Morphometric MRI profiles of multiple system atrophy variants and implications for differential diagnosis

Background Manual width measurements of the middle cerebellar peduncle on MRI were shown to improve the accuracy of an imaging‐guided diagnosis of multiple system atrophy (MSA). Recently, automated volume segmentation algorithms were able to reliably differentiate patients with Parkinson's dise...

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Vydáno v:Movement disorders Ročník 34; číslo 7; s. 1041 - 1048
Hlavní autoři: Krismer, Florian, Seppi, Klaus, Göbel, Georg, Steiger, Ruth, Zucal, Isabel, Boesch, Sylvia, Gizewski, Elke R., Wenning, Gregor K., Poewe, Werner, Scherfler, Christoph
Médium: Journal Article
Jazyk:angličtina
Vydáno: Chichester, UK John Wiley & Sons, Ltd 01.07.2019
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Témata:
Accuracy
Aged
Algorithms
Atrophy
Atrophy - diagnosis
Atrophy - pathology
Automation
Basal ganglia
Brain - pathology
Central nervous system diseases
Cerebellum
Diagnosis, Differential
Differential diagnosis
Female
FreeSurfer
Humans
Image processing
Information processing
Magnetic resonance imaging
Magnetic Resonance Imaging - methods
Male
Medical diagnosis
Middle Aged
Movement disorders
MRI
multiple system atrophy
Multiple System Atrophy - diagnosis
Multiple System Atrophy - pathology
Multiple System Atrophy - physiopathology
Neurodegenerative diseases
Neuroimaging
Parkinson Disease - diagnosis
Parkinson Disease - pathology
Parkinson's disease
Parkinsonian Disorders - diagnosis
Parkinsonian Disorders - pathology
Putamen
Putamen - pathology
Putamen - physiology
Segmentation
Substantia alba
Parkinson's disease
multiple system atrophy
MRI
FreeSurfer
atlas
ISSN:0885-3185, 1531-8257, 1531-8257
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Shrnutí:Background Manual width measurements of the middle cerebellar peduncle on MRI were shown to improve the accuracy of an imaging‐guided diagnosis of multiple system atrophy (MSA). Recently, automated volume segmentation algorithms were able to reliably differentiate patients with Parkinson's disease (PD) and the parkinsonian variant of MSA. The objective of the current study was to integrate probabilistic information of the middle cerebellar peduncle into an existing MRI atlas for automated subcortical segmentation and to evaluate the diagnostic properties of the novel atlas for the differential diagnosis of MSA (parkinsonian and cerebellar variant) versus PD. Methods Three Tesla MRI scans of 48 healthy individuals were used to establish an automated whole‐brain segmentation procedure that includes the volumes of the putamen, cerebellar gray and white matter, and the middle cerebellar peduncles. Classification accuracy of segmented volumes were tested in early‐stage MSA patients (18 MSA‐parkinsonism, 13 MSA‐cerebellar) and 19 PD patients using a C4.5 classifier. Results Putaminal and infratentorial atrophy were present in 77.8% and 61.1% of MSA‐parkinsonian patients, respectively. Four of 18 MSA‐parkinsonian patients (22.2%) had infratentorial atrophy without evidence of putaminal atrophy. Infratentorial atrophy was present in all MSA‐cerebellar patients, with concomitant putaminal atrophy in 46.2% of these cases. The diagnostic algorithm using putaminal and infratentorial volumetric information correctly classified all PD patients and 96.8% of MSA patients. Conclusions The middle cerebellar peduncle was successfully integrated into a subcortical segmentation atlas, and its excellent diagnostic accuracy outperformed existing volumetric MRI processing strategies in differentiating MSA patients with variable atrophy patterns from PD patients. © 2019 International Parkinson and Movement Disorder Society
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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Relevant conflicts of interests/financial disclosures: The authors have nothing to report in relation to this study.
Funding agency: This study was supported by the MSA Coalition.
The copyright line for this article was changed on July 29, 2019, after original print and online publication.
ISSN:0885-3185
1531-8257
1531-8257
DOI:10.1002/mds.27669