Journal Article

DZNE-2025-00977

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Added value of FDG-PET for detection of progressive supranuclear palsy.

Buchert, R. ; Huppertz, H.-J. ; Wegner, F. ; Berding, G. ; Brendel, M.DZNE* ; Apostolova, I. ; Buhmann, C. ; Poetter-Nerger, M. ; Dierks, A. ; Katzdobler, S.DZNE* ; Klietz, M. ; Levin, J.DZNE* ; Mahmoudi, N. ; Rinscheid, A. ; Quattrone, A.Extern* ; Rogozinski, S. ; Rumpf, J.-J. ; Schneider, C. ; Stöcklein, S.Extern* ; Spetsieris, P. G. ; Eidelberg, D. ; Sabri, O.Extern* ; Barthel, H. ; Wattjes, M. P. ; Höglinger, G. (Last author)DZNE* ; Initiative, A. D. N. (Collaboration Author)

2025
BMJ Publishing Group London

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Please use a persistent id in citations: doi:10.1136/jnnp-2024-333590

Abstract: Diagnostic criteria for progressive supranuclear palsy (PSP) include midbrain atrophy in MRI and hypometabolism in [18F]fluorodeoxyglucose (FDG)-positron emission tomography (PET) as supportive features. Due to limited data regarding their relative and sequential value, there is no recommendation for an algorithm to combine both modalities to increase diagnostic accuracy. This study evaluated the added value of sequential imaging using state-of-the-art methods to analyse the images regarding PSP features.The retrospective study included 41 PSP patients, 21 with Richardson's syndrome (PSP-RS), 20 with variant PSP phenotypes (vPSP) and 46 sex- and age-matched healthy controls. A pretrained support vector machine (SVM) for the classification of atrophy profiles from automatic MRI volumetry was used to analyse T1w-MRI (output: MRI-SVM-PSP score). Covariance pattern analysis was applied to compute the expression of a predefined PSP-related pattern in FDG-PET (output: PET-PSPRP expression score).The area under the receiver operating characteristic curve for the detection of PSP did not differ between MRI-SVM-PSP and PET-PSPRP expression score (p≥0.63): about 0.90, 0.95 and 0.85 for detection of all PSP, PSP-RS and vPSP. The MRI-SVM-PSP score achieved about 13% higher specificity and about 15% lower sensitivity than the PET-PSPRP expression score. Decision tree models selected the MRI-SVM-PSP score for the first branching and the PET-PSPRP expression score for a second split of the subgroup with normal MRI-SVM-PSP score, both in the whole sample and when restricted to PSP-RS or vPSP.FDG-PET provides added value for PSP-suspected patients with normal/inconclusive T1w-MRI, regardless of PSP phenotype and the methods to analyse the images for PSP-typical features.

Keyword(s): Humans (MeSH) ; Supranuclear Palsy, Progressive: diagnostic imaging (MeSH) ; Supranuclear Palsy, Progressive: pathology (MeSH) ; Female (MeSH) ; Male (MeSH) ; Positron-Emission Tomography: methods (MeSH) ; Fluorodeoxyglucose F18 (MeSH) ; Aged (MeSH) ; Magnetic Resonance Imaging (MeSH) ; Retrospective Studies (MeSH) ; Middle Aged (MeSH) ; Support Vector Machine (MeSH) ; Radiopharmaceuticals (MeSH) ; Brain: diagnostic imaging (MeSH) ; Brain: pathology (MeSH) ; Atrophy (MeSH) ; IMAGE ANALYSIS ; MOVEMENT DISORDERS ; MRI ; PET ; SUPRANUCLEAR PALSY ; Fluorodeoxyglucose F18 ; Radiopharmaceuticals

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Contributing Institute(s):

1. Molecular Neurodegeneration (AG Haass)
2. Clinical Research (Munich) (Clinical Research (Munich))
3. Clinical Neurodegeneration (AG Levin)

Research Program(s):

1. 352 - Disease Mechanisms (POF4-352) (POF4-352)
2. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2025

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Database coverage:
; ; ; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 10 ; JCR ; National-Konsortium ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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