Web-based Automated Imaging Differentiation of Parkinsonism

总结 在整个地球仪中，被诊断患有帕金森症的人数有相当大的增长。 据估计，从1990年到2015年，帕金森症的诊断数量翻了一番，超过6 到2040年，将有1200万和1420万人被诊断出来。 帕金森症帕金森病（PD）、多系统萎缩帕金森变异型（MSAp）和 进行性核上性麻痹（PSP）是帕金森综合征的神经退行性形式， 诊断，因为他们共享相似的运动和非运动功能，他们每个人都有增加的机会， 发展成痴呆症在PD诊断的前五年，约58%的PD被误诊，其中 大约一半的误诊是MSA或PSP。由于PD、MSAp和PSP需要独特的治疗计划， 和不同的药物，和临床试验测试新的药物需要正确的诊断，有一个 迫切需要用于PD、MSAp和PSP的鉴别诊断的临床就绪和临床试验就绪标志物。 在过去的十年中，我们已经开发了扩散成像作为区分PD的创新生物标志物， MSAp和PSP。在本提案中，我们将利用我们丰富的经验创建一个基于Web的软件工具 可以处理来自世界任何地方的扩散成像数据。我们将在 最大的帕金森症（PD，MSAp，PSP）参与者前瞻性队列，与 帕金森研究小组。之所以在帕金森研究小组网络中测试这一点，是因为他们是 社区评估帕金森症的II期和III期临床试验。这个基于网络的软件工具 将能够阅读原始扩散成像数据，执行质量保证程序，分析 数据，并提供成像指标和诊断概率。我们将测试 通过在21个研究中心共招募315例受试者（105例PD，105例MSAp，105例PSP）来评估wAID-P的性能 帕金森研究小组。每家临床试验机构将进行成像、临床量表、诊断，并将数据上传至 基于Web的软件工具。临床诊断将对诊断算法和成像设盲 诊断将与运动障碍训练神经科医生的诊断进行比较。我们也会招收一部分 将队列的样本输入脑库，以确定病理学确认，并针对具有以下特征的病例测试算法： 尸检诊断最后的结果将是传播一个有效的诊断算法， 帕金森神经和放射社区，并使其在网站上提供给所有人。

SUMMARY Across the globe, there has been a considerable growth in the number of people diagnosed with Parkinsonism. Estimates indicate that from 1990 to 2015 the number of Parkinsonism diagnoses doubled, with more than 6 million people currently carrying the diagnosis, and by year 2040, 12 and 14.2 million people will be diagnosed with Parkinsonism. Parkinson’s disease (PD), multiple system atrophy Parkinsonian variant (MSAp), and progressive supranuclear palsy (PSP) are neurodegenerative forms of Parkinsonism, which can be difficult to diagnose as they share similar motor and non-motor features, and they each have an increased chance of developing dementia. In the first five years of a PD diagnosis, about 58% of PD are misdiagnosed, and of these misdiagnoses about half have either MSA or PSP. Since PD, MSAp, and PSP require unique treatment plans and different medications, and clinical trials testing new medications require the correct diagnosis, there is an urgent need for both clinic ready and clinical-trial ready markers for differential diagnosis of PD, MSAp, and PSP. Over the past decade, we have developed diffusion imaging as an innovative biomarker for differentiating PD, MSAp, and PSP. In this proposal, we will leverage our extensive experience to create a web-based software tool that can process diffusion imaging data from anywhere in the world. We will disseminate and test the tool in the largest prospective cohort of participants with Parkinsonism (PD, MSAp, PSP), working closely with the Parkinson Study Group. The reason to test this in the Parkinson Study Group network, is because they are the community that evaluates Phase II and Phase III clinical trials in Parkinsonism. This web-based software tool will be capable of reading raw diffusion imaging data, performing quality assurance procedures, analyzing the data using a validated pipeline, and providing imaging metrics and diagnostic probability. We will test the performance of the wAID-P by enrolling 315 total subjects (105 PD, 105 MSAp, 105 PSP) across 21 sites in the Parkinson Study Group. Each site will perform imaging, clinical scales, diagnosis, and will upload the data to the web-based software tool. The clinical diagnosis will be blinded to the diagnostic algorithm and the imaging diagnosis will be compared to the movement disorders trained neurologist diagnosis. We will also enroll a portion of the cohort into a brain bank to ascertain pathological confirmation and to test the algorithm against cases with post-mortem diagnoses. The final outcome will be to disseminate a validated diagnostic algorithm to the Parkinson neurological and radiological community and to make it available to all on a website.