title: Visual discrimination among patients with depression and schizophrenia and healthy individuals using semiquantitative color-coded fast spin-echo T1-weighted magnetic resonance imaging.
abstract: BACKGROUND
  Fast spin-echo (FSE) T1-weighted (T1W) magnetic resonance imaging (MRI) at 3T, which is sensitive to neuromelanin-related contrast, can quantitatively detect signal alterations in the locus ceruleus (LC) and the substantia nigra pars compacta (SNc) of depressive and schizophrenic patients; however, its qualitative diagnostic performance remains unknown. We investigated whether visual interpretation of semiquantitative color maps can be used for discriminating between depressive and schizophrenic patients and healthy individuals.
  
  
  METHODS
  We retrospectively examined 23 patients with major depression, 23 patients with schizophrenia, and 23 age-matched healthy controls by using a FSE-T1W MRI technique. Semiquantitative color maps of sections through the LC and SNc were visually interpreted by nine raters using a continuous confidence rating scale for receiver operating characteristic (ROC) analysis.
  
  
  RESULTS
  The area under the ROC curve (Az), which reflects the performance in differentiating between depressive patients and controls, was 0.88, and the sensitivity and specificity at the maximum likelihood were 76% and 83%, respectively. In contrast, the Az value, sensitivity, and specificity values between schizophrenics and controls and between depressives and schizophrenics were 0.66 and 0.69, 42% and 48%, and 82% and 84%, respectively.
  
  
  CONCLUSIONS
  Semiquantitative, color-coded FSE-T1W MRI at 3T can be used for visually differentiating depressive patients from healthy individuals with a substantially high likelihood, but this technique cannot be applied to distinguish schizophrenic patients from the other two groups.
authors.affiliation: Advanced Medical Research Center, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Japan. masasaki@iwate-med.ac.jp
authors.forename: Makoto
authors.initials: M
authors.lastname: Sasaki
authors.forename: Eri
authors.initials: E
authors.lastname: Shibata
authors.forename: Kotaro
authors.initials: K
authors.lastname: Ohtsuka
authors.forename: Jin
authors.initials: J
authors.lastname: Endoh
authors.forename: Kohsuke
authors.initials: K
authors.lastname: Kudo
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Narumi
authors.forename: Akio
authors.initials: A
authors.lastname: Sakai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D003116:Color; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008125:Locus Coeruleus / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis* / Q000473:pathology; D012680:Sensitivity and Specificity; D013378:Substantia Nigra / Q000473:pathology*; D055815:Young Adult