Abstract
BackgroundDopamine transporter (DaT) imaging (DaTSCAN) is useful for the differential diagnosis of parkinsonian syndromes. Visual evaluation of DaTSCAN images represents the generally accepted diagnostic method, but it is strongly dependent on the observer’s experience and shows inter- and intra-observer variability. A reliable and automatic method for DaTSCAN evaluation can provide objective quantification; it is desirable for longitudinal studies, and it allows for a better follow-up control. Moreover, it is crucial for an automated method to produce coherent measures related to the severity of motor symptoms.MethodsIn this work, we propose a novel fully automated technique for DaTSCAN analysis that generates quantitative measures based on striatal intensity, shape, symmetry and extent. We tested these measures using a support vector machine (SVM) classifier.ResultsThe proposed measures reached 100 % accuracy in distinguishing between patients with Parkinson’s disease (PD) and control subjects. We also demonstrate the existence of a linear relationship and an exponential trend between pooled structural and functional striatal characteristics and the Unified Parkinson’s disease Rating Scale (UPDRS) motor score.ConclusionsWe present a novel, highly reproducible, user-independent technique for DaTSCAN analysis producing quantitative measures directly connected to striatum uptake and shape. In our method, no a priori assumption is required on the spatial conformation and localization of striatum, and both uptake and symmetry contribute to the index quantification. These measures can reliably support a computer-assisted decision system.Electronic supplementary materialThe online version of this article (doi:10.1186/s40658-016-0140-9) contains supplementary material, which is available to authorized users.
Highlights
Dopamine transporter (DaT) imaging (DaTSCAN) is useful for the differential diagnosis of parkinsonian syndromes
Correlation with motor symptoms Since it is very important, for any quantitative marker of damage, to reflect the progression of disease symptoms, we explored the relationship between our composite measure shapemodulated uptake (SMU) and the Unified Parkinson’s disease Rating Scale (UPDRS)-ME scores from the Parkinson’s disease (PD) group
We considered segmentation of the basal ganglia to be successful in all cases after visual inspection of the region of interest (ROI)
Summary
Dopamine transporter (DaT) imaging (DaTSCAN) is useful for the differential diagnosis of parkinsonian syndromes. A reliable and automatic method for DaTSCAN evaluation can provide objective quantification; it is desirable for longitudinal studies, and it allows for a better follow-up control. 123I-FP-CIT is a pre-synaptic radiopharmaceutical of the DaT presenting a significant uptake decrease in basal ganglia of PD subjects [9] and the most widely used tracer for pre-synaptic evaluations in both Europe and the USA [12]. The utility of this tracer for pre-synaptic evaluations has been shown in the differential diagnosis between essential tremor (ET) and idiopathic parkinsonism [13,14,15]
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