Comparative study of Susceptibility Map Weighted Image (SMWI) with Susceptibility Weighted Image (SWI) in substantia nigra for the diagnosis of Idiopathic Parkinson’s Disease and correlation with 18F-FP-CIT-PET
초록/요약
Purpose: Susceptibility Weighted Image (SWI) and Susceptibility Map Weighted Image (SMWI) are well known for delineating iron pathology of substantia nigra. The purpose of this study is to compare the image quality and diagnostic performance of SMWI and SWI in diagnosis of idiopathic Parkinson Disease (IPD) with 18F-FP-CIT PET as reference standard. Materials and methods: Patients who were clinically suspected for IPD were included in this retrospective study and their 3T brain MRI including SWI and 18F-FP-CIT PET results were obtained. Visual assessment of nigral hypersensitivity in SWMI and SWI were performed and their correlation with 18F-FP-CIT PET were compared using sensitivity, specificity, and diagnostic accuracy. Additional contrast-to-noise ratio of nigrosome-1 (CNRN1) were calculated in the control group including ET, DIP and VP patients for quantitative assessment. Correlation of SMWI and SWI with 18F-FP-CIT PET and diagnostic performance were compared using ROC curve. Results: Total of 122 patients were included in this study. SWMI showed higher sensitivity (Rt : 76.1% vs 70.7%, Lt : 69.0% vs 58.6%) and specificity (Rt : 66.7% vs 63.3 %, Lt : 68.6% vs 62.9%) than SWI for nigral hyperintensity in both sides as compared to 18F-FP-CIT PET. CNRN1 of SMWI was significantly higher than that of SWI (1.91±0.43 vs 1.50±0.52). Overall diagnostic accuracy of SMWI was significantly higher than that of SWI (80.3% vs 76.2%, p<0.05). Interobserver agreements for nigral hyperintensity in SWI were fair and good for both sides of nigrosome (Rt : κ=0.721, Lt : κ=0.724), where as those of SMWI were excellent for both sides (Rt : κ=0.932, Lt : κ=0.928). Conclusion: SMWI showed better image quality and higher diagnostic performance than SWI in diagnosis of IPD at 3T MRI with 18F-FP-CIT PET as reference standard.
more목차
I. Introduction 1
II. Materials and Method 3
A. Patients and clinical assessment 3
B. SWI and SMWI processing 3
C. Image analysis 4
D. Statistical analysis 4
III. Results 5
A. Clinical data 5
B. Inter-and intra- observer agreements for nigral hyperintensity 5
C. Comparison between SWI and SMWI and correlation with 18F-FP-CIT PET 5
D. Diagnostic performance of SWI and SMWI for diagnosis of IPD 5
V. Discussion 6
VI. List of Figures 8
A. Figure 1. Oblique coronal plane perpendicular to the midbrain for nigrosome-1 8
B. Figure 2. Representative examples of SMWI and SWI and CNR measurement 9
C. Figure 3. CNRN1 in the control group 10
D. Figure 4. Diagnostic performance of SWI and SMWI through ROC curve analysis 11
E. Figure 5. Representative case of IPD group 12
F. Figure 6. Representative case of control group 13
VII. List of Tables 14
A. Table 1. Demographics and clinical data 14
B. Table 2. The Results of SWI and SMWI for nigral hyperintensity and result of 18F-FP-CIT PET 15
C. Table 3. The sensitivity and specificity of SWI and SWMI for nigral hyperintensity and comparison with 18F-FP-CIT PET 16
VII. References 17
