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Diagnostic imaging of dementia with Lewy bodies by susceptibility-weighted imaging of nigrosomes versus striatal dopamine transporter single-photon emission computed tomography: a retrospective observational study

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An Erratum to this article was published on 22 March 2017

Abstract

Introduction

The characteristics of dementia with Lewy bodies (DLB), Alzheimer’s disease (AD) and amnestic mild cognitive impairment (a-MCI) overlap but require different treatments; therefore, it is important to differentiate these pathologies. Assessment of dopamine uptake in the striatum using dopamine transporter (DaT) single-photon emission computed tomography (SPECT) is the gold standard for diagnosing DLB; however, this modality is expensive, time consuming and involves radiation exposure. Degeneration of the substantia nigra nigrosome-1, which occurs in DLB, but not in AD/a-MCI, can be identified by 3T susceptibility-weighted imaging (SWI). Therefore, the aim of this retrospective observational study was to compare SWI with DaT-SPECT for differentiation of DLB from AD/a-MCI.

Methods

SWI data were acquired for patients with clinically diagnosed DLB (n = 29), AD (n = 18), a-MCI (n = 13) and healthy controls (n = 26). Images were analysed for nigrosome-1 degeneration. Diagnostic accuracy was evaluated for DLB, AD and a-MCI compared with striatal dopamine uptake using DaT-SPECT.

Results

SWI achieved 90% diagnostic accuracy (93% sensitivity, 87% specificity) for the detection of nigrosome-1 degeneration in DLB and not in AD/a-MCI as compared with 88.3% accuracy (93% sensitivity, 84% specificity) using DaT-SPECT.

Conclusions

SWI nigrosome-1 evaluation was useful in differentiating DLB from AD/a-MCI, with high accuracy. This less invasive and less expensive method is a potential alternative to DaT-SPECT for the diagnosis of DLB.

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Abbreviations

AD:

Alzheimer’s disease

a-MCI:

Amnestic mild cognitive impairment

DLB:

Dementia with Lewy bodies

DaT:

Dopamine transporter

MMSE:

Mini-mental state examination

MRI:

Magnetic resonance imaging

NINCDS–ADRDA:

National Institute of Neurological and Communicative Disorders and Stroke–Alzheimer’s Disease and Related Disorders Association

PD:

Parkinson’s disease

PDD:

Parkinson’s disease with dementia

SBR:

Specific binding ratio

SPECT:

Single-photon emission computed tomography

SWI:

Susceptibility-weighted imaging

123I-FP-CIT:

[123I]-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane

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Authors and Affiliations

  1. Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Koji Kamagata, Kanako Sato, Michimasa Suzuki, Masaaki Hori, Kanako K Kumamaru & Shigeki Aoki

  2. Department of Radiology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Sakura, 285-8741, Japan

    Tomoya Nakatsuka, Tsutomu Inaoka & Hitoshi Terada

  3. Department of Neurology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Sakura, 285-8741, Japan

    Ryuji Sakakibara & Yohei Tsuyusaki

  4. Department of Radiology, University of Yamanashi, 1111 Shimokato, Chuo-shi, Yamanashi, 409-3898, Japan

    Tomohiro Takamura

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  1. Koji Kamagata
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Correspondence to Koji Kamagata.

Ethics declarations

We declare that all human studies have been approved by the ethics committee of Toho University and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that due to the retrospective nature of the observational study design, informed consent was waived.

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We declare that we have no conflict of interest.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s00234-017-1814-2.

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Kamagata, K., Nakatsuka, T., Sakakibara, R. et al. Diagnostic imaging of dementia with Lewy bodies by susceptibility-weighted imaging of nigrosomes versus striatal dopamine transporter single-photon emission computed tomography: a retrospective observational study. Neuroradiology 59, 89–98 (2017). https://doi.org/10.1007/s00234-016-1773-z

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