[18F]FE-PE2I PET is a diagnostic tool in dementia with Lewy bodies

Andrea Sturchio; Jonas E Svensson; Mikael Tiger; Anton Forsberg Morén; Andrea Varrone; Per Svenningsson; Yoshiro Okubo; Amane Tateno

doi:10.1002/pcn5.70123

[¹⁸F]FE-PE2I PET is a diagnostic tool in dementia with Lewy bodies

PCN Rep. 2025 Jun 2;4(2):e70123. doi: 10.1002/pcn5.70123. eCollection 2025 Jun.

Authors

Andrea Sturchio^{1

2}, Jonas E Svensson^{3

4}, Mikael Tiger³, Anton Forsberg Morén³, Andrea Varrone³, Per Svenningsson¹, Yoshiro Okubo⁵, Amane Tateno⁵

Affiliations

¹ Department of Clinical Neuroscience, Neuro Svenningsson Karolinska Institute Stockholm Sweden.
² Department of Neurology James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders Cincinnati Ohio USA.
³ Department of Clinical Neuroscience Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm Stockholm Sweden.
⁴ Neurobiology Research Unit, Copenhagen University Hospital Copenhagen Denmark.
⁵ Department of Neuropsychiatry Nippon Medical School Tokyo Japan.

Abstract

Aim: Dementia with Lewy bodies (DLB) is characterized by motor and non-motor symptoms. The degeneration of the dopaminergic pathway is a hallmark of DLB; for this reason, we aimed to study a recent dopamine transporter (DAT) positron emission tomography (PET) radioligand as a diagnostic tool for DLB.

Methods: In this study, we used DAT-PET with the radioligand [¹⁸F]FE-PE2I to distinguish DLB subjects from healthy controls (HCs). We also aimed to analyze how DAT binding correlated with clinical features, amyloid load, measured by PET, and cardiac metaiodobenzylguanidine scintigraphy (MIBG).

Results: Binding potential (BP _ND) values of [¹⁸F]FE-PE2I were higher in HCs versus DLB in striatum (1.82 ± 0.34 vs. 1.15 ± 0.34; p < 0.001; 95% Confidence Interval [CI]: 0.40-0.96), putamen (2.2 ± 0.36 vs. 1.41 ± 0.51; p < 0.001; 95% CI: 0.39-1.17), caudate (1.38 ± 0.30 vs. 0.88 ± 0.20; p < 0.001; 95% CI: 0.28-0.70), and substantia nigra (0.49 ± 0.091 vs. 0.42 ± 0.084; p = 0.0437; 95% CI: 0.003 to 0.14). After adjusting for age, substantia nigra did not differ between DLB and HCs (p: 0.46; 95% CI: -0.049 to 0.11); however, BP _ND values between DLB and HC in striatum (p: <0.001; 95% CI: 0.25-0.85), putamen (p: 0.0012; 95% CI: 0.31-1.13), and caudate (p: 0.0027; 95% CI: 0.13-0.55) were still significant. Striatum was the best area to correctly classify DLB subjects versus HC compared to the putamen, caudate, and substantia nigra (area under the curve = 0.95, 0.90, 0.93, and 0.73, respectively; 95 CI: 0.87-1.00, 0.79-1.00, 0.84-1.00, 0.55-0.92, respectively). Subjects with altered MIBG showed lower BP _ND compared to subjects with normal MIBG in the putamen.

Conclusion: Our study showed that [¹⁸F]FE-PE2I PET represents a potential diagnostic tool with high accuracy in discriminating DLB patients versus HC, which is valuable for clinical practice.

Keywords: [18F]FE‐PE2I; dementia with Lewy bodies; dopamine transporter (DAT) imaging; neurodegeneration; neuroimaging.