Clinical validity of presynaptic dopaminergic imaging with (123)I-ioflupane and noradrenergic imaging with (123)I-MIBG in the differential diagnosis between Alzheimer's disease and dementia with Lewy bodies in the context of a structured 5-phase development framework

Ida Sonni, Osman Ratib, Marina Boccardi, Agnese Picco, Karl Herholz, Flavio Nobili, Andrea Varrone,

Research output: Contribution to journalArticlepeer-review

Abstract

The use of biomarkers (BMs) for accurate diagnosis of Alzheimer's disease (AD) has been proposed by recent diagnostic criteria; however, their maturity is not sufficient to grant implementation in the clinical routine. A proper diagnostic process requires not only confirmation of the disease but also the exclusion of similar disorders entering differential diagnosis, like dementia with Lewy bodies (DLB). This review is aimed at evaluating the clinical validity of (123)I-ioflupane brain single photon emission tomography and (123)I-MIBG cardiac scintigraphy as imaging BMs for DLB. For this purpose, we used an adapted version of the 5-phase oncology framework for BMs development. A review of the literature was conducted using homogenous search criteria with other BMs addressed in parallel reviews. Results of our literature search showed that the rationale for the use of both BMs in the differential diagnosis of DLB and AD is strong (phase 1) and that they allow a good discrimination ability (phase 2), but studies investigating BMs distribution antemortem and postmortem on pathology are lacking. Moreover, thresholds for test positivity have not been defined for (123)I-MIBG. The 2 BMs have not been yet assessed in early phases of DLB and AD (phase 3). No phase 4 and phase 5 studies have so far been carried out. This review highlights the priorities to address in future investigations to enable the proper use of (123)I-ioflupane and (123)I-MIBG for the differential diagnosis of dementia.

Original languageEnglish
Pages (from-to)228-242
Number of pages15
JournalNeurobiology of Aging
Volume52
Early online date17 Mar 2017
DOIs
Publication statusPublished - Apr 2017

Keywords

  • Journal Article
  • Review

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