Striatal uptake of the dopamine transporter ligand 123I-FPCIT is reduced in Parkinson's disease (PD). We examined whether FPCIT uptake might also be a diagnostic discriminator between dementia with Lewy bodies (DLB) and Alzheimer's disease (AD).
Triple-detector gamma camera SPECT imaging using 123I-FPCIT was performed on 23 patients with DLB, 34 with AD, 38 with PD, 36 with established PD who subsequently developed neuropsychiatric features of DLB (PD+) and 33 normal controls. SPECT scans were analysed semi-quantitatively using regions of interest over striata and occipital regions. Scans were also rated visually, both individually and consensually of five raters using a 4-point scale. Patients with DLB, PD and PD+ all demonstrated significant bilateral reduced striatal uptake compared with AD patients and controls (P<0.001). There were no differences between normal controls and patients with AD, nor between DLB and PD. There was good agreement between observers (kappa 0.88) and between each and consensus rating. Sensitivity was 88%, specificity 91% in differentiating controls/AD from DLB/PD/PD+, based on clinical diagnosis as the gold standard.
FPCIT imaging appears a reliable method for patients with dementia to distinguish those with DLB from AD. Scans in DLB were indistinguishable from those in PD.
Colloby SJ, Fenwick JD, Williams ED, Burn DJ, McKeith IG, O'Brien JT. Striatal uptake of 123I-FPCIT in dementia with Lewy bodies, Alzheimer's disease and Parkinson's disease. Nuc Med Commun 2003; 24: 455-5.
Professor E. David Williams, Sunderland Unit, Sunderland. Tel: +44 (0)191-569-9035.
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