The putaminal abnormalities on 3.0T magnetic resonance imaging: can they separate parkinsonism-predominant multiple system atrophy from Parkinson's disease?

Abstract

The signal changes in the putamen on T2W imaging on 3.0 T MRI, including slit-like hyperintense rim and putaminal hypointensity, are not specific signs for MSA-P. Putaminal atrophy is highly specific for differentiating MSA-P from PD and healthy controls, but its insufficient sensitivity limits its diagnostic value.

Differentiation of Parkinsonism-Predominant Multiple System Atrophy from Idiopathic Parkinson Disease Using 3T Susceptibility-Weighted MR Imaging, Focusing on Putaminal Change and Lesion Asymmetry

“…The sensitivity of this study was similar or slightly lower than those previously published for studies that used conventional fast spin-echo-based 3T MR imaging findings. 17,18 The sensitivity of our study was comparable with those of published studies that used T2*-weighted imaging. 19,20 By ROC curve analysis of the quantitative phase-shift values, sensitivity was increased to 77.8%, while specificity was slightly decreased (76.0%).…”

“…This finding was not clearly indicated by previous imaging studies, even those that used 3T imaging or 3T SWI. 18,23 Our quantitative measurement method was not a volumetric method and did not include all putaminal areas or consider the high-iron-deposition area that was proposed to be meaningful by previous publications. 11,13 Haacke et al 11 demonstrated that putative iron deposition in the high-iron-content region increases with age.…”

Imaging biomarkers in Parkinson’s disease and Parkinsonian syndromes: current and emerging concepts

“…1b) may also be observed in MSA [43]. Putaminal atrophy shows a high specificity (92.3%), but low sensitivity (44.4%) for distinguishing MSA- P from PD [44]. Meta-analysis of six studies (although heterogeneous) found putaminal volume to be significantly reduced in MSA patients versus PD, which may be helpful in the differential diagnosis [45].…”

“…T2* visual grade was comparable in possible and probable MSA- C patients suggesting improved utility to support the diagnosis at earlier stages [46]. Another study compared the T2 appearances of the ‘putaminal rim sign’ and T2-putaminal hypointensities on a 3T scanner and found these to be unhelpful in distinguishing MSA- P , PD and controls [44]. However, a combination of T2-putaminal hypointensity on gradient-echo sequence together with putaminal atrophy improved the diagnostic specificity of MSA- P to 98% (versus PD) and 95% (versus PSP), without altering the sensitivity [47].…”

Classification of Neurodegenerative Diseases using Machine Learning Methods

“…Salvatore et al (2014) rely on T1 weighted MRI to differentiate PD from PSP, using Principle Component Analysis (PCA) for feature extraction and SVM for classification of diseases [15]. Feng et al (2014) [18]. Zanigni et al (2015) rely on MR Proton Spectroscopy (1H MRS) method for differential diagnosis between PD and other parkinsonian syndromes (MSA-C, MSA-P and Richardson syndrome (PSP-RS)).…”