摘要：

Reduced nigrostriatal uptake on N-(3-fluoropropyl)-2 beta-carbomethoxy-3b-(4-[I-123]iodophenyl) nortropane (I-123-FP-CIT) SPECT reflects dopamine dysfunction, while other imaging markers could be complementary when used together. We assessed how well I-123-FP-CIT SPECT differentiates dementia with Lewy bodies (DLBs) from Alzheimer's disease dementia (ADem) and whether multimodal imaging provides additional value. I-123-FP-CIT SPECT, magnetic resonance imaging, [F-18]2-fluoro-deoxy-D-glucose-positron emission tomography (PET), and C-11-Pittsburgh compound B (PiB)-PET were assessed in 35 participants with DLBs and 14 participants with ADem (autopsy confirmation in 9 DLBs and 4 ADem). Nigrostriatal dopamine transporter uptake was evaluated with I-123-FP-CIT SPECT using DaTQUANT software. Hippocampal volume was calculated with magnetic resonance imaging, cingulate island sign ratio with FDG-PET, and global cortical PiB retention with PiB-PET. The DaTQUANT z-scores of the putamen showed the highest c-statistic of 0.916 in differentiating DLBs from ADem among the analyzed imaging biomarkers. Adding another imaging modality to I-123-FP-CIT SPECT had c-statistics ranging from 0.968 to 0.975, and I-123-FP-CIT SPECT in combination with 2 other imaging modalities presented c-statistics ranging from 0.987 to 0.996. These findings suggest that multimodal imaging with I-123-FP-CIT SPECT aids in differentiating DLBs and ADem and in detecting comorbid Lewy-related and Alzheimer's disease pathology in patients with DLBs and ADem. (C) 2020 Elsevier Inc. All rights reserved.

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