image, cardiac ¹²³I-metaiodobenzylguanidine (¹²³I-MIBG) image, and perfusion image, are detailed, in terms of scan protocol, image analyses, a role as a diagnostic tool, and clinical correlates of DLB. Reduced striatal dopamine transporter binding, reduced cardiac ¹²³I-MIBG binding, and diffuse cortical hypoperfusion with most prominent occipital lobe involvement is the typical imaging finding of DLB. Pearls and pitfall for diagnosing DLB is discussed.