Document Detail


A decision tree for differentiating multiple system atrophy from Parkinson's disease using 3-T MR imaging.
MedLine Citation:
PMID:  23300042     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To develop a decision tree based on standard magnetic resonance imaging (MRI) and diffusion tensor imaging to differentiate multiple system atrophy (MSA) from Parkinson's disease (PD).
METHODS: 3-T brain MRI and DTI (diffusion tensor imaging) were performed on 26 PD and 13 MSA patients. Regions of interest (ROIs) were the putamen, substantia nigra, pons, middle cerebellar peduncles (MCP) and cerebellum. Linear, volumetry and DTI (fractional anisotropy and mean diffusivity) were measured. A three-node decision tree was formulated, with design goals being 100 % specificity at node 1, 100 % sensitivity at node 2 and highest combined sensitivity and specificity at node 3.
RESULTS: Nine parameters (mean width, fractional anisotropy (FA) and mean diffusivity (MD) of MCP; anteroposterior diameter of pons; cerebellar FA and volume; pons and mean putamen volume; mean FA substantia nigra compacta-rostral) showed statistically significant (P < 0.05) differences between MSA and PD with mean MCP width, anteroposterior diameter of pons and mean FA MCP chosen for the decision tree. Threshold values were 14.6 mm, 21.8 mm and 0.55, respectively. Overall performance of the decision tree was 92 % sensitivity, 96 % specificity, 92 % PPV and 96 % NPV. Twelve out of 13 MSA patients were accurately classified.
CONCLUSION: Formation of the decision tree using these parameters was both descriptive and predictive in differentiating between MSA and PD.
KEY POINTS: • Parkinson's disease and multiple system atrophy can be distinguished on MR imaging. • Combined conventional MRI and diffusion tensor imaging improves the accuracy of diagnosis. • A decision tree is descriptive and predictive in differentiating between clinical entities. • A decision tree can reliably differentiate Parkinson's disease from multiple system atrophy.
Authors:
Shalini Rajandran Nair; Li Kuo Tan; Norlisah Mohd Ramli; Shen Yang Lim; Kartini Rahmat; Hazman Mohd Nor
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2013-01-10
Journal Detail:
Title:  European radiology     Volume:  23     ISSN:  1432-1084     ISO Abbreviation:  Eur Radiol     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-17     Completed Date:  2013-12-26     Revised Date:  2014-08-26    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1459-66     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Anisotropy
Brain Mapping / methods
Decision Trees
Diagnosis, Differential
Diffusion Tensor Imaging / methods
Female
Humans
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Multiple System Atrophy / diagnosis*
Observer Variation
Parkinson Disease / diagnosis*
Reproducibility of Results
Sensitivity and Specificity
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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