Abstract
PurposeTo investigate the usefulness of a novel computer-aided classification framework for the differential diagnosis of parkinsonian disorders (PDs) based on 11C-methyl-N-2β-carbomethoxy-3β-(4-fluorophenyl)-tropanel (11C-CFT) positron emission tomography (PET) imaging.MethodsPatients with different forms of PDs—including Parkinson's disease (PD), multiple system atrophy (MSA) and progressive supranuclear palsy (PSP)—underwent dopamine transporter (DAT) imaging with 11C-CFT PET. A novel multistep computer-aided classification framework—consisting of magnetic resonance imaging (MRI)-assisted PET segmentation, feature extraction and prediction, and automatic subject classification—was developed. A random forest method was used to assess the diagnostic relevance of different regions to the classification process. Finally, the performance of the computer-aided classification system was tested using various training strategies involving patients with early and advanced disease stages.ResultsAccuracy values for identifying PD, MSA, and PSP were 85.0, 82.2, and 89.7%, respectively—with an overall accuracy of 80.4%. The caudate and putamen provided the highest diagnostic relevance to the proposed classification framework, whereas the contribution of midbrain was negligible. With the exception of sensitivity for diagnosing PSP, the strategy comprising both early and advanced disease stages performed better in terms of sensitivity, specificity, positive predictive value, and negative predictive value within each PDs subtype.ConclusionsThe proposed computer-aided classification framework based on 11C-CFT PET imaging holds promise for improving the differential diagnosis of PDs.
Highlights
Parkinsonian disorders (PDs) are a heterogeneous group of neurological disorders characterized by tremor, bradykinesia, rigidity, and poor postural stability
The proposed computer-aided classification framework based on 11C-CFT positron emission tomography (PET) imaging holds promise for improving the differential diagnosis of PDs
Parkinson’s disease (PD)— the most common PDs occurring in the elderly (Pringsheim et al, 2014)—should be differentiated by other atypical parkinsonian syndromes (APSs), including multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) (Fahn et al, 2011)
Summary
Parkinsonian disorders (PDs) are a heterogeneous group of neurological disorders characterized by tremor, bradykinesia, rigidity, and poor postural stability. Parkinson’s disease (PD)— the most common PDs occurring in the elderly (Pringsheim et al, 2014)—should be differentiated by other atypical parkinsonian syndromes (APSs), including multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) (Fahn et al, 2011). The key pathogenic mechanisms of PDs consist of a progressive neuronal loss in the substantia nigra of midbrain (Burns et al, 1983) and the occurrence of dopaminergic dysfunction in the striatum (Hantraye et al, 1992; Strafella et al, 2017). PDs were found to have different midbrain neuronal loss and striatal dopaminergic dysfunction patterns, their effect in PDs classification remains to be discussed (MartinBastida et al, 2017)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
