Diagnostic value of brain MRI and 18F-FDG PET in the differentiation of Parkinsonian-type multiple system atrophy from Parkinson's disease.
OBJECTIVE
Differentiation between parkinsonian type multiple system atrophy (MSA-P) and Parkinson's disease (PD) is important but often difficult. We investigated the diagnostic value of brain magnetic resonance imaging (MRI) and (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) in differentiating MSA-P from PD.


METHODS
Twenty-four patients with MSA-P (16 probable and 8 possible) and eight patients with PD were included in this study.


RESULTS
For analysis using the putaminal findings, the sensitivities were 58.3% by visual analysis of brain MRI, 95.8% by visual analysis of (18)F-FDG PET, and 79.2% by statistical parametric mapping (SPM) analysis of (18)F-FDG PET in differentiating MSA-P from PD; the specificity was 100% for each analysis. Using the putaminal findings, visual analysis of (18)F-FDG PET had a higher sensitivity compared with brain MRI (P = 0.004) and SPM analysis of (18)F-FDG PET revealed a tendency towards higher sensitivity compared with brain MRI (P = 0.063). For analysis using both putaminal and infratentorial findings, the sensitivities were 79.2% by visual analysis of brain MRI, 95.8% by visual analysis of (18)F-FDG PET, 95.8% by SPM analysis of (18)F-FDG PET in differentiating MSA-P from PD; the specificity was 100% for each analysis.


CONCLUSIONS
Both brain MRI and (18)F-FDG PET showed diagnostic usefulness in differentiating MSA-P from PD, with (18)F-FDG PET being more sensitive than brain MRI.
Kwon
K-Y
KY
Department of Neurology, Center for Parkinsonism and Other Movement Disorders, University of Ulsan College of Medicine, Seoul, Korea.
Choi
C G
CG
Kim
J S
JS
Lee
M C
MC
Chung
S J
SJ
D000328:Adult; D000368:Aged; D002531:Cerebellum / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D010300:Parkinson Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D011149:Pons / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D049268:Positron-Emission Tomography; D011699:Putamen / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016037:Single-Blind Method
D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005947:Glucose