Neuromelanin or DaT‐<scp>SPECT</scp>: which is the better marker for discriminating advanced Parkinson's disease?

Okuzumi, Ayami; Hatano, Taku; Kamagata, Koji; Hori, Masaaki; Mori, Akio; Oji, Yusuke; Taniguchi, Daisuke; Daida, Kensuke; Shimo, Yasushi; Yanagisawa, Naotake; Nojiri, Shuko; Aoki, Shigeki

doi:10.1111/ene.14009

Cited by 30 publications

(29 citation statements)

References 23 publications

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“…Given that a recent study showed that the signal intensity in neuromelanin‐sensitive MRI (NM‐MRI) is correlated with NM concentration (Cassidy et al, 2019), an analysis using NM‐MRI may help determine which area is most impacted in early‐stage IPD. In previous studies, in order to determine abnormality in the SNpc, a contrast ratio (CR) was measured in the two or three subdivisions of the SNpc (Fabbri et al, 2017; Ohtsuka et al, 2014; Prasad et al, 2018; Wang et al, 2018; Xiang et al, 2017), or a whole or regional volume of the SN was calculated using a specific threshold (Castellanos et al, 2015; Isaias et al, 2016; Kashihara, Shinya, & Higaki, 2011; Kuya et al, 2018; Le Berre et al, 2019; Matsusue et al, 2019; Ogisu et al, 2013; Okuzumi et al, 2019; Pyatigorskaya et al, 2018; Reimao, Pita Lobo, Neutel, Correia Guedes, et al, 2015; Reimao, Pita Lobo, Neutel, Guedes, et al, 2015; Schwarz et al, 2011; Schwarz, Xing, Tomar, Bajaj, & Auer, 2017; Takahashi et al, 2018; Taniguchi et al, 2018; Vitali et al, 2020; Zupan, Suput, Pirtosek, & Vovk, 2019), and the values were compared between IPD patients and healthy subjects. These results failed to specify the most affected region of the SNpc.…”

Section: Introductionmentioning

confidence: 99%

Early‐stage Parkinson's disease: Abnormal nigrosome 1 and 2 revealed by a voxelwise analysis of neuromelanin‐sensitive MRI

Sung

Noh

Kim

2021

Human Brain Mapping

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Previous pathologic studies evaluated the substantia nigra pars compacta (SNpc) of a limited number of idiopathic Parkinson's disease (IPD) patients with relatively longer disease durations. Therefore, it remains unknown which region of the SNpc is most significantly affected in early‐stage IPD. We hypothesized that a voxelwise analysis of thin‐section neuromelanin‐sensitive MRI (NM‐MRI) may help determine the significantly affected regions of the SNpc in early‐stage IPD and localize these areas in each nigrosome on high‐spatial‐resolution susceptibility map‐weighted imaging (SMwI). Ninety‐six healthy subjects and 50 early‐stage IPD patients underwent both a 0.8 × 0.8 × 0.8 mm3 NM‐MRI and a 0.5 × 0.5 × 1.0 mm3 multi‐echo gradient‐recalled echo imaging for SMwI. Both NM‐MRI and SMwI templates were created by using image data from the 96 healthy subjects. Permutation‐based nonparametric tests were conducted to investigate spatial differences between the two groups in NM‐MRI, and the results were displayed on both NM‐MRI and SMwI templates. The posterolateral and anteromedial regions of the SNpc in NM‐MRI were significantly different between the two groups, corresponding to the nigrosome 1 and nigrosome 2 regions, respectively, on the SMwI template. There were the areas of significant spatial difference in the hypointense SN on SMwI between early‐stage IPD patients and healthy subjects. These areas on SMwI were slightly greater than those on NM‐MRI, including the areas showing group difference on NM‐MRI. Our voxelwise analysis of NM‐MRI suggests that two regions (nigrosome 1 and nigrosome 2) of the SNpc are separately affected in early‐stage IPD.

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Section: Introductionmentioning

confidence: 99%

Early‐stage Parkinson's disease: Abnormal nigrosome 1 and 2 revealed by a voxelwise analysis of neuromelanin‐sensitive MRI

Sung

Noh

Kim

2021

Human Brain Mapping

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“…Using manual delineation of the SN, studies reported [50][51][52] that the SN size correlated with DaT-SPECT results in PD. Okuzumi et al [50] found that several clinical tools commonly used to assess the severity of PD correlated better with SN size but not as well with DaT-SPECT results. However, manual segmentation methods tend to be subjective, and volumetric analysis is unacceptably time-consuming.…”

Section: Discussionmentioning

confidence: 99%

Semi-Automatic Signature-Based Segmentation Method for Quantification of Neuromelanin in Substantia Nigra

et al. 2019

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In Parkinson’s disease (PD), there is a reduction of neuromelanin (NM) in the substantia nigra (SN). Manual quantification of the NM volume in the SN is unpractical and time-consuming; therefore, we aimed to quantify NM in the SN with a novel semi-automatic segmentation method. Twenty patients with PD and twelve healthy subjects (HC) were included in this study. T1-weighted spectral pre-saturation with inversion recovery (SPIR) images were acquired on a 3T scanner. Manual and semi-automatic atlas-free local statistics signature-based segmentations measured the surface and volume of SN, respectively. Midbrain volume (MV) was calculated to normalize the data. Receiver operating characteristic (ROC) analysis was performed to determine the sensitivity and specificity of both methods. PD patients had significantly lower SN mean surface (37.7 ± 8.0 vs. 56.9 ± 6.6 mm2) and volume (235.1 ± 45.4 vs. 382.9 ± 100.5 mm3) than HC. After normalization with MV, the difference remained significant. For surface, sensitivity and specificity were 91.7 and 95 percent, respectively. For volume, sensitivity and specificity were 91.7 and 90 percent, respectively. Manual and semi-automatic segmentation methods of the SN reliably distinguished between PD patients and HC. ROC analysis shows the high sensitivity and specificity of both methods.

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“…However, we endeavored to provide alternative eligible reference standard for the proper decision of the nigrosome-1 status by addressing clinical diagnosis, and, more importantly, by assessing the results from 123I-FP-CIT SPECT. Moreover, Okuzumi et al [35] suggested that neuromelanin-imaging is a better marker for discriminating advanced PD than SPECT, but in early stage of the disease, SPECT could be superior to neuromelanin-imaging. Therefore, in our study which included many de novo PD patients in their early stage of the disease, 123 I-FP-CIT SPECT could act as an effective and decisive proof for the true nigrosome-1 status.…”

Section: I-fp-cit Spect Is a Proven Modality With A High Diagnostic Accuracymentioning

confidence: 99%

Comparison of susceptibility-weighted imaging and susceptibility map-weighted imaging for the diagnosis of Parkinsonism with nigral hyperintensity

Bae

Song

Choi

et al. 2021

European Journal of Radiology

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To determine whether susceptibility map-weighted imaging (SMWI) was superior to conventional susceptibility-weighted imaging (SWI) in the diagnosis of Parkinson's disease (PD) and in its correlation with 123 I-2bcarbomethoxy-3b-(4-iodophenyl)-N-(3-fluoropropyl)-nortropane single photon emission computerized tomography ( 123 I-FP-CIT SPECT). Methods: Between May 2017 and February 2018, 125 consecutive patients diagnosed with idiopathic PD, vascular pseudoparkinsonism, essential tremor, or drug-induced parkinsonism and who underwent 123 I-FP-CIT SPECT imaging and 3 T SWI on the same day or within 3 months were included in this retrospective study. In all patients, SMWI images were generated from SWI images. On both MRIs, two neuroradiologists independently evaluated the status of nigral hyperintensity on each side of substantia nigra. Inter-observer agreements for the nigral hyperintensity were tested. Using consensus reading, concordance between SWI, SMWI, and 123 I-FP-CIT SPECT were evaluated, and the diagnostic performance between SWI and SMWI for PD was compared. Results: Inter-observer agreement for the nigral hyperintensity was higher for SMWI (right, κ = 0.919; left, κ = 0.984) than for SWI (right, κ = 0.918; left, κ = 0.902). SMWI (right 67.2 %, left 68.0 %) showed a higher concordance rate with the results of 123 I-FP-CIT SPECT than SWI (right 60.0 %, left 59.2 %). SMWI (area under curve [AUC], 0.791) provided significantly higher diagnostic performance for PD than SWI (AUC, 0.720; P = 0.0005). Conclusion: SMWI may be a superior assessment tool for nigral hyperintensity than SWI and may be an improved diagnostic imaging modality for patients with suspected PD.

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Neuromelanin or DaT‐SPECT: which is the better marker for discriminating advanced Parkinson's disease?

Cited by 30 publications

References 23 publications

Early‐stage Parkinson's disease: Abnormal nigrosome 1 and 2 revealed by a voxelwise analysis of neuromelanin‐sensitive MRI

Early‐stage Parkinson's disease: Abnormal nigrosome 1 and 2 revealed by a voxelwise analysis of neuromelanin‐sensitive MRI

Semi-Automatic Signature-Based Segmentation Method for Quantification of Neuromelanin in Substantia Nigra

Comparison of susceptibility-weighted imaging and susceptibility map-weighted imaging for the diagnosis of Parkinsonism with nigral hyperintensity

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