FDG PET in the differential diagnosis of parkinsonian disorders
FDG PET in the differential diagnosis of parkinsonian disorders
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DOI：
10.1016/j.neuroimage.2005.03.012
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发表时间：
2005-07-01
期刊：
影响因子：
5.7
通讯作者：
Eidelberg, D
中科院分区：
文献类型：
--
作者：
Eckert, T;Barnes, A;Eidelberg, D
帕金森病的鉴别诊断具有挑战性，尤其是在病程早期。[F-18]-氟脱氧葡萄糖（FDG） PET成像已被用于识别特发性帕金森病（PD）患者队列中区域糖代谢的特征模式，以及多种形式的帕金森病，如多系统萎缩（MSA）、进行性核上性麻痹（PSP）和皮质基底变性（CBGD）。在这项研究中，我们评估了FDG PET在临床帕金森病患者个体鉴别诊断中的应用。135名帕金森患者接受了FDG PET检查，以确定他们的诊断是否可以根据他们的扫描做出准确的诊断。影像学诊断是通过个人扫描的视觉评估和计算机辅助解释获得的。研究结果与独立运动障碍专家进行的2年随访临床评估进行了比较，这些专家对原始PET结果不知情。我们发现92.4%的受试者（97.7%的早期PD， 91.6%的晚期PD， 96%的MSA， 85%的PSP， 90.1%的CBGD， 86.5%的健康对照）的盲法计算机评估与临床诊断一致。85.4%的扫描患者（早期PD 88.4%，晚期PD 97.2%, MSA 76%, PSP 60%, CBGD 90.9%，健康对照90.9%）的视觉检查与临床诊断的符合率为85.4%。本研究表明，在帕金森病初次转诊时进行的FDG PET可以准确预测个体患者在后续随访时的临床诊断。在没有经验丰富的FDG PET图像读取器的情况下，计算机辅助方法可能特别有用。(c) 2005爱思唯尔公司版权所有。
The differential diagnosis of parkinsonian disorders can be challenging, especially early in the disease course. PET imaging with [F-18]-fluorodeoxyglucose (FDG) has been used to identify characteristic patterns of regional glucose metabolism in patient cohorts with idiopathic Parkinson's disease (PD), as well as variant forms of parkinsonism such as multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBGD). In this study, we assessed the utility of FDG PET in the differential diagnosis of individual patients with clinical parkinsonism.135 parkinsonian patients were referred for FDG PET to determine whether their diagnosis could be made accurately based upon their scans. Imaging-based diagnosis was obtained by visual assessment of the individual scans and also by computer-assisted interpretation. The results were compared with 2-year follow-up clinical assessments made by independent movement disorders specialists who were blinded to the original PET findings.We found that blinded computer assessment agreed with clinical diagnosis in 92.4% of all subjects (97.7% early PD, 91.6% late PD, 96% MSA, 85% PSP, 90.1% CBGD, 86.5% healthy control subjects). Concordance of visual inspection with clinical diagnosis was achieved in 85.4% of the patients scanned (88.4% early PD, 97.2% late PD, 76% MSA, 60% PSP, 90.9% CBGD, 90.9% healthy control subjects). This study demonstrates that FDG PET performed at the time of initial referral for parkinsonism accurately predicted the clinical diagnosis of individual patients made at subsequent follow-up. Computer-assisted methodologies may be particularly helpful in situations where experienced readers of FDG PET images are not readily available. (c) 2005 Elsevier Inc. All rights reserved.