Differentiation between Parkinson disease and other forms of Parkinsonism using support vector machine analysis of susceptibility-weighted imaging (SWI): initial results

Objectives: To diagnose Parkinson disease (PD) at the individual level using pattern recognition of brain susceptibility-weighted imaging (SWI). Methods: We analysed brain SWI in 36 consecutive patients with Parkinsonism suggestive of PD who had (1) SWI at 3T, (2) brain 123I-ioflupane SPECT and (3) extensive neurological testing including follow-up (16 PD, 67.4 ± 6.2years, 11 female; 20 OTHER, a heterogeneous group of atypical Parkinsonism syndromes 65.2 ± 12.5years, 6 female). Analysis included group-level comparison of SWI values and individual-level support vector machine (SVM) analysis. Results: At the group level, simple visual analysis yielded no differences between groups. However, the group-level analyses demonstrated increased SWI in the bilateral thalamus and left substantia nigra in PD patients versus other Parkinsonism. The inverse comparison yielded no supra-threshold clusters. At the individual level, SVM correctly classified PD patients with an accuracy above 86%. Conclusions: SVM pattern recognition of SWI data provides accurate discrimination of PD among patients with various forms of Parkinsonism at an individual level, despite the absence of visually detectable alterations. This pilot study warrants further confirmation in a larger cohort of PD patients and with different MR machines and MR parameters. Key Points: • Magnetic resonance imaging data offers new insights into Parkinson's disease • Visual susceptibility-weighted imaging (SWI) analysis could not discriminate idiopathic from atypical PD • However, support vector machine (SVM) analysis provided highly accurate detection of idiopathic PD • SVM analysis may contribute to the clinical diagnosis of individual PD patients • Such information can be readily obtained from routine MR dat

Neuroimaging of acute and chronic unilateral and bilateral thalamic lesions

Abstract The thalami are bilateral ovoid grey matter cerebral structures bordering the third ventricle on both sides, which participate in functions such as relaying of sensory and motor signals, regulation of consciousness, and alertness. Pathologies affecting the thalami can be of neoplastic, infectious, vascular, toxic, metabolic, or congenital origin. The purpose of this review is to provide a comprehensive approach to the thalamus focusing on its anatomy, the main pathologies affecting this structure and their radiological semiology on CT and MRI. We will also illustrate the importance of multimodal MR imaging (morphologic sequences, diffusion-weighted imaging, perfusion, spectroscopy) for the diagnosis and treatment of these conditions

Evaluation of electrode position in deep brain stimulation by image fusion (MRI and CT)

Introduction: Imaging has an essential role in the evaluation of correct positioning of electrodes implanted for deep brain stimulation (DBS). Although MRI offers superior anatomic visualization of target sites, there are safety concerns in patients with implanted material; imaging guidelines are inconsistent and vary. The fusion of postoperative CT with preoperative MRI images can be an alternative for the assessment of electrode positioning. The purpose of this study was to assess the accuracy of measurements realized on fused images (acquired without a stereotactic frame) using a manufacturer-provided software. Methods: Data from 23 Parkinson's disease patients who underwent bilateral electrode placement for subthalamic nucleus (STN) DBS were acquired. Preoperative high-resolution T2-weighted sequences at 3T, and postoperative CT series were fused using a commercially available software. Electrode tip position was measured on the obtained images in three directions (in relation to the midline, the AC-PC line and an AC-PC line orthogonal, respectively) and assessed in relation to measures realized on postoperative 3D T1 images acquired at 1.5T. Results: Mean differences between measures carried out on fused images and on postoperative MRI lay between 0.17 and 0.97mm. Conclusion: Fusion of CT and MRI images provides a safe and fast technique for postoperative assessment of electrode position in DBS

Erratum to: State-of-the-art MRI techniques in neuroradiology: principles, pitfalls, and clinical applications

International audienceThis article reviews the most relevant state-of-the-art magnetic resonance (MR) techniques, which are clinically available to investigate brain diseases. MR acquisition techniques addressed include notably diffusion imaging (diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), and diffusion kurtosis imaging (DKI)) as well as perfusion imaging (dynamic susceptibility contrast (DSC), arterial spin labeling (ASL), and dynamic contrast enhanced (DCE)). The underlying models used to process these images are described, as well as the theoretic underpinnings of quantitative diffusion and perfusion MR imaging-based methods. The technical requirements and how they may help to understand, classify, or follow-up neurological pathologies are briefly summarized. Techniques, principles, advantages but also intrinsic limitations, typical artifacts, and alternative solutions developed to overcome them are discussed. In this article, we also review routinely available three-dimensional (3D) techniques in neuro MRI, including state-of-the-art and emerging angiography sequences, and briefly introduce more recently proposed 3D quantitative neuro-anatomy sequences, and new technology, such as multi-slice and multi-transmit imaging