Abstract

To assess the classification performance between Parkinson's disease (PD) and normal control (NC) when semi-quantitative indicators and shape features obtained on dopamine transporter (DAT) single photon emission computed tomography (SPECT) are combined as a feature of machine learning (ML). A total of 100 cases of both PD and normal control (NC) from the Parkinson's Progression Markers Initiative database were evaluated. A summed image was generated and regions of interests were set to the left and right striata. Area, equivalent diameter, major axis length, minor axis length, perimeter and circularity were calculated as shape features. Striatum binding ratios (SBRputamen and SBRcaudate) were used as comparison features. The classification performance of the PD and NC groups according to receiver operating characteristic analysis of the shape features was compared in terms of SBRs. Furthermore, we compared the classification performance of ML when shape features or SBRs were used alone and in combination. The shape features (except minor axis length) and SBRs indicated significant differences between the NC and PD groups (p < 0.05). The top five areas under the curves (AUC) were as follows: circularity (0.972), SBRputamen (0.972), major axis length (0.945), SBRcaudate (0.928) and perimeter (0.896). When classification was done using ML, AUC was as follows: circularity and SBRs (0.995), circularity alone (0.990), and SBRs (0.973). The classification performance was significantly improved by combining SBRs and circularity than by SBRs alone (p = 0.018). We found that the circularity obtained from DAT-SPECT images could help in distinguishing NC and PD. Furthermore, the classification performance of ML was significantly improved using circularity in SBRs together.

Highlights

  • Parkinson’s disease (PD) is characterized by motor symptoms, such as tremor, muscular rigidity, immobility and postural reflex disorder, and involves frequent complications of nonmotor symptoms, such as autonomic nervous disorder, depression, sleep disturbance and dementia [1]

  • We found that the circularity obtained from Dopamine transporter (DAT)-single photon emission computed tomography (SPECT) images could help in distinguishing normal control (NC) and PD

  • The classification performance of machine learning (ML) was significantly improved using circularity in striatum binding ratio (SBR) together

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Summary

Introduction

Parkinson’s disease (PD) is characterized by motor symptoms, such as tremor, muscular rigidity, immobility and postural reflex disorder, and involves frequent complications of nonmotor symptoms, such as autonomic nervous disorder, depression, sleep disturbance and dementia [1]. The striatum to which dopamine neurons are projected is one of the nerve nuclei constituting the basal ganglia and comprises the caudate nucleus and putamen. Dopamine transporter (DAT)-single photon emission computed tomography (SPECT) contributes to the diagnosis of PD and Lewy body dementia by providing a SPECT image reflecting DAT distribution density in the striatum. Semi-quantitative indicators can provide information regarding the count of the striatum in the background; the information of the striatum shape cannot be obtained. Oliveira et al [13] described that the length of the striatal uptake region revealed clinical added value because the accuracy obtained was slightly higher than the best accuracy achieved by the standard uptake ratio-based features. It is well known that typical PD indicates egg or dot shape because a decrease in the uptake of the striatum occurs from the putamen and caudate uptake is retained. We believed that it would be suitable to distinguish between PD and NC using the circularity of the striatal accumulation shape as a feature

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