Objective: The development of easily useful neuroimaging may resolve to the delays of diagnosis.

Background: Dementia with Lewy bodies (DLB) is easy to be misdiagnosed but frequent subtype of dementia.

Methods: All dementia patients received examined neurological examination by a neurologist and neuropsychological examination by an experienced neuropsychologist. Magnetic resonance imaging (MRI) and Tc-99m ECD SPECT were performed routinely for evaluating brain organic lesion and brain perfusion. Tc-99m ECD SPECT images were anatomically standardized with an original 99mTc-ECD template using easy Z-score imaging system (eZIS). Quantitative 99mTc-Trodat-1 SPECT was extra arranged if movement symptom was found in these dementia patients. All quantitative SPECT images were reconstructed with full physical corrections and normalized to MRI brain template. DAT parameter as specific binding ratio (SBR) as [(target – background)/background] and left-right SBR symmetry (SBRS) was calculated with MRI voxel-based striatal ROI template.

Results: In this study, six of the patients were diagnosed with probable DLB. Decreased regional cerebral blood flow (rCBF) of the occipital cortex, precuneus gyrus and the posterior cingulate cortex were recognized in Tc-99m ECD SPECT. In quantitative 99mTc-Trodat-1 SPECT, SBR values were significantly lower than those of normal reference.

Conclusions: Combination of Tc-99m ECD SPECT with eZIS analysis and quantitative TRODAT-1 SPECT can be easily used as adjuncts to early-diagnosis of DLB in Taiwan hospital.

References: 1. Journal of the Neurological Sciences 260 (2007) 57–64

2. J Nucl Med. 2004 Mar;45(3):393-401

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MDS Abstracts - https://www.mdsabstracts.org/abstract/improved-diagnosis-of-dementia-with-lewy-bodies-by-the-combination-of-tc-99m-ecd-spect-with-ezis-analysis-and-quantitative-trodat-1-spect-images/