Semiautomated Algorithm for the Diagnosis of Multiple System Atrophy With Predominant Parkinsonism
Objective Putaminal iron deposition is an important feature that helps differentiate multiple system atrophy with predominant parkinsonism (MSA-p) from Parkinson’s disease (PD). Most previous studies used visual inspection or quantitative methods with manual manipulation to perform this differentiat...
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| Format: | Article |
| Language: | English |
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Korean Movement Disorder Society
2022-09-01
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| Series: | Journal of Movement Disorders |
| Subjects: | |
| Online Access: | http://www.e-jmd.org/upload/jmd-21178.pdf |
| _version_ | 1797757997205684224 |
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| author | Woong-Woo Lee Han-Joon Kim Hong Ji Lee Han Byul Kim Kwang Suk Park Chul-Ho Sohn Beomseok Jeon |
| author_facet | Woong-Woo Lee Han-Joon Kim Hong Ji Lee Han Byul Kim Kwang Suk Park Chul-Ho Sohn Beomseok Jeon |
| author_sort | Woong-Woo Lee |
| collection | DOAJ |
| description | Objective Putaminal iron deposition is an important feature that helps differentiate multiple system atrophy with predominant parkinsonism (MSA-p) from Parkinson’s disease (PD). Most previous studies used visual inspection or quantitative methods with manual manipulation to perform this differentiation. We investigated the value of a new semiautomated diagnostic algorithm using 3T-MR susceptibility-weighted imaging for MSA-p. Methods This study included 26 MSA-p, 68 PD, and 41 normal control (NC) subjects. The algorithm was developed in 2 steps: 1) determine the image containing the remarkable putaminal margin and 2) calculate the phase-shift values, which reflect the iron concentration. The next step was to identify the best differentiating conditions among several combinations. The highest phase-shift value of each subject was used to assess the most effective diagnostic set. Results The raw phase-shift values were present along the lateral margin of the putamen in each group. It demonstrates an anterior-to-posterior gradient that was identified most frequently in MSA-p. The average of anterior 5 phase shift values were used for normalization. The highest area under the receiver operating characteristic curve (0.874, 80.8% sensitivity, and 86.7% specificity) of MSA-p versus PD was obtained under the combination of 3 or 4 vertical pixels and one dominant side when the normalization methods were applied. In the subanalysis for the MSA-p patients with a longer disease duration, the performance of the algorithm improved. Conclusion This algorithm detected the putaminal lateral margin well, provided insight into the iron distribution of the putaminal rim of MSA-p, and demonstrated good performance in differentiating MSA-p from PD. |
| first_indexed | 2024-03-12T18:23:36Z |
| format | Article |
| id | doaj.art-e9f804cdd73f48d89c9fc2d31d7e5c90 |
| institution | Directory Open Access Journal |
| issn | 2005-940X 2093-4939 |
| language | English |
| last_indexed | 2024-03-12T18:23:36Z |
| publishDate | 2022-09-01 |
| publisher | Korean Movement Disorder Society |
| record_format | Article |
| series | Journal of Movement Disorders |
| spelling | doaj.art-e9f804cdd73f48d89c9fc2d31d7e5c902023-08-02T08:40:42ZengKorean Movement Disorder SocietyJournal of Movement Disorders2005-940X2093-49392022-09-0115323224010.14802/jmd.21178398Semiautomated Algorithm for the Diagnosis of Multiple System Atrophy With Predominant ParkinsonismWoong-Woo Lee0Han-Joon Kim1Hong Ji Lee2Han Byul Kim3Kwang Suk Park4Chul-Ho Sohn5Beomseok Jeon6 Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea Department of Neurology, Seoul National University Hospital, Seoul, Korea Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea Department of Radiology, Seoul National University Hospital, Seoul, Korea Department of Neurology, Seoul National University Hospital, Seoul, KoreaObjective Putaminal iron deposition is an important feature that helps differentiate multiple system atrophy with predominant parkinsonism (MSA-p) from Parkinson’s disease (PD). Most previous studies used visual inspection or quantitative methods with manual manipulation to perform this differentiation. We investigated the value of a new semiautomated diagnostic algorithm using 3T-MR susceptibility-weighted imaging for MSA-p. Methods This study included 26 MSA-p, 68 PD, and 41 normal control (NC) subjects. The algorithm was developed in 2 steps: 1) determine the image containing the remarkable putaminal margin and 2) calculate the phase-shift values, which reflect the iron concentration. The next step was to identify the best differentiating conditions among several combinations. The highest phase-shift value of each subject was used to assess the most effective diagnostic set. Results The raw phase-shift values were present along the lateral margin of the putamen in each group. It demonstrates an anterior-to-posterior gradient that was identified most frequently in MSA-p. The average of anterior 5 phase shift values were used for normalization. The highest area under the receiver operating characteristic curve (0.874, 80.8% sensitivity, and 86.7% specificity) of MSA-p versus PD was obtained under the combination of 3 or 4 vertical pixels and one dominant side when the normalization methods were applied. In the subanalysis for the MSA-p patients with a longer disease duration, the performance of the algorithm improved. Conclusion This algorithm detected the putaminal lateral margin well, provided insight into the iron distribution of the putaminal rim of MSA-p, and demonstrated good performance in differentiating MSA-p from PD.http://www.e-jmd.org/upload/jmd-21178.pdfautomationmultiple system atrophyparkinson’s diseaseputamensusceptibility-weighted image |
| spellingShingle | Woong-Woo Lee Han-Joon Kim Hong Ji Lee Han Byul Kim Kwang Suk Park Chul-Ho Sohn Beomseok Jeon Semiautomated Algorithm for the Diagnosis of Multiple System Atrophy With Predominant Parkinsonism Journal of Movement Disorders automation multiple system atrophy parkinson’s disease putamen susceptibility-weighted image |
| title | Semiautomated Algorithm for the Diagnosis of Multiple System Atrophy With Predominant Parkinsonism |
| title_full | Semiautomated Algorithm for the Diagnosis of Multiple System Atrophy With Predominant Parkinsonism |
| title_fullStr | Semiautomated Algorithm for the Diagnosis of Multiple System Atrophy With Predominant Parkinsonism |
| title_full_unstemmed | Semiautomated Algorithm for the Diagnosis of Multiple System Atrophy With Predominant Parkinsonism |
| title_short | Semiautomated Algorithm for the Diagnosis of Multiple System Atrophy With Predominant Parkinsonism |
| title_sort | semiautomated algorithm for the diagnosis of multiple system atrophy with predominant parkinsonism |
| topic | automation multiple system atrophy parkinson’s disease putamen susceptibility-weighted image |
| url | http://www.e-jmd.org/upload/jmd-21178.pdf |
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