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Superior cerebellar peduncle atrophy of progressive supranuclear palsy on phase difference enhanced imaging: a comparison with Parkinson’s disease

  • Diagnostic Neuroradiology
  • Published:
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Abstract

Purpose

Phase difference enhanced (PADRE) imaging can enhance myelin density and delineate the superior cerebellar peduncle (SCP). We aimed to determine if SCP atrophy was distinguishable on PADRE imaging and evaluate its diagnostic performance compared with previous MRI progressive supranuclear palsy (PSP) findings.

Methods

Two reviewers measured the SCP widths on PADRE in 20 PSP and 31 Parkinson’s disease (PD) patients. The SCP and middle cerebellar peduncle (MCP) widths and the pons and midbrain areas were measured on 3D-T1WI, and the ratio of the area of the pons to the area of the midbrain, the MCP/SCP ratio, and the magnetic resonance parkinsonism index (MRPI) were calculated. We used the Steel–Dwass test to compare PSP, PD, and HS, and receiver operating characteristic curve (ROC) analyses to assess the sensitivity and specificity for diagnosing PSP from PD. A comparison of ROC curves was performed between the SCP on PADRE and these 3D-T1WI parameters.

Results

In radiologist 1, the SCP on PADRE in PSP (1.1 ± 0.3 mm) was significantly smaller than those in PD (2.4 ± 0.4 mm) (P < 0.001); the area under the curve (AUC) was 0.97. At a 1.75-mm cutoff value, the diagnostic sensitivity and specificity for differentiating PSP from PD were 93.5% and 100%, respectively. The AUC of the SCP on PADRE was significantly higher than the 3D-T1WI parameters (the SCP, MCP, pons area, MCP/SCP ratio, and MRPI).

Conclusion

Assessing SCP with PADRE imaging may yield high diagnostic accuracy for discriminating PSP from PD.

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Data availability

The datasets generated and/or analyzed during the current study are not publicly available due to the anonymity of the patients but are available from the corresponding author at reasonable request.

Abbreviations

HS:

Healthy subjects

MCP:

Middle cerebellar peduncles

MRPI:

The magnetic resonance parkinsonism index

MSA:

Multiple system atrophy

PADRE:

Phase difference enhanced imaging

PD:

Parkinson’s disease

P/M ratio:

The area of the pons to the area of the midbrain

PSP:

Progressive supranuclear palsy

PSP-CBS:

PSP-corticobasal syndrome

PSP-PGF:

PSP-progressive gait freezing

PSP-P:

PSP-parkinsonism

PSP-RS:

PSP-Richardson’s syndrome (PSP-RS)

SCP:

Superior cerebellar peduncle

TE:

Echo times

3D-T1W1:

Three-dimensional T1-weighted images

vPSP:

Variant PSP phenotypes

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Authors and Affiliations

  1. Department of Radiology, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-Ku, Kitakyushu, Fukuoka, 807-8555, Japan

    Mari Miyata, Satoru Ide & Yukunori Korogi

  2. Department of Radiology, Hirosaki University Graduate School of Medicine, Aomori, Japan

    Shingo Kakeda

  3. Department of Medical Physics in Advanced Biomedical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan

    Tetsuya Yoneda

  4. Department of Neurology, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan

    Kazumasa Okada & Hiroaki Adachi

Authors
  1. Mari Miyata
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  2. Shingo Kakeda
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  3. Tetsuya Yoneda
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  4. Satoru Ide
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  5. Kazumasa Okada
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  6. Hiroaki Adachi
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  7. Yukunori Korogi
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Contributions

M.M., S.K., and Y.K. planned and designed the study and wrote the manuscript. T.Y. and S.I. analyzed the data. H.A. and K.O. collected study participants and clinical date. All authors reviewed the manuscript.

Corresponding author

Correspondence to Mari Miyata.

Ethics declarations

Conflict of interest

This work was supported in part by grants-in-aid from the Japan Society for the Promotion of Science (JSPS) KAKENHI 19K17182 to Mari Miyata (managed at Juntendo University).

Ethics approval

This study protocol was approved by the Institutional Review Board at the University of Occupational and Environmental Health School of Medicine (Kitakyushu, Fukuoka, Japan, UOEHCRB22-013) and was conducted in accordance with the Declaration of Helsinki. Imaging and clinical data were retrospectively acquired from 20 patients with PSP, 31 patients with PD and 20 healthy subjects.

Informed consent

The Ethics Committee of the University of Occupational and Environmental Health granted a permission to use the retrospective data in the study without individual informed consent.

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Miyata, M., Kakeda, S., Yoneda, T. et al. Superior cerebellar peduncle atrophy of progressive supranuclear palsy on phase difference enhanced imaging: a comparison with Parkinson’s disease. Neuroradiology 65, 719–727 (2023). https://doi.org/10.1007/s00234-023-03119-8

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  • DOI: https://doi.org/10.1007/s00234-023-03119-8

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