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| - | * Different types of brain perfusion scans can be done:[([[https://ebmh.bmj.com/content/21/2/61|Surendranathan, A. et al. (2018). Clinical imaging in dementia with Lewy bodies. Evidence-based mental health, 21(2), 61-65.]])] | + | * Different types of [[neurology:spect|brain perfusion scans (SPECT)]] can be done:[([[https://ebmh.bmj.com/content/21/2/61|Surendranathan, A. et al. (2018). Clinical imaging in dementia with Lewy bodies. Evidence-based mental health, 21(2), 61-65.]])] |
| - | * <sup>123</sup>Iodine-metaiodobenzylguanidine myocardial scintigraphy (MIBG) may show low striatal dopamine transporter uptake | + | * **<sup>123</sup>Iodine-metaiodobenzylguanidine myocardial scintigraphy (MIBG)** may show low striatal dopamine transporter uptake |
| - | * <sup>123</sup>I-ioflupane single-photon emission computed tomography (SPECT) or dopamine transporter (DAT) scans | + | * **<sup>123</sup>I-ioflupane single-photon emission computed tomography (SPECT)** or dopamine transporter (DAT) scans |
| * <sup>123</sup>I-ioflupane single-photon emission computed tomography (SPECT) assesses DAT uptake in the basal ganglia in vivo, and has been shown to be more specific than clinical diagnostic criteria for DLB. | * <sup>123</sup>I-ioflupane single-photon emission computed tomography (SPECT) assesses DAT uptake in the basal ganglia in vivo, and has been shown to be more specific than clinical diagnostic criteria for DLB. | ||
| * It maybe the most reliable imaging modality of choice in differentiating DLB from pure AD. | * It maybe the most reliable imaging modality of choice in differentiating DLB from pure AD. | ||
| - | * Fluorodeoxyglucose PET (FDG PET) may show occipital hypometabolism | + | * **Fluorodeoxyglucose PET (FDG PET)** may show occipital hypometabolism |
| - | * Brain perfusion SPECT (bp-SPECT) may show occipital hypoperfusion, but sensitivity is around 70% and specificity around 76%.[([[https://pubmed.ncbi.nlm.nih.gov/23917803/|Yeo, J. M., Lim, X., Khan, Z., & Pal, S. (2013). Systematic review of the diagnostic utility of SPECT imaging in dementia. European archives of psychiatry and clinical neuroscience, 263(7), 539–552.]])][([[https://pubmed.ncbi.nlm.nih.gov/28130808/|Kobayashi, S., Makino, K., Hatakeyama, S., Ishii, T., Tateno, M., Iwamoto, T., Tsujino, H., Kawasaki, K., Mikuni, K., Ukai, W., Murayama, T., Hashimoto, E., Utsumi, K., & Kawanishi, C. (2017). The usefulness of combined brain perfusion single-photon emission computed tomography, Dopamine-transporter single-photon emission computed tomography, and 123 I-metaiodobenzylguanidine myocardial scintigraphy for the diagnosis of dementia with Lewy bodies. Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society, 17(4), 247–255. https://doi.org/10.1111/psyg.12227]])] | + | * **Routine brain perfusion SPECT (bp-SPECT)** may show occipital hypoperfusion, but sensitivity is around 70% and specificity around 76%.[([[https://pubmed.ncbi.nlm.nih.gov/23917803/|Yeo, J. M., Lim, X., Khan, Z., & Pal, S. (2013). Systematic review of the diagnostic utility of SPECT imaging in dementia. European archives of psychiatry and clinical neuroscience, 263(7), 539–552.]])][([[https://pubmed.ncbi.nlm.nih.gov/28130808/|Kobayashi, S., Makino, K., Hatakeyama, S., Ishii, T., Tateno, M., Iwamoto, T., Tsujino, H., Kawasaki, K., Mikuni, K., Ukai, W., Murayama, T., Hashimoto, E., Utsumi, K., & Kawanishi, C. (2017). The usefulness of combined brain perfusion single-photon emission computed tomography, Dopamine-transporter single-photon emission computed tomography, and 123 I-metaiodobenzylguanidine myocardial scintigraphy for the diagnosis of dementia with Lewy bodies. Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society, 17(4), 247–255. https://doi.org/10.1111/psyg.12227]])] |
| * On MRI, generalized atrophy can be seen in most dementias. | * On MRI, generalized atrophy can be seen in most dementias. | ||
| * DLB can similarly have such generalized atrophy, but there is more relative sparing of the medial temporal lobes (MTL).[([[https://pubmed.ncbi.nlm.nih.gov/10214736/|Barber, R., Gholkar, A., Scheltens, P., Ballard, C., McKeith, I. G., & O’Brien, J. T. (1999). Medial temporal lobe atrophy on MRI in dementia with Lewy bodies. Neurology, 52(6), 1153-1153.]])] | * DLB can similarly have such generalized atrophy, but there is more relative sparing of the medial temporal lobes (MTL).[([[https://pubmed.ncbi.nlm.nih.gov/10214736/|Barber, R., Gholkar, A., Scheltens, P., Ballard, C., McKeith, I. G., & O’Brien, J. T. (1999). Medial temporal lobe atrophy on MRI in dementia with Lewy bodies. Neurology, 52(6), 1153-1153.]])] | ||