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The role of molecular imaging in the frame of the revised dementia with Lewy body criteria

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A Correction to this article was published on 06 May 2019

This article has been updated

Abstract

Introduction

Recommendations about clinical and pathologic diagnosis of dementia with Lewy bodies (DLB) have been recently refined by the DLB Consortium. Substantial new information has been incorporated with increased diagnostic weighting given to molecular imaging biomarkers. The present work attempted to present a comprehensive evaluation of the role of molecular imaging in the frame of the revised DLB criteria.

Methods

To this end, we briefly review the molecular imaging tools in the fourth Consensus report of the DLB Consortium, highlighting several indicative and supportive surrogate markers, including I-123 brain dopamine transporter (DaT), I-123 mIBG cardiac norepinephrine transporter (NeT) and brain F-18 fluorodeoxyglucose (FDG) imaging, as the main way to increase accuracy of ante-mortem diagnosis of probable or possible DLB.

Results

Along with main neuropathological and clinical issues, we focus on the diagnostic performance and appropriate use of current available items included in the index by nuclear medicine physicians, namely a low DaT uptake, a low NeT expression in myocardial tissue, and reduced parieto-occipital metabolism on brain FDG-PET. Moreover, a critical summary of the current state of the art in pathological validation of other biomarkers including amyloid and tau-PET imaging is provided.

Discussion

DLB Consortium clearly states that clinical diagnosis in clinical routine is suboptimal and gives more weight to molecular imaging biomarkers to offer a more objective information. Along with DaT, mIBG and FDG techniques, brain PET with more specific radiotracers could open a new scenario for an accurate evaluation of biomarkers involved in DLB.

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Change history

  • 06 May 2019

    In the article mentioned above all authors were assigned affiliation 14, which is wrong. Affiliation 14 belongs only to author Agostino Chiaravalloti.

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Authors and Affiliations

  1. Nuclear Medicine Unit, Nuovo Ospedale di Prato (NOP) S. Stefano, Prato, Italy

    Stelvio Sestini

  2. Nuclear Medicine Unit, San Raffaele G. Giglio Institute, Cefalù, Palermo, Italy

    Pierpaolo Alongi

  3. Nuclear Medicine Unit, Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Florence, Italy

    Valentina Berti

  4. Department of Diagnostic Imaging, Radiation Oncology and Haematology, Institute of Nuclear Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica DEL Sacro Cuore, Rome, Italy

    Maria Lucia Calcagni

  5. Nuclear Medicine Unit, Department of Medicine-DIMED, Padova University Hospital, Padua, Italy

    Diego Cecchin

  6. Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy

    Agostino Chiaravalloti

  7. Genoa Section, National Institute of Nuclear Physics (INFN), Genoa, Italy

    Andrea Chincarini

  8. Positron Emission Tomography Centre, IRMET S.p.A., Affidea, Turin, Italy

    Angelina Cistaro

  9. Department of Nuclear Medicine, Poliambulanza Foundation, Brescia, Italy

    Ugo Paolo Guerra

  10. Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy

    Sabina Pappatà

  11. Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy

    Pietro Tiraboschi

  12. Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy

    Flavio Nobili

  13. IRCCS Ospedale Policlinico San Martino, Genoa, Italy

    Flavio Nobili

  14. IRCCS Neuromed, Pozzilli, IT, Italy

    Stelvio Sestini, Pierpaolo Alongi, Valentina Berti, Maria Lucia Calcagni, Diego Cecchin, Agostino Chiaravalloti, Andrea Chincarini, Angelina Cistaro, Ugo Paolo Guerra, Sabina Pappatà, Pietro Tiraboschi & Flavio Nobili

  15. Padova Neuroscience Center, University of Padua, Padua, Italy

    Diego Cecchin

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  1. Stelvio Sestini
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Correspondence to Stelvio Sestini.

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Sestini, S., Alongi, P., Berti, V. et al. The role of molecular imaging in the frame of the revised dementia with Lewy body criteria. Clin Transl Imaging 7, 83–98 (2019). https://doi.org/10.1007/s40336-019-00321-8

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  • DOI: https://doi.org/10.1007/s40336-019-00321-8

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