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The utility of cerebral perfusion SPECT analysis using SPM8, eZIS and vbSEE for the diagnosis of multiple system atrophy-parkinsonism

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Abstract

Objective

Although a correct diagnosis is important for appropriate management, accurately differentiating between multiple system atrophy with predominant parkinsonism (MSA-P) and Parkinson’s disease (PD) is often difficult because of similarities in the early-stage symptoms. The aim of this study was to evaluate the diagnostic value of cerebral perfusion single photon emission computed tomography (SPECT) and voxel-based analysis for diagnosing MSA-P patients.

Methods

Thirty-eight subjects (9 with early-stage MSA-P, 11 with PD, and 18 controls) were included in this study. Z-scores suggestive of hypoperfusion were calculated between patients and controls using statistical parametric mapping (SPM) 8 and easy Z-score imaging system (eZIS) programs. A voxel-based stereotactic extraction estimation (vbSEE) program was performed to determine the target volumes of interest (VOIs) in the putamen, pons, and cerebellum, and quantify Z-scores as “extent” (the rate of voxels with a Z-score >2.0 in these VOIs) and “severity” (average Z-scores in these VOIs). These parameters were used as the determinant in receiver operating characteristic (ROC) analyses.

Results

The extent and severity of the cerebellar VOIs were higher in MSA-P patients than in PD patients. In ROC analyses, the extent and severity of the cerebellar VOI exhibited the highest areas under the curves of 0.86 and 0.84, and accuracies of 90 and 90 %, respectively.

Conclusions

The diagnostic value of significant cerebellar hypoperfusion was the highest for differentiating MSA-P from PD. This voxel-based analysis of cerebral perfusion SPECT using the SPM8, eZIS, and vbSEE programs is useful for clinically diagnosing MSA-P.

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Acknowledgments

This study was supported in part by a Grant-in-Aid for Scientific Research (Kakenhi C) (24591785; KS).

Ethical standard

We declare that all human and animal studies have been approved by the Ethics Committee for Clinical Research of Nagoya City University Graduate School of Medical Sciences and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that this manuscript does not contain patients’ private information and the privacy of the patients is completely protected.

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Authors and Affiliations

  1. Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan

    Keita Sakurai, Yoshiyuki Ozawa, Masahiro Muto, Motoo Nakagawa & Yuta Shibamoto

  2. Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan

    Etsuko Imabayashi

  3. Department of Diagnostic Radiology, Tokyo Metropolitan Medical Center of Gerontology, Tokyo, Japan

    Kimiteru Ito & Aya M. Tokumaru

  4. Department of Neurology and Neuroscience, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

    Kenji Okita & Noriyuki Matsukawa

Authors
  1. Keita Sakurai
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  2. Etsuko Imabayashi
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  9. Noriyuki Matsukawa
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Correspondence to Keita Sakurai.

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Sakurai, K., Imabayashi, E., Ito, K. et al. The utility of cerebral perfusion SPECT analysis using SPM8, eZIS and vbSEE for the diagnosis of multiple system atrophy-parkinsonism. Ann Nucl Med 29, 206–213 (2015). https://doi.org/10.1007/s12149-014-0928-4

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  • DOI: https://doi.org/10.1007/s12149-014-0928-4

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