BackgroundDiagnosing Dementia with Lewy Bodies (DLB) remains a challenge in clinical practice. The use of 123I-ioflupane (DaTscan™) SPECT imaging, which detects reduced dopamine transporter (DAT) uptake—a key biomarker in DLB diagnosis—could improve diagnostic accuracy. However, DAT imaging is underutilized despite its potential, contributing to delays and suboptimal patient management.MethodsThis review evaluates DLB diagnostic practices and challenges faced within the U.S. by synthesizing information from current literature, consensus guidelines, expert opinions, and recent updates on DaTscan FDA filings. It contrasts DAT SPECT with alternative biomarkers, provides recommendations for when DAT SPECT imaging may be indicated and discusses the potential of emerging biomarkers in enhancing diagnostic approaches.ResultsThe radiopharmaceutical 123I-ioflupane for SPECT imaging was initially approved in Europe (2000) and later in the US (2011) for Parkinsonism/Essential Tremor. Its application was extended in 2022 to include the diagnosis of DLB. DaTscan’s diagnostic efficacy for DLB, with its sensitivity, specificity, and predictive values, confirms its clinical utility. However, US implementation faces challenges such as insurance barriers, costs, access issues, and regional availability disparities.Conclusion123I-ioflupane SPECT Imaging is indicated for DLB diagnosis and differential diagnosis of Alzheimer’s Disease, particularly in uncertain cases. Addressing diagnostic obstacles and enhancing physician-patient education could improve and expedite DLB diagnosis. Collaborative efforts among neurologists, geriatric psychiatrists, psychologists, and memory clinic staff are key to increasing diagnostic accuracy and care in DLB management.

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DAT SPECT 成像在路易体痴呆诊断中的实际应用：美国对当前指南和未来方向的看法

背景诊断路易体痴呆（DLB）仍然是临床实践中的一个挑战。指某东西的用途123碘氟烷 (DaTscan™) SPECT 成像可检测多巴胺转运蛋白 (DAT) 摄取的减少（DLB 诊断中的关键生物标志物），可以提高诊断准确性。然而，DAT 成像尽管具有潜力，但并未得到充分利用，导致延误和次优的患者管理。方法本综述通过综合当前文献、共识指南、专家意见和 DaTscan FDA 备案文件的最新更新信息，评估了 DLB 诊断实践和美国面临的挑战。它将 DAT SPECT 与替代生物标志物进行了对比，为何时需要 DAT SPECT 成像提供了建议，并讨论了新兴生物标志物在增强诊断方法方面的潜力。123用于 SPECT 成像的 I-ioflupane 最初在欧洲 (2000 年) 获得批准，后来在美国 (2011 年) 被批准用于治疗帕金森症/特发性震颤。其应用范围于 2022 年扩展至包括 DLB 的诊断。 DaTscan 对 DLB 的诊断功效及其敏感性、特异性和预测价值证实了其临床实用性。然而，美国的实施面临着保险障碍、成本、准入问题和地区可用性差异等挑战。 结论123I-ioflupane SPECT 成像适用于 DLB 诊断和阿尔茨海默病的鉴别诊断，特别是在不确定的病例中。解决诊断障碍和加强医患教育可以改善和加快 DLB 诊断。神经科医生、老年精神病学家、心理学家和记忆诊所工作人员之间的合作是提高 DLB 管理诊断准确性和护理的关键。