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

Paul C. Donaghy; Gemma Greenfinch; George Petrides; Joseph P.M. Kane; Hein J. Verberne; John Paul Taylor; John T. O'Brien; Alan J. Thomas; Afina W. Lemstra; Alp Notghi; Andrea Bozoki; Aurelien Lathuiliere; Bhavana Patel; Burc Cagri Poyraz; Carla Abdelnour; Daniel Alcolea; Daniel Weintraub; Douglas Galasko; Durval C. Costa; Federico Massa; Federico Rodriguez-Porcel; Frederic Blanc; Iosif A. Mendichovszky; Jan Booij; Jan Laczó; Jon B. Toledo; Joseph P.M. Kane; Kathryn Wyman-Chick; Katrina Cockburn; Kejal Kantarci; Leonidas Chouliaras; Manabu Ikeda; Ludy Shih; Mario Ricciardi; Melissa J. Armstrong; Melissa M. Yu; Mitsuhiro Yoshita; Natasha E. Fullerton; Kevin M. Bradley; Rimona S. Weil; Salvatore Spina; Samantha Holden; Sarah B. Berman; Sonja W. Scholz; Yuto Satake; DLB Indicative Imaging Biomarker Study Group

doi:10.1002/dad2.70296

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

Paul C. Donaghy, Gemma Greenfinch, George Petrides, Joseph P.M. Kane, Hein J. Verberne, John Paul Taylor, John T. O'Brien, Alan J. Thomas, Afina W. Lemstra, Alp Notghi, Andrea Bozoki, Aurelien Lathuiliere, Bhavana Patel, Burc Cagri Poyraz, Carla Abdelnour, Daniel Alcolea, Daniel Weintraub, Douglas Galasko, Durval C. Costa, Federico MassaFederico Rodriguez-Porcel, Frederic Blanc, Iosif A. Mendichovszky, Jan Booij, Jan Laczó, Jon B. Toledo, Joseph P.M. Kane, Kathryn Wyman-Chick, Katrina Cockburn, Kejal Kantarci, Leonidas Chouliaras, Manabu Ikeda, Ludy Shih, Mario Ricciardi, Melissa J. Armstrong, Melissa M. Yu, Mitsuhiro Yoshita, Natasha E. Fullerton, Kevin M. Bradley, Rimona S. Weil, Salvatore Spina, Samantha Holden, Sarah B. Berman, Sonja W. Scholz, Yuto Satake, DLB Indicative Imaging Biomarker Study Group

Research output: Contribution to journal › Article › peer-review

Abstract

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

Original language	English (US)
Article number	e70296
Journal	Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
Volume	18
Issue number	1
DOIs	https://doi.org/10.1002/dad2.70296
State	Published - Jan 1 2026

Keywords

dementia with Lewy bodies
imaging
ioflupane
metaiodobenzylguanidine
mild cognitive impairment with Lewy bodies

ASJC Scopus subject areas

Clinical Neurology
Psychiatry and Mental health

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Donaghy, P. C., Greenfinch, G., Petrides, G., Kane, J. P. M., Verberne, H. J., Taylor, J. P., O'Brien, J. T., Thomas, A. J., Lemstra, A. W., Notghi, A., Bozoki, A., Lathuiliere, A., Patel, B., Poyraz, B. C., Abdelnour, C., Alcolea, D., Weintraub, D., Galasko, D., Costa, D. C., ... DLB Indicative Imaging Biomarker Study Group (2026). 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. Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring, 18(1), Article e70296. https://doi.org/10.1002/dad2.70296

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. / Donaghy, Paul C.; Greenfinch, Gemma; Petrides, George et al.
In: Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring, Vol. 18, No. 1, e70296, 01.01.2026.

Research output: Contribution to journal › Article › peer-review

Donaghy, PC, Greenfinch, G, Petrides, G, Kane, JPM, Verberne, HJ, Taylor, JP, O'Brien, JT, Thomas, AJ, Lemstra, AW, Notghi, A, Bozoki, A, Lathuiliere, A, Patel, B, Poyraz, BC, Abdelnour, C, Alcolea, D, Weintraub, D, Galasko, D, Costa, DC, Massa, F, Rodriguez-Porcel, F, Blanc, F, Mendichovszky, IA, Booij, J, Laczó, J, Toledo, JB, Kane, JPM, Wyman-Chick, K, Cockburn, K, Kantarci, K, Chouliaras, L, Ikeda, M, Shih, L, Ricciardi, M, Armstrong, MJ, Yu, MM, Yoshita, M, Fullerton, NE, Bradley, KM, Weil, RS, Spina, S, Holden, S, Berman, SB, Scholz, SW, Satake, Y & DLB Indicative Imaging Biomarker Study Group 2026, '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', Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring, vol. 18, no. 1, e70296. https://doi.org/10.1002/dad2.70296

Donaghy PC, Greenfinch G, Petrides G, Kane JPM, Verberne HJ, Taylor JP et al. 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. Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring. 2026 Jan 1;18(1):e70296. doi: 10.1002/dad2.70296

Donaghy, Paul C. ; Greenfinch, Gemma ; Petrides, George et al. / 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. In: Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring. 2026 ; Vol. 18, No. 1.

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title = "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",

abstract = "INTRODUCTION: 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. METHODS: 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. RESULTS: Overall, 36/70 statements (51\%) were accepted in Round 1, and 19/37 (51\%) were accepted in Round 2. DISCUSSION: 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.",

keywords = "dementia with Lewy bodies, imaging, ioflupane, metaiodobenzylguanidine, mild cognitive impairment with Lewy bodies",

author = "Donaghy, \{Paul C.\} and Gemma Greenfinch and George Petrides and Kane, \{Joseph P.M.\} and Verberne, \{Hein J.\} and Taylor, \{John Paul\} and O'Brien, \{John T.\} and Thomas, \{Alan J.\} and Lemstra, \{Afina W.\} and Alp Notghi and Andrea Bozoki and Aurelien Lathuiliere and Bhavana Patel and Poyraz, \{Burc Cagri\} and Carla Abdelnour and Daniel Alcolea and Daniel Weintraub and Douglas Galasko and Costa, \{Durval C.\} and Federico Massa and Federico Rodriguez-Porcel and Frederic Blanc and Mendichovszky, \{Iosif A.\} and Jan Booij and Jan Lacz{\'o} and Toledo, \{Jon B.\} and Kane, \{Joseph P.M.\} and Kathryn Wyman-Chick and Katrina Cockburn and Kejal Kantarci and Leonidas Chouliaras and Manabu Ikeda and Ludy Shih and Mario Ricciardi and Armstrong, \{Melissa J.\} and Yu, \{Melissa M.\} and Mitsuhiro Yoshita and Fullerton, \{Natasha E.\} and Bradley, \{Kevin M.\} and Weil, \{Rimona S.\} and Salvatore Spina and Samantha Holden and Berman, \{Sarah B.\} and Scholz, \{Sonja W.\} and Yuto Satake and \{DLB Indicative Imaging Biomarker Study Group\}",

note = "Publisher Copyright: {\textcopyright} 2026 The Author(s). Alzheimer's \& Dementia: Diagnosis, Assessment \& Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association.",

year = "2026",

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doi = "10.1002/dad2.70296",

language = "English (US)",

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T1 - 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

AU - Donaghy, Paul C.

AU - Greenfinch, Gemma

AU - Petrides, George

AU - Kane, Joseph P.M.

AU - Verberne, Hein J.

AU - Taylor, John Paul

AU - O'Brien, John T.

AU - Thomas, Alan J.

AU - Lemstra, Afina W.

AU - Notghi, Alp

AU - Bozoki, Andrea

AU - Lathuiliere, Aurelien

AU - Patel, Bhavana

AU - Poyraz, Burc Cagri

AU - Abdelnour, Carla

AU - Alcolea, Daniel

AU - Weintraub, Daniel

AU - Galasko, Douglas

AU - Costa, Durval C.

AU - Massa, Federico

AU - Rodriguez-Porcel, Federico

AU - Blanc, Frederic

AU - Mendichovszky, Iosif A.

AU - Booij, Jan

AU - Laczó, Jan

AU - Toledo, Jon B.

AU - Kane, Joseph P.M.

AU - Wyman-Chick, Kathryn

AU - Cockburn, Katrina

AU - Kantarci, Kejal

AU - Chouliaras, Leonidas

AU - Ikeda, Manabu

AU - Shih, Ludy

AU - Ricciardi, Mario

AU - Armstrong, Melissa J.

AU - Yu, Melissa M.

AU - Yoshita, Mitsuhiro

AU - Fullerton, Natasha E.

AU - Bradley, Kevin M.

AU - Weil, Rimona S.

AU - Spina, Salvatore

AU - Holden, Samantha

AU - Berman, Sarah B.

AU - Scholz, Sonja W.

AU - Satake, Yuto

AU - DLB Indicative Imaging Biomarker Study Group

PY - 2026/1/1

Y1 - 2026/1/1

N2 - INTRODUCTION: 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. METHODS: 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. RESULTS: Overall, 36/70 statements (51%) were accepted in Round 1, and 19/37 (51%) were accepted in Round 2. DISCUSSION: 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.

AB - INTRODUCTION: 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. METHODS: 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. RESULTS: Overall, 36/70 statements (51%) were accepted in Round 1, and 19/37 (51%) were accepted in Round 2. DISCUSSION: 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.

KW - dementia with Lewy bodies

KW - imaging

KW - ioflupane

KW - metaiodobenzylguanidine

KW - mild cognitive impairment with Lewy bodies

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VL - 18

JO - Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring

JF - Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring

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ER -

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

Abstract

Keywords

ASJC Scopus subject areas

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