The British Journal of Psychiatry (2009) 194: 34-39. doi: 10.1192/bjp.bp.108.052050
© 2009 The Royal College of Psychiatrists
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Diagnostic accuracy of 123I-FP-CIT SPECT in possible dementia with Lewy bodies

John T. O’Brien, DM and Ian G. McKeith, FMedSci

Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK

Zuzana Walker, MD

Department of Mental Health Sciences, University College London, UK

Klaus Tatsch, MD

Department of Nuclear Medicine, Ludwig Maximilians University Hospital, Munich, Germany

Jan Booij, MD

Department of Nuclear Medicine, Academic Medical Centre, Amsterdam, Netherlands

Jacques Darcourt, MD

Department of Nuclear Medicine, Medical Faculty, University of Nice Sophia-Antipolis, Nice, France

Moritz Marquardt and Cornelia Reininger, MD, GE

Healthcare, Clinical Research and Development, Munich, Germany

the DLB Study Group*

Correspondence: John T. O’Brien, Institute for Ageing and Health, Wolfson Research Centre, Newcastle General Hospital, Newcastle upon Tyne NE4 6BE, UK. Email: j.t.o'brien{at}ncl.ac.uk

Declaration of interest

At the time of the study, M.M. and C.R. were GE Healthcare employees. J.O’B, I.McK, Z.W., K.T., J.B. and J.D. have received consultancy payments from GE Healthcare.

* Investigators in the DLB study group are listed in an online supplement.

Background

123I-FP-CIT SPECT (single photon emission computed tomography) can help in the differential diagnosis of probable dementia with Lewy bodies (Lewy body dementia) and Alzheimer’s disease.

Aims

Our aim was to determine the accuracy of 123I-FP-CIT SPECT in diagnosing people with possible dementia with Lewy bodies.

Method

We undertook a 12-month follow-up of 325 individuals with probable or possible Lewy body or non-Lewy body dementia who had previously undergone 123I-FP-CIT SPECT. A consensus panel, masked to SPECT findings, established diagnosis at 12 months in 264 people.

Results

Of 44 people with possible dementia with Lewy bodies at baseline, at follow-up the diagnosis for 19 people was probable dementia with Lewy bodies (43%), in 7 people non-Lewy body dementia (16%) and for 18 individuals it remained possible dementia with Lewy bodies (41%). Of the 19 who at follow-up were diagnosed with probable dementia with Lewy bodies, 12 had abnormal scans at baseline (sensitivity 63%); all 7 individuals with a possible diagnosis who were diagnosed as having Alzheimer’s disease at follow-up had normal scans (specificity 100%).

Conclusions

Our findings confirm the diagnostic accuracy of 123I-FP-CIT SPECT in distinguishing Lewy body from non-Lewy body dementia and also suggest a clinically useful role in diagnostically uncertain cases, as an abnormal scan in a person with possible dementia with Lewy bodies is strongly suggestive of dementia with Lewy bodies.


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