Comparison of brain MRI and 18F-FDG PET in the differential diagnosis of multiple system atrophy from Parkinson's disease

• Published in: Movement disorders Vol. 22; no. 16; pp. 2352 - 2358
• Main Authors: Kwon, Kyum-Yil, Choi, Choong G., Kim, Jae S., Lee, Myoung C., Chung, Sun J.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-12-2007; Wiley
• Subjects: 18F-FDG PET; Aged; Biological and medical sciences; Brain - diagnostic imaging; Brain - pathology; Brain Mapping; Diagnosis, Differential; Female; Fluorodeoxyglucose F18; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; MRI; multiple system atrophy; Multiple System Atrophy - diagnosis; Multiple System Atrophy - diagnostic imaging; Multiple System Atrophy - pathology; Neurology; Parkinson Disease - diagnosis; Parkinson Disease - diagnostic imaging; Parkinson Disease - pathology; Parkinson's disease; Positron-Emission Tomography; Predictive Value of Tests; Radiopharmaceuticals; Retrospective Studies; Nervous system diseases; 18F-FDG PET; Parkinson's disease; MRI; Central nervous system; Parkinson disease; Nuclear magnetic resonance imaging; Differential diagnostic; Cerebral disorder; Encephalon; Central nervous system disease; Multiple system atrophy; Degenerative disease; Positron emission tomography; Comparative study; Extrapyramidal syndrome; Positron; Emission tomography
• ISSN: 0885-3185; 1531-8257
• DOI: 10.1002/mds.21714

To investigate the diagnostic value of brain magnetic resonance image (MRI) and 18F‐fluorodeoxyglucose positron emission tomography (18F‐FDG PET) in the differentiation of multiple system atrophy (MSA) from Parkinson's disease (PD). Thirty‐five patients with MSA (23 MSA‐P and 12 MSA‐C) and 17 patients with PD were included in this study. Overall correct diagnosis rates between clinical and imaging diagnosis among MSA‐P, MSA‐C, and PD patients were 80% for visual MRI analysis, 88.5% for visual 18F‐FDG PET analysis, and 84.3% for SPM‐supported analysis of 18F‐FDG PET. The sensitivity of brain MRI, and visual and SPM analysis of 18F‐FDG PET in differentiating MSA from PD was 72.7%, 90.9%, and 95.5%, respectively, the specificity was 100% for each imaging analysis, the positive predictive value was 100% for each imaging analysis, and the negative predictive value was 60%, 81.8%, and 90%, respectively. Our results suggest that brain MRI and 18F‐FDG PET are diagnostically useful in differentiating MSA (MSA‐P and MSA‐C) from PD, and indicate that 18F‐FDG PET has a tendency toward higher sensitivity compared to brain MRI, but a larger longitudinal study including pathological data will be required to confirm our findings. © 2007 Movement Disorder Society