# Delphi consensus guidelines for the use of striatal dopaminergic imaging and cardiac metaiodobenzylguanidine (MIBG) scintigraphy for the diagnosis of dementia and mild cognitive impairment with Lewy bodies

## TL;DR

Experts created guidelines to help doctors use brain and heart scans to better diagnose dementia and cognitive issues linked to Lewy bodies.

## Contribution

Developed first international consensus guidelines for using specific imaging biomarkers in Lewy body dementia diagnosis.

## Key findings

- Striatal dopaminergic imaging and cardiac MIBG scintigraphy are useful for diagnosing Lewy body-related conditions.
- Consensus was reached on 51% of statements across two rounds of expert evaluation.
- Guidelines address when to use these biomarkers and how comorbidities and medications affect their interpretation.

## Abstract

The aim of this Delphi process was to develop consensus guidelines to support the effective use of striatal dopaminergic imaging and cardiac metaiodobenzylguanidine (MIBG) scintigraphy in the diagnosis of dementia with Lewy bodies and mild cognitive impairment with Lewy bodies.

A Delphi consensus panel of 37 international experts independently indicated their agreement or disagreement with statements on indications for the use of these biomarkers and clinical situations in which each biomarker should and should not be used. Statements were accepted if they reached > 80% agreement.

Overall, 36/70 statements (51%) were accepted in Round 1, and 19/37 (51%) were accepted in Round 2.

The Delphi consensus process has developed freely available guidelines outlining clinical situations in which striatal dopaminergic imaging and cardiac MIBG scintigraphy may be useful and considerations for their use, including the effect of specific comorbidities and medications on each of the biomarkers.

Striatal dopaminergic imaging and cardiac metaiodobenzylguanidine scintigraphy are indicative biomarkers for dementia with Lewy bodies.The application of these biomarkers in clinical practice remains variable.A Delphi process was carried out with an international panel of 37 experts.Consensus was gained on how and when to use these biomarkers.The resulting guidelines can be adapted and used in clinical services.

Striatal dopaminergic imaging and cardiac metaiodobenzylguanidine scintigraphy are indicative biomarkers for dementia with Lewy bodies.

The application of these biomarkers in clinical practice remains variable.

A Delphi process was carried out with an international panel of 37 experts.

Consensus was gained on how and when to use these biomarkers.

The resulting guidelines can be adapted and used in clinical services.