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  • 123I-FP-CIT SPECT in dementia with Lewy bodies, Parkinson’s disease and Alzheimer’s disease: a new quantitative analysis of autopsy confirmed cases

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Neurodegeneration
Original research
123I-FP-CIT SPECT in dementia with Lewy bodies, Parkinson’s disease and Alzheimer’s disease: a new quantitative analysis of autopsy confirmed cases
  1. Francisco P M Oliveira1,
  2. Zuzana Walker2,3,
  3. Rodney W H Walker4,
  4. Johannes Attems5,
  5. Joana C Castanheira1,
  6. Ângelo Silva1,
  7. Carla Oliveira1,
  8. Sofia Vaz1,
  9. Mariana Silva1,
  10. Durval C Costa1
  1. 1 Champalimaud Centre for the Unknown, Champalimaud Foundation, Lisboa, Portugal
  2. 2 Division of Psychiatry, University College London, London, UK
  3. 3 Essex Partnership University NHS Foundation Trust, Wickford, Essex, UK
  4. 4 Department of Neurology, The Royal London Hospital, Barts Health NHS Trust, London, UK
  5. 5 Clinical and Translational Research Institute, Newcastle University, Newcastle upon Tyne, UK
  1. Correspondence to Dr Francisco P M Oliveira, Champalimaud Centre for the Unknown, Champalimaud Foundation, Lisboa 1400-038, Portugal; francisco.oliveira{at}fundacaochampalimaud.pt

Abstract

Purpose The aim of this study was to re-evaluate the differentiation of patients with dementia with Lewy bodies (DLB) from Alzheimer’s disease (AD) and Parkinson’s disease (PD) using a quantitative analysis of 123I-FP-CIT SPECT scans.

Methods Thirty-six patients with in vivo 123I-FP-CIT SPECT and neuropathological diagnoses were included. Based on neuropathological criteria, patients were further subclassified into nine AD, eight DLB, ten PD and nine with other diagnoses. An additional 16 healthy controls (HC) scanned with 123I-FP-CIT SPECT were also included. All images were visually assessed as normal versus abnormal uptake by consensus of five nuclear medicine physicians. Bihemispheric mean was calculated for caudate binding potential (CBP), putamen binding potential (PBP) and putamen-to-caudate ratio (PCR).

Results Patients with DLB had significantly lower CBP and PBP than patients with AD and significantly higher PCR than patients with PD. Qualitative visual analysis of the images gave an accuracy of 88% in the evaluation of the status of the nigrostriatal pathway considering all individuals, and 96% considering only the patients with PD, AD and DLB. Quantitative analyses provided a balanced accuracy of 94%, 94% and 100% in binary classifications DLB versus AD, DLB versus PD and PD versus AD, respectively, and an accuracy of 93% in the differentiation among patients with DLB, AD and PD simultaneously. No statistically significant differences were observed between the AD and HC.

Conclusions This study demonstrates a very high diagnostic accuracy of the quantitative analysis of(123I-FP-CIT SPECT data to differentiate among patients with DLB, PD and AD.

Data availability statement

Image and clinical data will be available on a reasonable request after ethical approval.

https://doi.org/10.1136/jnnp-2020-324606

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    Data availability statement

    Image and clinical data will be available on a reasonable request after ethical approval.

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    Footnotes

    • Correction notice This article has been corrected since it appeared Online First. In the title, 123I FP-CIT has been corrected to read 123I-FP-CIT

    • Contributors Study conception and design, data analysis and organisation and critical revision of the manuscript: FPMO, ZW, RWHW, JA and DCC. Data collection and manuscript writing: all authors.

    • Funding Tissue for this study was provided by the Newcastle Brain Tissue Resource, which is funded in part by a grant from the UK Medical Research Council (G0400074), by Brains for Dementia Research, a joint venture between Alzheimer’s Society and Alzheimer’s Research UK, and by the National Institute for Health Research (NIHR) Newcastle Biomedical Research Centre awarded to the Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University.

    • Competing interests ZW and DCC received consultancy fees from GE Healthcare (previously Amersham Health), which also provided the 123I-FP-CIT ligand. ZW also received research support from GE Healthcare.

    • Provenance and peer review Not commissioned; externally peer reviewed.