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Diagnostic performance of neuromelanin-sensitive magnetic resonance imaging for patients with Parkinson’s disease and factor analysis for its heterogeneity: a systematic review and meta-analysis

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Abstract

Objective

To determine the diagnostic performance of neuromelanin-sensitive magnetic resonance imaging discriminating between patients with Parkinson’s disease and normal healthy controls and to identify factors causing heterogeneity influencing the diagnostic performance.

Methods

A systematic literature search in the Ovid-MEDLINE and EMBASE databases was performed for studies reporting the relevant topic before February 17, 2020. The pooled sensitivity and specificity values with their 95% confidence intervals were calculated using bivariate random-effects modeling. Subgroup and meta-regression analyses were also performed to determine factors influencing heterogeneity.

Results

Twelve articles including 403 patients with Parkinson’s disease and 298 control participants were included in this systematic review and meta-analysis. Neuromelanin-sensitive magnetic resonance imaging showed a pooled sensitivity of 89% (95% confidence interval, 86–92%) and a pooled specificity of 83% (95% confidence interval, 76–88%). In the subgroup and meta-regression analysis, a disease duration longer than 5 and 10 years, comparisons using measured volumes instead of signal intensities, a slice thickness in terms of magnetic resonance imaging parameters of more than 2 mm, and semi-/automated segmentation methods instead of manual segmentation improved the diagnostic performance.

Conclusion

Neuromelanin-sensitive magnetic resonance imaging had a favorable diagnostic performance in discriminating patients with Parkinson’s disease from healthy controls. To improve diagnostic accuracy, further investigations directly comparing these heterogeneity-affecting factors and optimizing these parameters are necessary.

Key Points

• Neuromelanin-sensitive MRI favorably discriminates patients with Parkinson’s disease from healthy controls.

• Disease duration, parameters used for comparison, magnetic resonance imaging slice thickness, and segmentation methods affected heterogeneity across the studies.

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Abbreviations

HC:

Normal healthy control

HSROC:

Hierarchical summary receiver operating characteristic

LC:

Locus coeruleus

NM-MRI:

Neuromelanin-sensitive MRI

PD:

Parkinson’s disease

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

QUADAS-2:

Quality Assessment of Diagnostic Accuracy Studies-2

SN:

Substantia nigra

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Funding

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT; No. 2019R1F1A1063771) and by the SNUBH Research Fund (Grant No. 09-2019-003).

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea

    Se Jin Cho, Yun Jung Bae, Sung Hyun Baik, Leonard Sunwoo, Byung Se Choi & Jae Hyoung Kim

  2. Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea

    Jong-Min Kim

  3. Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, 75, Bokji-ro, Busanjin-gu, Busan, 47392, Republic of Korea

    Donghyun Kim

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  1. Se Jin Cho
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Correspondence to Yun Jung Bae.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors (Se Jin Cho) has significant statistical expertise.

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Cho, S.J., Bae, Y.J., Kim, JM. et al. Diagnostic performance of neuromelanin-sensitive magnetic resonance imaging for patients with Parkinson’s disease and factor analysis for its heterogeneity: a systematic review and meta-analysis. Eur Radiol 31, 1268–1280 (2021). https://doi.org/10.1007/s00330-020-07240-7

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  • DOI: https://doi.org/10.1007/s00330-020-07240-7

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