Iodine‐123 Metaiodobenzylguanidine Scintigraphy and Iodine‐123 Ioflupane Single Photon Emission Computed Tomography in Lewy Body Diseases: Complementary or Alternative Techniques?

Abstract

LBD usually present both myocardial sympathetic and striatal dopaminergic impairments. (123)I-FP-CIT SPECT presents high sensitivity in the diagnosis of LBD; (123)I-MIBG scintigraphy may have a complementary role in differential diagnosis between PD and other parkinsonism. These scintigraphic methods showed similar diagnostic accuracy in differential diagnosis between DLB and other dementia.

Imaging the Functional Brain-Heart Axis: Neurodegenerative Diseases

“…In probable DLB, an impairment of both myocardial [ 123 I]-MIBG uptake and striatal dopaminergic imaging was found (Camacho et al 2011 ;Treglia et al 2014 ), suggesting that myocardial sympathetic degeneration and nigrostriatal degeneration parallel similarly in these patients.…”

“…For example, imaging of dopamine transporter (DAT) binding with [ 123 I]-N -ω-fl uoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropan (FP-CIT) successfully visualizes presynaptic dopaminergic degeneration of the nigrostriatal tract. This procedure allows differentiation of DLB from other dementias (Papathanasiou et al 2012 ) and degenerative parkinsonism from movement disorders that are not associated with dopaminergic defi cit, such as essential tremor (Treglia et al 2014 ). DAT imaging alone, however, does not differentiate the various types of degenerative parkinsonism with suffi cient accuracy (Südmeyer et al 2011 ;Treglia et al 2014 ).…”

“…123 I]-MIBG scintigraphy may have a complementary role in differential diagnosis between PD and other parkinsonisms (Treglia et al 2014 ).…”

“…For these reasons, autonomic dysfunction, as measured by sympathetic noradrenergic denervation, seems to occur independently of the dopaminergic impairment that causes the movement disorders in PD. Because of this independence, evidence of myocardial sympathetic denervation can be an early fi nding but may also occur after the movement disorder is overt in PD (Treglia et al 2014 ).…”

“…This differential diagnosis may be diffi cult using other neuroimaging methods such as striatal dopaminergic imaging (Treglia et al 2014 ).…”