Value of Combining Activated Brain FDG-PET and Cardiac MIBG for the Differential

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Value of Combining Activated Brain FDG-PET and Cardiac MIBG for the

Differential Diagnosis of Dementia: Differentiation of Dementia With

Lewy Bodies and Alzheimer Disease When the Diagnoses Based on

Clinical and Neuroimaging Criteria Are Difficult.

June 2008

Abstract:

Dementia with Lewy bodies (DLB) is the second most common cause of

dementia. The diagnosis of DLB is particularly important because

these patients show good response to cholinesterase inhibitors.

Clinical and neuroimaging criteria for DLB have not been acceptable

for predictive accuracy. We report a case of progressive dementia in

which the differentiation of DLB and Alzheimer disease (AD) on the

basis of clinical criteria alone was not possible. The patient was

admitted to the hospital because he became worse after he had started

treatment for severe AD. Both MRI and brain magnetic resonance

spectroscopy were normal. The patient underwent myocardial

scintigraphy with I-123 MIBG showing marked reduction in cardiac MIBG

accumulation. The heart to mediastinum ratio of MIBG uptake was

impaired in both early and delayed images. FDG-PET scan before and

after activation with a visual attention task showed occipital cortex

hypometabolism as compared with AD and a normal control. This case

illustrates the value of combining activated brain FDG PET and

cardiac MIBG. The association of these 2 techniques could be used as

a potential diagnostic tool in a patient with dementia misdiagnosed

as AD.

Source:

http://tinyurl.com/5yp988