Automatic covariance pattern analysis outperforms visual reading of 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) in variant progressive supranuclear palsy

IF 7.4 1区医学 Q1 CLINICAL NEUROLOGY Movement Disorders Pub Date : 2023-09-01 DOI:10.1002/mds.29581

Ralph Buchert PhD, Florian Wegner MD, Hans-Jürgen Huppertz MD, Georg Berding MD, Matthias Brendel MD, Ivayla Apostolova MD, Carsten Buhmann MD, Alexander Dierks MD, Sabrina Katzdobler MD, Martin Klietz MD, Johannes Levin MD, Nima Mahmoudi MD, Andreas Rinscheid PhD, Sophia Rogozinski MD, Jost-Julian Rumpf MD, Christine Schneider MD, Sophia Stöcklein MD, Phoebe G. Spetsieris PhD, David Eidelberg MD, Mike P. Wattjes MD, PhD, Osama Sabri MD, Henryk Barthel MD, Günter Höglinger MD, for the Alzheimer's Disease Neuroimaging Initiative

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引用次数: 1

Abstract

Background

To date, studies on positron emission tomography (PET) with ¹⁸F-fluorodeoxyglucose (FDG) in progressive supranuclear palsy (PSP) usually included PSP cohorts overrepresenting patients with Richardson's syndrome (PSP-RS).

Objectives

To evaluate FDG-PET in a patient sample representing the broad phenotypic PSP spectrum typically encountered in routine clinical practice.

Methods

This retrospective, multicenter study included 41 PSP patients, 21 (51%) with RS and 20 (49%) with non-RS variants of PSP (vPSP), and 46 age-matched healthy controls. Two state-of-the art methods for the interpretation of FDG-PET were compared: visual analysis supported by voxel-based statistical testing (five readers) and automatic covariance pattern analysis using a predefined PSP-related pattern.

Results

Sensitivity and specificity of the majority visual read for the detection of PSP in the whole cohort were 74% and 72%, respectively. The percentage of false-negative cases was 10% in the PSP-RS subsample and 43% in the vPSP subsample. Automatic covariance pattern analysis provided sensitivity and specificity of 93% and 83% in the whole cohort. The percentage of false-negative cases was 0% in the PSP-RS subsample and 15% in the vPSP subsample.

Conclusions

Visual interpretation of FDG-PET supported by voxel-based testing provides good accuracy for the detection of PSP-RS, but only fair sensitivity for vPSP. Automatic covariance pattern analysis outperforms visual interpretation in the detection of PSP-RS, provides clinically useful sensitivity for vPSP, and reduces the rate of false-positive findings. Thus, pattern expression analysis is clinically useful to complement visual reading and voxel-based testing of FDG-PET in suspected PSP. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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在变异性进行性核上性麻痹中，自动协方差模式分析优于18F-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）的视觉读数

背景迄今为止，18F-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）在进行性核上性麻痹（PSP）中的研究通常包括理查森综合征（PSP-RS）患者的PSP队列。目的评估FDG-PET在代表常规临床实践中常见的广泛表型PSP谱的患者样本中的表现。方法这项回顾性多中心研究包括41名PSP患者，21名（51%）患有RS，20名（49%）患有PSP的非RS变体，以及46名年龄匹配的健康对照。比较了FDG-PET的两种最先进的解释方法：基于体素的统计测试支持的视觉分析（五个阅读器）和使用预定义PSP相关模式的自动协方差模式分析。结果在整个队列中，大多数视觉读数对PSP检测的敏感性和特异性分别为74%和72%。PSP-RS子样本中假阴性病例的百分比为10%，vSP子样本中为43%。在整个队列中，自动协方差模式分析的敏感性和特异性分别为93%和83%。PSP-RS子样本中假阴性病例的百分比为0%，vSP子样本中为15%。结论基于体素检测支持的FDG-PET视觉判读为PSP-RS的检测提供了良好的准确性，但对vSP的敏感性较差。自动协方差模式分析在检测PSP-RS方面优于视觉解释，为vSP提供了临床有用的灵敏度，并降低了假阳性发现率。因此，模式表达分析在临床上有助于补充可疑PSP中FDG-PET的视觉读取和基于体素的测试。©2023作者。Wiley Periodicals LLC代表国际帕金森病和运动障碍协会出版的《运动障碍》。

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来源期刊

Movement Disorders 医学-临床神经学

CiteScore

13.30

自引率

8.10%

发文量

371

审稿时长

12 months

期刊介绍： Movement Disorders publishes a variety of content types including Reviews, Viewpoints, Full Length Articles, Historical Reports, Brief Reports, and Letters. The journal considers original manuscripts on topics related to the diagnosis, therapeutics, pharmacology, biochemistry, physiology, etiology, genetics, and epidemiology of movement disorders. Appropriate topics include Parkinsonism, Chorea, Tremors, Dystonia, Myoclonus, Tics, Tardive Dyskinesia, Spasticity, and Ataxia.