title: Diffusional kurtosis imaging of cingulate fibers in Parkinson disease: comparison with conventional diffusion tensor imaging.
abstract: OBJECTIVE
  The pathological changes in Parkinson disease begin in the brainstem; reach the limbic system and ultimately spread to the cerebral cortex. In Parkinson disease (PD) patients, we evaluated the alteration of cingulate fibers, which comprise part of the limbic system, by using diffusional kurtosis imaging (DKI).
  
  
  METHODS
  Seventeen patients with PD and 15 age-matched healthy controls underwent DKI with a 3-T MR imager. Diffusion tensor tractography images of the anterior and posterior cingulum were generated. The mean kurtosis (MK) and conventional diffusion tensor parameters measured along the images in the anterior and posterior cingulum were compared between the groups. Receiver operating characteristic (ROC) analysis was also performed to compare the diagnostic abilities of the MK and conventional diffusion tensor parameters.
  
  
  RESULTS
  The MK and fractional anisotropy (FA) in the anterior cingulum were significantly lower in PD patients than in healthy controls. The area under the ROC curve was 0.912 for MK and 0.747 for FA in the anterior cingulum. MK in the anterior cingulum had the best diagnostic performance (mean cutoff, 0.967; sensitivity, 0.87; specificity, 0.94).
  
  
  CONCLUSIONS
  DKI can detect alterations of the anterior cingulum in PD patients more sensitively than can conventional diffusion tensor imaging. Use of DKI can be expected to improve the ability to diagnose PD.
authors.affiliation: Department of Radiology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. Electronic address: kkamagat@juntendo.ac.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Kamagata
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tomiyama
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Motoi
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kano
authors.forename: Osamu
authors.initials: O
authors.lastname: Abe
authors.forename: Kenji
authors.initials: K
authors.lastname: Ito
authors.forename: Keigo
authors.initials: K
authors.lastname: Shimoji
authors.forename: Michimasa
authors.initials: M
authors.lastname: Suzuki
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hori
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakanishi
authors.forename: Ryohei
authors.initials: R
authors.lastname: Kuwatsuru
authors.forename: Keisuke
authors.initials: K
authors.lastname: Sasai
authors.forename: Shigeki
authors.initials: S
authors.lastname: Aoki
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Hattori
mesh_terms: D000368:Aged; D000465:Algorithms; D016880:Anisotropy; D001921:Brain / Q000473:pathology; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000473:pathology; D004058:Diffusion; D056324:Diffusion Tensor Imaging; D005260:Female; D006179:Gyrus Cinguli / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008032:Limbic System / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000473:pathology*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013997:Time Factors
keywords: Cingulate fiber; Diffusion tensor imaging; Diffusional kurtosis imaging; Parkinson disease; Tract-specific analysis