title: Quantitative Analysis Versus Visual Assessment of Neuromelanin MR Imaging for the Diagnosis of Parkinson's disease.
abstract: BACKGROUND
  Specific MR sequences have been able to identify the loss of neuromelanin in the substantia nigra (SN) of early stage Parkinson's disease (PD) patients. Since this technique may have a significant impact in clinical patient management, easy and widely available imaging analysis is needed for routine use.
  
  
  OBJECTIVE
  In this study we compared a quantitative analysis with a visual assessment of SN neuromelanin-sensitive MR images in early stage PD patients, in terms of pattern changes recognition and diagnostic accuracy.
  
  
  METHODS
  The inclusion criteria were untreated "de novo" PD patients or a 2-5 year PD duration; in addition, age matched controls were enrolled. These were studied with a high-resolution T1-weighted MR imaging sequence at 3.0 Tesla to visualize neuromelanin. The primary outcome was the comparison of quantitative width measurement with visual assessment by experienced neuroradiologists of SN neuromelanin sensitive MR images for PD diagnosis.
  
  
  RESULTS
  A total of 12 "de novo" PD patients, 10 PD patients with 2-5 year disease duration and 10 healthy controls were evaluated. We obtained a good accuracy in discriminating early-stage PD patients from controls using either a quantitative width measurement of the T1 high signal or a simple visual image inspection of the SN region.
  
  
  CONCLUSIONS
  Visual inspection of neuromelanin-sensitive MR images by experienced neuroradiologists provides comparable results to quantitative width measurement in the detection of early stage PD SN changes and may become a useful tool in clinical practice.
authors.affiliation: Neurological Imaging Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Portugal.|Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Portugal.
authors.forename: Sofia
authors.initials: S
authors.lastname: Reimão
authors.affiliation: Neurology Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Portugal.|Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Portugal.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Pita Lobo
authors.affiliation: Neurology Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Portugal.|Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Portugal.
authors.forename: Dulce
authors.initials: D
authors.lastname: Neutel
authors.affiliation: Neurology Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Portugal.|Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Portugal.
authors.forename: Leonor Correia
authors.initials: LC
authors.lastname: Guedes
authors.affiliation: Neurology Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Portugal.|Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Portugal.
authors.forename: Miguel
authors.initials: M
authors.lastname: Coelho
authors.affiliation: Neurology Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Portugal.|Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Portugal.
authors.forename: Mario M
authors.initials: MM
authors.lastname: Rosa
authors.affiliation: Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Ferreira
authors.affiliation: Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Portugal.
authors.forename: Daisy
authors.initials: D
authors.lastname: Abreu
authors.affiliation: Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Portugal.
authors.forename: Nilza
authors.initials: N
authors.lastname: Gonçalves
authors.affiliation: Neurological Imaging Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Portugal.
authors.forename: Carlos
authors.initials: C
authors.lastname: Morgado
authors.affiliation: Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa, Portugal.
authors.forename: Rita G
authors.initials: RG
authors.lastname: Nunes
authors.affiliation: Neurological Imaging Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Portugal.
authors.forename: Jorge
authors.initials: J
authors.lastname: Campos
authors.affiliation: Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Portugal.|Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Portugal.
authors.forename: Joaquim J
authors.initials: JJ
authors.lastname: Ferreira
mesh_terms: D000368:Aged; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008543:Melanins / Q000378:metabolism*; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis* / Q000378:metabolism; D010363:Pattern Recognition, Automated; D012372:ROC Curve; D015203:Reproducibility of Results; D013378:Substantia Nigra / Q000378:metabolism / Q000473:pathology*
chemical_list: D008543:Melanins; C014121:neuromelanin
keywords: MRI; Neuromelanin; Parkinson’s disease; locus ceruleus; substantia nigra