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 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; Kathryn Wyman-Chick; Katrina Cockburn; Kejal Kantarci; Leonidas Chouliaras; Ludy Shih; Manabu Ikeda; 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 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, Kathryn Wyman-Chick, Katrina Cockburn, Kejal Kantarci, Leonidas Chouliaras, Ludy Shih, Manabu Ikeda, 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

^*Corresponding author for this work

School of Medicine, Dentistry and Biomedical Sciences

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

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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.

Original language	English
Article number	e70296
Number of pages	10
Journal	Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring
Volume	18
Issue number	1
DOIs	https://doi.org/10.1002/dad2.70296 https://doi.org/10.1002/dad2.70296
Publication status	Published - 01 Mar 2026

Bibliographical note

Publisher Copyright:
© 2026 The Author(s). Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association.

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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10.1002/dad2.70296Licence: CC BY
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
Copyright 2026 the authors. This is an open access article published under a Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium, provided the author and source are cited.
Final published version, 378 KBLicence: CC BY

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Donaghy, P. C., Greenfinch, G., Petrides, G., Kane, J., 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 & Dementia: Diagnosis, Assessment & Disease Monitoring, 18(1), Article e70296. https://doi.org/10.1002/dad2.70296, https://doi.org/10.1002/dad2.70296

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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.",

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 Joseph Kane 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 Kathryn Wyman-Chick and Katrina Cockburn and Kejal Kantarci and Leonidas Chouliaras and Ludy Shih and Manabu Ikeda 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",

month = mar,

day = "1",

doi = "10.1002/dad2.70296",

language = "English",

volume = "18",

journal = "Alzheimer's \& Dementia: Diagnosis, Assessment \& Disease Monitoring",

issn = "2352-8729",

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Donaghy, PC, Greenfinch, G, Petrides, G, Kane, J, 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, Wyman-Chick, K, Cockburn, K, Kantarci, K, Chouliaras, L, Shih, L, Ikeda, M, 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 & Dementia: Diagnosis, Assessment & Disease Monitoring, vol. 18, no. 1, e70296. https://doi.org/10.1002/dad2.70296, 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 & Dementia: Diagnosis, Assessment & Disease Monitoring, Vol. 18, No. 1, e70296, 01.03.2026.

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

TY - JOUR

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

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 - Wyman-Chick, Kathryn

AU - Cockburn, Katrina

AU - Kantarci, Kejal

AU - Chouliaras, Leonidas

AU - Shih, Ludy

AU - Ikeda, Manabu

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 - 2026/3/1

Y1 - 2026/3/1

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. Keywords: dementia with Lewy bodies; imaging; ioflupane; metaiodobenzylguanidine; mild cognitive impairment with Lewy bodies.

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. Keywords: dementia with Lewy bodies; imaging; ioflupane; metaiodobenzylguanidine; mild cognitive impairment with Lewy bodies.

KW - dementia with Lewy bodies

KW - imaging

KW - ioflupane

KW - metaiodobenzylguanidine

KW - mild cognitive impairment with Lewy bodies

U2 - 10.1002/dad2.70296

DO - 10.1002/dad2.70296

M3 - Article

AN - SCOPUS:105032811054

SN - 2352-8729

VL - 18

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

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

IS - 1

M1 - e70296

ER -

Donaghy PC, Greenfinch G, Petrides G, Kane J, 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 & Dementia: Diagnosis, Assessment & Disease Monitoring. 2026 Mar 1;18(1):e70296. doi: 10.1002/dad2.70296, 10.1002/dad2.70296