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Abstract Details

The Value of Multimodal Imaging with 123I-FP-CIT SPECT in Differential Diagnosis of Dementia with Lewy Bodies and Alzheimer’s Disease Dementia
Aging, Dementia, and Behavioral Neurology
Aging and Dementia Posters (7:00 AM-5:00 PM)
042
To assess how well 123I-FP-CIT SPECT differentiates Dementia with Lewy Bodies (DLB) from Alzheimer’s Disease Dementia (ADem) and whether multimodal imaging provides additional value.
Reduced striatonigral uptake on 123I-FP-CIT SPECT reflects dopamine dysfunction, while other imaging markers could be complementary when used together.

Ioflupane-SPECT, MRI, FDG-PET, and PiB-PET were assessed on 35 DLB and 14 ADem patients (including 12 patients with eventual autopsy). Striatonigral dopamine transporter uptake was evaluated semi-quantitatively with 123I-FP-CIT SPECT using DaTQUANT software (GE Healthcare) to calculate z-scores of putamen uptake. Hippocampal volume was calculated with structural MRI, cingulate island sign (CIS) ratio with FDG-PET, and global cortical PiB retention with PiB-PET.
Lower DaTQUANT z-scores of putamen were observed in DLB patients compared to ADem patients (c-statistic 0.916, p<0.001). The DaTQUANT z-scores of putamen showed higher c-statistic in differentiating DLB from ADem than hippocampal volume on MRI (c-statistic 0.739, p=0.016), CIS on FDG-PET (c-statistic 0.878, p=0.002), or global cortical PiB retention on PiB-PET (c-statistic 0.884, p=0.001), though some overlap between two diagnostic groups was still observed with the single imaging modality. Adding another imaging modality to 123I-FP-CIT SPECT enhanced c-statistics similarly with each combination (+MRI 0.968, +FDG-PET 0.975, +PiB-PET 0.975), and 123I-FP-CIT SPECT in combination with both MRI and PiB-PET showed the highest c-statistic of 0.996 when three imaging modalities were combined.
Ioflupane-SPECT is an excellent imaging modality to identify DLB by detecting striatonigral dopamine dysfunction and underlying Lewy-related pathology. Correlative neuroimaging with MRI, FDG-PET, or PiB-PET may add incremental value in differentiation of DLB and ADem and detecting concurrent AD and Lewy-related pathologies.
Authors/Disclosures
Toji Miyagawa, MD, PhD (Mayo Clinic)
PRESENTER 		Dr. Miyagawa has nothing to disclose.
Scott Przybelski Scott Przybelski has nothing to disclose.
No disclosure on file
No disclosure on file
No disclosure on file
Timothy Lesnick No disclosure on file
Jonathan Graff-Radford, MD, FÂ鶹´«Ã½Ó³»­ Dr. Graff-Radford has received personal compensation for serving as an employee of Mayo Clinic. Dr. Graff-Radford has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NINDS/NIH. Dr. Graff-Radford has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Graff-Radford has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Open evidence . The institution of Dr. Graff-Radford has received research support from NIH. The institution of Dr. Graff-Radford has received research support from Eisai. The institution of Dr. Graff-Radford has received research support from Cognition therapeutics. Dr. Graff-Radford has received personal compensation in the range of $5,000-$9,999 for serving as a Faculty Member with IMPACT AD .
David T. Jones, MD (Mayo Clinic) Dr. Jones has stock in Cephlodyne Neurotechnologies, Inc.. Dr. Jones has received intellectual property interests from a discovery or technology relating to health care.
Rodolfo Savica, MD, PhD, FÂ鶹´«Ã½Ó³»­ (Mayo Clinic) The institution of Dr. Savica has received research support from ACADIA Pharmaceuticals, Inc.
David S. Knopman, MD, FÂ鶹´«Ã½Ó³»­ (Mayo Clinic) Dr. Knopman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for DIAN TU study. The institution of Dr. Knopman has received research support from NIH.
Ronald C. Petersen, MD, PhD, FÂ鶹´«Ã½Ó³»­ (Mayo Clinic) Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly and Co.. Dr. Petersen has received personal compensation in the range of $0-$499 for serving as a Consultant for Eisai, Inc.. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novo Nordisk. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has a non-compensated relationship as a Board of Directors with American Brain Foundation that is relevant to Â鶹´«Ã½Ó³»­ interests or activities.
Walter Kremers The institution of Walter Kremers has received research support from NIH. The institution of an immediate family member of Walter Kremers has received research support from NIH.
Leah K. Forsberg, PhD (Mayo Clinic) Ms. Forsberg has nothing to disclose.
Laura Allen, NP (Mayo Clinic) Ms. Allen has nothing to disclose.
Joseph E. Parisi, MD (Mayo Clinic) Dr. Parisi has nothing to disclose.
Ross Reichard Ross Reichard has nothing to disclose.
Melissa Murray, PhD (Mayo Clinic) Dr. Murray has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Avid Radiopharmaceuticals. The institution of Dr. Murray has received research support from National Institute on Aging. The institution of Dr. Murray has received research support from Alzheimer's Association. The institution of Dr. Murray has received research support from Chan Zuckerberg Initiative.
Dennis W. Dickson, MD (Mayo Clinic) Dr. Dickson has nothing to disclose.
Bradley F. Boeve, MD, FÂ鶹´«Ã½Ó³»­ (Mayo Clinic) Dr. Boeve has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Rainwater Charitable Foundation. The institution of Dr. Boeve has received research support from Alector. The institution of Dr. Boeve has received research support from EIP Pharma. The institution of Dr. Boeve has received research support from Transposon. The institution of Dr. Boeve has received research support from Cognition Therapeutics. Dr. Boeve has received publishing royalties from a publication relating to health care.
Kejal Kantarci, MD (Mayo Clinic) The institution of Dr. Kantarci has received research support from Eli Lilly. The institution of Dr. Kantarci has received research support from NIH. The institution of Dr. Kantarci has received research support from ADDF. The institution of Dr. Kantarci has received research support from Eisai. The institution of Dr. Kantarci has received research support from BioArctic.
Val J. Lowe, MD (Mayo Clinic) Dr. Lowe has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for AVID Radiopharmaceutical. Dr. Lowe has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai Inc. The institution of Dr. Lowe has received research support from AVID Radiopharmaceuticals.