[Improved diagnosis of dementia with Lewy bodies by the combination of 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy and 99mTc-ethylcysteinate dimmer (ECD) brain perfusion SPECT].

Clinical diagnostic criteria for dementia with Lewy bodies (DLB) include abnormal findings on MIBG myocardial scintigraphy and occipital hypoperfusion as supportive features. In this study, 36 patients with probable DLB underwent MIBG scintigraphy and brain perfusion SPECT. The results of SPECT were analyzed using three different cerebral blood flow (CBF)-analyzing programs, an easy Z-score imaging system (e-ZIS), 3DSRT, and FineSRT. Among these assessments, delayed heart-to-mediastinum (dH/M) ratios on MIBG scintigraphy showed superior sensitivity (92%) to detect characteristic abnormalities in DLB. The sensitivities of CBF-analyzing programs to detect occipital hypoperfusion were 67%, 74%, and 81% for e-ZIS, 3DSRT, and FineSRT, respectively. Our results demonstrate that the combination of MIBG scintigraphy and brain perfusion SPECT could increase the accuracy of the clinical diagnosis of DLB. MIBG scintigraphy could be recommended for DLB patients in the clinical setting.