Classification of patients with parkinsonian syndromes using medical imaging and artificial intelligence algorithms

Abstract

The distinction of Parkinsonian Syndromes (PS) is challenging due to similarities of symptoms and signs at early stages of disease. Thus, the need of accurate methods for differential diagnosis at those early stages has emerged. To improve the evaluation of medical images, artificial intelligence turns out to be a useful tool. Parkinson’s Disease, the commonest PS, is characterized by the degeneration of dopamine neurons in the substantia nigra which is detected by the dopamine transporter scan (DaTscanTM), a single photon-emission tomography (SPECT) exam that uses of a radiotracer that binds dopamine receptors. In fact, by using such exam it was possible to identify a sub-group of PD patients known as “Scans without evidence of dopaminergic deficit” (SWEDD) that present a normal exam, unlike PD patients. In this study, an approach based on Convolutional Neural Networks (CNNs) was proposed for classifying PD patients, SWEDD patients and healthy subjects using SPECT and Magnetic Resonance Imaging (MRI) images. Then, these images were divided into subsets of slices in the axial view that contains particular regions of interest since 2D images are the norm in clinical practice. The classifier evaluation was performed with Cohen’s Kappa and Receiver Operating Characteristic (ROC) curve. The results obtained allow to conclude that the CNN using imaging information of the Basal Ganglia and the mesencephalon was able to distinguish PD patients from healthy subjects since achieved 97.4% accuracy using MRI and 92.4% accuracy using SPECT, and PD from SWEDD with 97.3% accuracy using MRI and 93.3% accuracy using SPECT. Nonetheless, using the same approach, it was not possible to discriminate SWEDD patients from healthy subjects (60% accuracy) using DaTscanTM and MRI. These results allow to conclude that this approach may be a useful tool to aid in PD diagnosis in the future

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