Se Jin Cho1, Yun Jung Bae2, Jong-Min Kim3, Hyun Jin Kim4, Sung Hyun Baik1, Leonard Sunwoo1, Byung Se Choi1, Cheolkyu Jung1, Jae Hyoung Kim1. 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. 2. 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. bae729@gmail.com. 3. 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. 4. Department of Radiology, Daejin Medical Center, Bundang Jesaeng General Hospital, Seongnam, Gyeonggi, Republic of Korea.
Abstract
OBJECTIVE: To evaluate the diagnostic performance of iron-sensitive sequences targeting the substantia nigra for distinguishing patients with Parkinson's disease from control participants and to identify factors causing heterogeneity. METHODS: A systematic literature search in the Ovid-MEDLINE and EMBASE databases was performed for studies reporting the relevant topic before March 6, 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 affecting the diagnostic performance among the clinical, MRI, and analytic characteristics. RESULTS: A total of 22 articles including 1126 patients with Parkinson's disease and 933 control participants were enrolled in this systematic review and meta-analysis. Of those, 12 studies used objective analyses of quantitative susceptibility measurements, and 10 visually assessed the nigrosome-1 in subjective analyses. Iron-sensitive nigral magnetic resonance imaging showed a pooled sensitivity of 92% (95% confidence interval 88-95%) and a pooled specificity of 90% (95% confidence interval 81-95%). According to subgroup and meta-regression analyses, a longer mean disease duration in patients with Parkinson's disease (≥ 5 years), subjective analysis, a smaller size of pixel (< 0.6 mm2), a larger flip angle (> 15°), a smaller slice thickness (≤ 1 mm), and specific targeting of the substantia nigra pars compacta improved the diagnostic performance. CONCLUSION: Iron-sensitive nigral magnetic resonance imaging had a favorable diagnostic performance in discriminating patients with Parkinson's disease from control participants. Subjective analytic methods remain superior to objective approaches. Further improvements of the spatial resolution and contrast-to-noise ratio to specifically target the nigrosome-1 with objective analytic methods will be needed.
OBJECTIVE: To evaluate the diagnostic performance of iron-sensitive sequences targeting the substantia nigra for distinguishing patients with Parkinson's disease from control participants and to identify factors causing heterogeneity. METHODS: A systematic literature search in the Ovid-MEDLINE and EMBASE databases was performed for studies reporting the relevant topic before March 6, 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 affecting the diagnostic performance among the clinical, MRI, and analytic characteristics. RESULTS: A total of 22 articles including 1126 patients with Parkinson's disease and 933 control participants were enrolled in this systematic review and meta-analysis. Of those, 12 studies used objective analyses of quantitative susceptibility measurements, and 10 visually assessed the nigrosome-1 in subjective analyses. Iron-sensitive nigral magnetic resonance imaging showed a pooled sensitivity of 92% (95% confidence interval 88-95%) and a pooled specificity of 90% (95% confidence interval 81-95%). According to subgroup and meta-regression analyses, a longer mean disease duration in patients with Parkinson's disease (≥ 5 years), subjective analysis, a smaller size of pixel (< 0.6 mm2), a larger flip angle (> 15°), a smaller slice thickness (≤ 1 mm), and specific targeting of the substantia nigra pars compacta improved the diagnostic performance. CONCLUSION:Iron-sensitive nigral magnetic resonance imaging had a favorable diagnostic performance in discriminating patients with Parkinson's disease from control participants. Subjective analytic methods remain superior to objective approaches. Further improvements of the spatial resolution and contrast-to-noise ratio to specifically target the nigrosome-1 with objective analytic methods will be needed.
Entities:
Keywords:
Magnetic resonance imaging; Meta-analysis; Parkinson disease; Systematic review
Authors: S F Calloni; G Conte; S Sbaraini; R Cilia; V E Contarino; S Avignone; G Sacilotto; G Pezzoli; F M Triulzi; E Scola Journal: Eur J Radiol Date: 2018-11-01 Impact factor: 3.528
Authors: Yun Jung Bae; Jong-Min Kim; Eunhee Kim; Kyung Mi Lee; Seo Young Kang; Hyun Soo Park; Kyeong Joon Kim; Young Eun Kim; Eung Seok Oh; Ji Young Yun; Ji Seon Kim; Hye-Jin Jeong; Beomseok Jeon; Sang Eun Kim Journal: Mov Disord Date: 2016-03-17 Impact factor: 10.338
Authors: M Azuma; T Hirai; K Yamada; S Yamashita; Y Ando; M Tateishi; Y Iryo; T Yoneda; M Kitajima; Y Wang; Y Yamashita Journal: AJNR Am J Neuroradiol Date: 2016-01-28 Impact factor: 3.825
Authors: Walter L Devillé; Frank Buntinx; Lex M Bouter; Victor M Montori; Henrica C W de Vet; Danielle A W M van der Windt; P Dick Bezemer Journal: BMC Med Res Methodol Date: 2002-07-03 Impact factor: 4.615
Authors: Yun Jung Bae; Jong-Min Kim; Byung Se Choi; Yoo Sung Song; Yoonho Nam; Se Jin Cho; Jae Hyoung Kim; Sang Eun Kim Journal: Taehan Yongsang Uihakhoe Chi Date: 2022-05-25