title: Chemical Exchange Saturation Transfer MR Imaging is Superior to Diffusion-Tensor Imaging in the Diagnosis and Severity Evaluation of Parkinson's Disease: A Study on Substantia Nigra and Striatum.
abstract: Parkinson's disease (PD) is a neurodegenerative disorder characterized by nigrostriatal cell loss. To date, the diagnosis of PD is still based primarily on the clinical manifestations, which may be typical and obvious only in advanced-stage PD. Thus, it is crucial to find a reliable marker for the diagnosis of PD. We conducted this study to assess the diagnostic efficiency of chemical exchange saturation transfer (CEST) imaging and diffusion-tensor imaging (DTI) in PD at 3 T by evaluating changes on substantia nigra and striatum. Twenty-three PD patients and twenty-three age-matched normal controls were recruited. All patients and controls were imaged on a 3-T MR system, using an eight-channel head coil. CEST imaging was acquired in two transverse slices of the head, including substantia nigra and striatum. The magnetization transfer ratio asymmetry at 3.5 ppm, MTRasym(3.5 ppm), and the total CEST signal intensity between 0 and 4 ppm were calculated. Multi-slice DTI was acquired for all the patients and normal controls. Quantitative analysis was performed on the substantia nigra, globus pallidus, putamen, and caudate. The MTRasym(3.5 ppm) value, the total CEST signal intensity, and fractional anisotropy value of the substantia nigra were all significantly lower in PD patients than in normal controls (P = 0.003, P = 0.004, and P < 0.001, respectively). The MTRasym(3.5 ppm) values of the putamen and the caudate were significantly higher in PD patients than in normal controls (P = 0.010 and P = 0.009, respectively). There were no significant differences for the mean diffusivity in these four regions between PD patients and normal controls. In conclusion, CEST MR imaging provided multiple CEST image contrasts in the substantia nigra and the striatum in PD and may be superior to DTI in the diagnosis of PD.
authors.affiliation: Department of Radiology, Beijing Hospital , Beijing , China.
authors.forename: Chunmei
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Radiology, Beijing Hospital , Beijing , China.
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Neurology, Beijing Hospital , Beijing , China.
authors.forename: Haibo
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Neurology, Beijing Hospital , Beijing , China.
authors.forename: Wen
authors.initials: W
authors.lastname: Su
authors.affiliation: Department of Neurology, Beijing Hospital , Beijing , China.
authors.forename: Shuhua
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Radiology, Johns Hopkins University , Baltimore, MD , USA ; Philips Healthcare , Beijing , China.
authors.forename: Xuna
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Radiology, Johns Hopkins University , Baltimore, MD , USA.
authors.forename: Jinyuan
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Radiology, Beijing Hospital , Beijing , China.
authors.forename: Jian
authors.initials: J
authors.lastname: Qiao
authors.affiliation: Department of Radiology, Beijing Hospital , Beijing , China.
authors.forename: Baohui
authors.initials: B
authors.lastname: Lou
authors.affiliation: Department of Radiology, Beijing Hospital , Beijing , China.
authors.forename: Guodong
authors.initials: G
authors.lastname: Song
authors.affiliation: Department of Radiology, Beijing Hospital , Beijing , China.
authors.forename: Min
authors.initials: M
authors.lastname: Chen
keywords: Parkinson’s disease; amide proton transfer; chemical exchange saturation transfer; diffusion-tensor imaging; striatum; substantia nigra