Clinical Utility of (123) I-MIBG Scintigraphy in Suspected Dementia with Lewy Bodies

A Clinical diagnosis of Lewy Body Dementia (LBD) has low sensitivity (positive predictive values of 34% to 47%). Although Dopamine Active Transporter (DaT) brain scintigraphy is generally useful in suspected LBD, it has a diagnostic sensitivity of only 85%. A normal scan may, therefore, present a dilemma. 123I-MIBG Myocardial Scintigraphy (MIBG) may support diagnosis, but the diagnostic cut-off values are poorly defined. Here, we describe the presentation of an assessment of a patient with cognitive impairment and psychotic symptoms and discuss the role of investigations aimed at supporting the diagnosis of LBD in clinical practice.