Utility of Imaging of Nigrosome‐1 on 3T <scp>MRI</scp> and Its Comparison with <scp>18F‐DOPA PET</scp> in the Diagnosis of Idiopathic Parkinson Disease and Atypical Parkinsonism

Kathuria, Heena; Mehta, Sahil; Ahuja, Chirag; Chakravarty, Kamalesh; Ray, Sucharita; Mittal, Bhagwant Rai; Singh, Paramjeet; Lal, Vivek

doi:10.1002/mdc3.13091

Cited by 17 publications

(14 citation statements)

References 30 publications

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“…Our study results may indicate a potential advantage of N1 and 6-[ 18 F]FDOPA PET accuracy in synucleopathies, but, due to the small sample size, this statement remains speculative. Furthermore, there are several studies that do not show any differences between detection rate of synucleopathies or tauopathies in 3 T SWI MR imaging [ 30 – 33 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of 6-[18F]FDOPA PET with Nigrosome 1 detection in patients with parkinsonism

et al. 2021

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Background The functional 6-[18F]FDOPA positron emission tomography (PET) can be a helpful tool in differentiating parkinsonism with dopaminergic deficiency from clinically similar differential diagnoses. Furthermore, in T2*/susceptibility-weighted imaging (SWI) magnetic resonance imaging (MRI) sequences the structural integrity of the Nigrosome 1 (N1) can be assessed by checking the presence of the swallow tail sign (STS). We therefore retrospectively compared the performance of the 6-[18F]FDOPA PET with the N1 detection in patients suspected with parkinsonian diseases. Forty-three consecutive patients (m: 23, f: 20, mean age: 63 ± 12 years) were included in the study. They underwent clinically indicated 6-[18F]FDOPA PET/MRI scans as part of their neurological evaluation of uncertain parkinsonian syndromes. Visual and semi-quantitative PET imaging results were statistically compared with visual N1 assessment on 3 T SWI. As the gold standard, we defined the clinical diagnosis at the last follow-up, which included idiopathic Parkinson syndrome (IPS; n = 18), atypical parkinsonian syndromes (APS; n = 9) and other neurological diseases without dopaminergic deficit (n = 16). Results Thirty-five of 43 patients (81%, Kappa 0.611) had corresponding results in 6-[18F]FDOPA PET and SWI. Seven of the remaining 8 patients were correctly diagnosed by 6-[18F]FDOPA PET alone. Sensitivity, specificity and accuracy for 6-[18F]FDOPA and N1 imaging were 93%, 94%, 93% and 82%, 75%, 79%, respectively. Conclusions 6-[18F]FDOPA PET and Nigrosome 1 evaluation had an overall good intermodality agreement. Diagnostic agreement was very good in cases of clinically suspected idiopathic Parkinson syndrome and fair in atypical parkinsonian syndromes, but poor in patients with non-parkinsonian disorders. 6-[18F]FDOPA PET showed higher sensitivity, specificity and accuracy in discriminating parkinsonian syndromes from non-parkinsonian disorders than the N1 evaluation. In summary, the additional benefit of N1 assessment in patients with APS or parkinsonism without dopaminergic deficit needs to be proven by prospective studies.

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Section: Discussionmentioning

confidence: 99%

Comparison of 6-[18F]FDOPA PET with Nigrosome 1 detection in patients with parkinsonism

et al. 2021

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“…Furthermore, a loss of STS has also been observed in patients suffering from idiopathic rapid eye movement sleep behavior disorder and DLB [50,51]. Whilst the loss of nigrosome-1 on SWI sequences may assist as a potential imaging biomarker in the diagnosis of degenerative parkinsonian syndromes, it cannot differentiate between idiopathic PD and PS [52,53]. Nevertheless, it has been reported that anatomical changes of SN, detected via the SWI sequence at 7T, may distinguish MSA and PSP from CBD [54], thereby confirming the pathological heterogeneity of these diseases.…”

Section: Nigrosome-1 Imagingmentioning

confidence: 99%

Imaging of Substantia Nigra in Parkinson’s Disease: A Narrative Review

et al. 2021

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Parkinson’s disease (PD) is a progressive neurodegenerative disorder, characterized by motor and non-motor symptoms due to the degeneration of the pars compacta of the substantia nigra (SNc) with dopaminergic denervation of the striatum. Although the diagnosis of PD is principally based on a clinical assessment, great efforts have been expended over the past two decades to evaluate reliable biomarkers for PD. Among these biomarkers, magnetic resonance imaging (MRI)-based biomarkers may play a key role. Conventional MRI sequences are considered by many in the field to have low sensitivity, while advanced pulse sequences and ultra-high-field MRI techniques have brought many advantages, particularly regarding the study of brainstem and subcortical structures. Nowadays, nigrosome imaging, neuromelanine-sensitive sequences, iron-sensitive sequences, and advanced diffusion weighted imaging techniques afford new insights to the non-invasive study of the SNc. The use of these imaging methods, alone or in combination, may also help to discriminate PD patients from control patients, in addition to discriminating atypical parkinsonian syndromes (PS). A total of 92 articles were identified from an extensive review of the literature on PubMed in order to ascertain the-state-of-the-art of MRI techniques, as applied to the study of SNc in PD patients, as well as their potential future applications as imaging biomarkers of disease. Whilst none of these MRI-imaging biomarkers could be successfully validated for routine clinical practice, in achieving high levels of accuracy and reproducibility in the diagnosis of PD, a multimodal MRI-PD protocol may assist neuroradiologists and clinicians in the early and differential diagnosis of a wide spectrum of neurodegenerative disorders.

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“…SWI sequences were considered to have a stronger and more accurate correlation with brain iron load than R 2 relaxation rate alone [38]. Studies have shown that this sequence is severely sensitive to mineralization and substances with magnetic susceptibility, hence, to be more sensitive than conventional gradient echo sequence in the detection of PD and parkinsonian syndromes [41,42].…”

Section: Diffusion Tensor Imagingmentioning

confidence: 99%

Imaging modalities in differential diagnosis of Parkinson’s disease: opportunities and challenges

Mortezazadeh

Seyedarabi

Moeini

et al. 2021

Egypt J Radiol Nucl Med

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Background Parkinson’s disease (PD) diagnosis is yet largely based on the related clinical aspects. However, genetics, biomarkers, and neuroimaging studies have demonstrated a confirming role in the diagnosis, and future developments might be used in a pre-symptomatic phase of the disease. Main text This review provides an update on the current applications of neuroimaging modalities for PD diagnosis. A literature search was performed to find published studies that were involved on the application of different imaging modalities for PD diagnosis. An organized search of PubMed/MEDLINE, Embase, ProQuest, Scopus, Cochrane, and Google Scholar was performed based on MeSH keywords and suitable synonyms. Two researchers (TM and JPI) independently and separately performed the literature search. Our search strategy in each database was done by the following terms: ((Parkinson [Title/Abstract]) AND ((“Parkinsonian syndromes ”[Mesh]) OR Parkinsonism [Title/Abstract])) AND ((PET [Title/Abstract]) OR “SPECT”[Mesh]) OR ((Functional imaging, Transcranial sonography [Title/Abstract]) OR “Magnetic resonance spectroscopy ”[Mesh]). Database search had no limitation in time, and our last update of search was in February 2021. To have a comprehensive search and to find possible relevant articles, a manual search was conducted on the reference list of the articles and limited to those published in English. Conclusion Early diagnosis of PD could be vital for early management and adequate neuroprotection. Recent neuroimaging modalities such as SPECT and PET imaging using radiolabeled tracers, MRI, and CT are used to discover the disease. By the modalities, it is possible to early diagnose dopaminergic degeneration and also to differentiate PD from others parkinsonian syndromes, to monitor the natural progression of the disease and the effect of neuroprotective treatments on the progression. In this regard, functional imaging techniques have provided critical insights and roles on PD.

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Utility of Imaging of Nigrosome‐1 on 3T MRI and Its Comparison with 18F‐DOPA PET in the Diagnosis of Idiopathic Parkinson Disease and Atypical Parkinsonism

Cited by 17 publications

References 30 publications

Comparison of 6-[18F]FDOPA PET with Nigrosome 1 detection in patients with parkinsonism

Comparison of 6-[18F]FDOPA PET with Nigrosome 1 detection in patients with parkinsonism

Imaging of Substantia Nigra in Parkinson’s Disease: A Narrative Review

Imaging modalities in differential diagnosis of Parkinson’s disease: opportunities and challenges

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