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

Authors

  • Kyum-Yil Kwon MD,

    1. Center for Parkinsonism and Other Movement Disorders, Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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  • Choong G. Choi MD,

    1. Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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  • Jae S. Kim MD,

    1. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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  • Myoung C. Lee MD,

    1. Center for Parkinsonism and Other Movement Disorders, Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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  • Sun J. Chung MD

    Corresponding author
    1. Center for Parkinsonism and Other Movement Disorders, Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
    • Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap-dong, Songpa-gu, Seoul 138-736, South Korea
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Abstract

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

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