Clinicopathological and ¹²³I‐FP‐CIT SPECT correlations in patients with dementia

Abstract

The relationship between clinicopathologic diagnosis and 123I‐FP‐CIT SPECT in 18 patients with dementia (12 with Lewy body disease) from one center in the United States was assessed. The sensitivity and specificity of abnormal 123I‐FP‐CIT SPECT with reduced striatal uptake on visual inspection for predicting Lewy body disease were 91.7% and 83.3%, respectively. The mean calculated putamen to occipital ratio (mPOR) based on regions of interest was significantly reduced in Lewy body disease compared to non‐Lewy body disease cases (P = 0.002). In this study, abnormal 123I‐FP‐CIT SPECT was strongly associated with underlying Lewy body disease pathology, supporting the utility of 123I‐FP‐CIT SPECT in the clinical diagnosis of dementia with Lewy bodies.

Confirmation of 123I-FP-CIT SPECT Quantification Methods in Dementia with Lewy Bodies and Other Neurodegenerative Disorders

“…123 I-N-v-fluoropropyl-2b-carbomethoxy-3b-(4-iodophenyl)nortropane ( 123 I-FP-CIT) SPECT, an indicative biomarker of pDLB, is currently one of the most widely used probes for imaging dopamine transporters (7,8). One study demonstrated a strong correlation between abnormal 123 I-FP-CIT SPECT binding and LBD (7), and other studies suggested that 123 I-FP-CIT SPECT has 70%-80% sensitivity for diagnosing clinical pDLB and more than 80% specificity for excluding non-pDLB neurodegenerative syndromes (7).…”

“…For these reasons, automated, semiautomated, and manual quantitative methods for 123 I-FP-CIT SPECT could be helpful (8,9). Ratios that compare the 123 I-FP-CIT SPECT radiopharmaceutical uptake to a reference region of low dopamine transporter density are used in quantitative analyses (7). Some software programs may give options to manually position regions of interest (ROIs) on the images; however, this procedure is timeconsuming and leads to intrarater and interrater variability (10).…”

“…Several quantification methods are available, including DaTQUANT (GE Healthcare) (9), MIMneuro (MIM Software Inc.) (13), and manual ROI creation on an Advantage Workstation (GE Healthcare) (7). In this study, we paired neuropathologic findings and clinical data to investigate the comparative diagnostic accuracy of these quantification methods for predicting LBD versus non-LBD.…”

123I-FP-CIT SPECT in dementia with Lewy bodies, Parkinson’s disease and Alzheimer’s disease: a new quantitative analysis of autopsy confirmed cases

“…8 This European multicenter study was based on a clinical consensus diagnosis and was in keeping with previously published data with autopsy diagnoses. [10][11][12][13] Recently a new visual rating scale for Lewy body disease (LBD) was developed by the Newcastle group with improved sensitivity of 97% and specificity of 100% in the differentiation of LBD versus non-LBD. 9 However, the visual assessment could not distinguish the different Lewy bodies disorders, i.e., DLB vs PD vs PDD.…”

“…[5][6][7][8] There are relatively few published papers concerning [ 123 I]FP-CIT brain SPECT in DLB with subsequent neuropathology. [9][10][11][12][13] The majority of previous studies focused mainly on visual assessment of [ 123 I]FP-CIT. We found no single study with autopsy diagnoses including patients with DLB and PD to ascertain differences in the pattern of dopaminergic deficit between the two conditions in vivo.…”