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<meta name="DC.Title" content="Nigrosome 1 Detection at 3T MRI for the Diagnosis of Early-Stage Idiopathic Parkinson Disease: Assessment of Diagnostic Accuracy and Agreement on Imaging Asymmetry and Clinical Laterality" />
<meta name="DC.Identifier" content="10.3174/ajnr.A4412" />
<meta name="DC.Date" content="2015-11-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: In the early stages of idiopathic Parkinson disease, motor symptoms are usually asymmetric. We aimed to assess the feasibility of nigrosome 1 detection at 3T MR imaging to analyze the agreement of its asymmetry and clinical laterality.

MATERIALS AND METHODS: High-resolution 3D multiecho imaging was performed at 3T MR imaging in 13 healthy subjects and 24 patients with idiopathic Parkinson disease confirmed by N-3-fluoropropyl-2-β-carbomethoxy-3-β-(4-iodophenyl) nortropane (18F-FP-CIT) PET. The nigrosome 1 detection findings by using the MR imaging data were rated as “normal,” “possibly abnormal,” and “abnormal” by 2 independent reviewers. The degree of 18F-FP-CIT binding was visually assessed in the caudate nucleus and putamen on PET images. Clinical laterality was evaluated by scores of the Unified Parkinson Disease Rating Scale, Part III. Asymmetry of the affected nigrosome 1 and the degree of 18F-FP-CIT binding were analyzed for agreement with clinical laterality.

RESULTS: The diagnostic sensitivity, specificity, and accuracy of the nigrosome 1 detection at 3T MR imaging was 100%, 84.6%, and 94.6%, respectively. Interrater agreements for the abnormality and asymmetry of nigrosome 1 were excellent (κ = 0.863 and 0.835, respectively). In patients with idiopathic Parkinson disease, the agreement of asymmetry between clinical laterality and nigrosome 1 detection was good (κ = 0.724). The degree of the 18F-FP-CIT PET binding showed fair agreement (κ = 0.235) with clinical laterality.

CONCLUSIONS: The abnormality involving nigrosome 1 can be detected at 3T MR imaging with an accuracy of 94.6%. The clinical laterality is in high concordance with the laterality of the nigrosome 1 detection at 3T (κ = 0.724).

DAT
:   dopamine transporter
18F-FP-CIT
:   N-3-fluoropropyl-2-β-carbomethoxy-3-β-(4-iodophenyl) nortropane
H&amp;Y
:   Hoehn and Yahr stage
IPD
:   idiopathic Parkinson disease
MEDIC
:   multiecho data image combination
UPDRS III
:   Unified Parkinson Disease Rating Scale, Part III" />
<meta name="DC.Contributor" content="Y. Noh" />
<meta name="DC.Contributor" content="Y.H. Sung" />
<meta name="DC.Contributor" content="J. Lee" />
<meta name="DC.Contributor" content="E.Y. Kim" />
<meta name="article:published_time" content="2015-11-01" />
<meta name="article:section" content="ADULT BRAIN" />
<meta name="citation_title" content="Nigrosome 1 Detection at 3T MRI for the Diagnosis of Early-Stage Idiopathic Parkinson Disease: Assessment of Diagnostic Accuracy and Agreement on Imaging Asymmetry and Clinical Laterality" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;In the early stages of idiopathic Parkinson disease, motor symptoms are usually asymmetric. We aimed to assess the feasibility of nigrosome 1 detection at 3T MR imaging to analyze the agreement of its asymmetry and clinical laterality.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;High-resolution 3D multiecho imaging was performed at 3T MR imaging in 13 healthy subjects and 24 patients with idiopathic Parkinson disease confirmed by N-3-fluoropropyl-2-β-carbomethoxy-3-β-(4-iodophenyl) nortropane (&lt;sup&gt;18&lt;/sup&gt;F-FP-CIT) PET. The nigrosome 1 detection findings by using the MR imaging data were rated as “normal,” “possibly abnormal,” and “abnormal” by 2 independent reviewers. The degree of &lt;sup&gt;18&lt;/sup&gt;F-FP-CIT binding was visually assessed in the caudate nucleus and putamen on PET images. Clinical laterality was evaluated by scores of the Unified Parkinson Disease Rating Scale, Part III. Asymmetry of the affected nigrosome 1 and the degree of &lt;sup&gt;18&lt;/sup&gt;F-FP-CIT binding were analyzed for agreement with clinical laterality.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;The diagnostic sensitivity, specificity, and accuracy of the nigrosome 1 detection at 3T MR imaging was 100%, 84.6%, and 94.6%, respectively. Interrater agreements for the abnormality and asymmetry of nigrosome 1 were excellent (κ = 0.863 and 0.835, respectively). In patients with idiopathic Parkinson disease, the agreement of asymmetry between clinical laterality and nigrosome 1 detection was good (κ = 0.724). The degree of the &lt;sup&gt;18&lt;/sup&gt;F-FP-CIT PET binding showed fair agreement (κ = 0.235) with clinical laterality.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;The abnormality involving nigrosome 1 can be detected at 3T MR imaging with an accuracy of 94.6%. The clinical laterality is in high concordance with the laterality of the nigrosome 1 detection at 3T (κ = 0.724).&lt;/p&gt;" />
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<meta name="twitter:title" content="Nigrosome 1 Detection at 3T MRI for the Diagnosis of Early-Stage Idiopathic Parkinson Disease: Assessment of Diagnostic Accuracy and Agreement on Imaging Asymmetry and Clinical Laterality" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: In the early stages of idiopathic Parkinson disease, motor symptoms are usually asymmetric. We aimed to assess the feasibility of nigrosome 1 detection at 3T MR imaging to analyze the agreement of its asymmetry and clinical laterality.

MATERIALS AND METHODS: High-resolution 3D multiecho imaging was performed at 3T MR imaging in 13 healthy subjects and 24 patients with idiopathic Parkinson disease confirmed by N-3-fluoropropyl-2-β-carbomethoxy-3-β-(4-iodophenyl) nortropane (18F-FP-CIT) PET. The nigrosome 1 detection findings by using the MR imaging data were rated as “normal,” “possibly abnormal,” and “abnormal” by 2 independent reviewers. The degree of 18F-FP-CIT binding was visually assessed in the caudate nucleus and putamen on PET images. Clinical laterality was evaluated by scores of the Unified Parkinson Disease Rating Scale, Part III. Asymmetry of the affected nigrosome 1 and the degree of 18F-FP-CIT binding were analyzed for agreement with clinical laterality.

RESULTS: The diagnostic sensitivity, specificity, and accuracy of the nigrosome 1 detection at 3T MR imaging was 100%, 84.6%, and 94.6%, respectively. Interrater agreements for the abnormality and asymmetry of nigrosome 1 were excellent (κ = 0.863 and 0.835, respectively). In patients with idiopathic Parkinson disease, the agreement of asymmetry between clinical laterality and nigrosome 1 detection was good (κ = 0.724). The degree of the 18F-FP-CIT PET binding showed fair agreement (κ = 0.235) with clinical laterality.

CONCLUSIONS: The abnormality involving nigrosome 1 can be detected at 3T MR imaging with an accuracy of 94.6%. The clinical laterality is in high concordance with the laterality of the nigrosome 1 detection at 3T (κ = 0.724).

DAT
:   dopamine transporter
18F-FP-CIT
:   N-3-fluoropropyl-2-β-carbomethoxy-3-β-(4-iodophenyl) nortropane
H&amp;Y
:   Hoehn and Yahr stage
IPD
:   idiopathic Parkinson disease
MEDIC
:   multiecho data image combination
UPDRS III
:   Unified Parkinson Disease Rating Scale, Part III" />
<meta name="og-title" property="og:title" content="Nigrosome 1 Detection at 3T MRI for the Diagnosis of Early-Stage Idiopathic Parkinson Disease: Assessment of Diagnostic Accuracy and Agreement on Imaging Asymmetry and Clinical Laterality" />
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<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: In the early stages of idiopathic Parkinson disease, motor symptoms are usually asymmetric. We aimed to assess the feasibility of nigrosome 1 detection at 3T MR imaging to analyze the agreement of its asymmetry and clinical laterality.

MATERIALS AND METHODS: High-resolution 3D multiecho imaging was performed at 3T MR imaging in 13 healthy subjects and 24 patients with idiopathic Parkinson disease confirmed by N-3-fluoropropyl-2-β-carbomethoxy-3-β-(4-iodophenyl) nortropane (18F-FP-CIT) PET. The nigrosome 1 detection findings by using the MR imaging data were rated as “normal,” “possibly abnormal,” and “abnormal” by 2 independent reviewers. The degree of 18F-FP-CIT binding was visually assessed in the caudate nucleus and putamen on PET images. Clinical laterality was evaluated by scores of the Unified Parkinson Disease Rating Scale, Part III. Asymmetry of the affected nigrosome 1 and the degree of 18F-FP-CIT binding were analyzed for agreement with clinical laterality.

RESULTS: The diagnostic sensitivity, specificity, and accuracy of the nigrosome 1 detection at 3T MR imaging was 100%, 84.6%, and 94.6%, respectively. Interrater agreements for the abnormality and asymmetry of nigrosome 1 were excellent (κ = 0.863 and 0.835, respectively). In patients with idiopathic Parkinson disease, the agreement of asymmetry between clinical laterality and nigrosome 1 detection was good (κ = 0.724). The degree of the 18F-FP-CIT PET binding showed fair agreement (κ = 0.235) with clinical laterality.

CONCLUSIONS: The abnormality involving nigrosome 1 can be detected at 3T MR imaging with an accuracy of 94.6%. The clinical laterality is in high concordance with the laterality of the nigrosome 1 detection at 3T (κ = 0.724).

DAT
:   dopamine transporter
18F-FP-CIT
:   N-3-fluoropropyl-2-β-carbomethoxy-3-β-(4-iodophenyl) nortropane
H&amp;Y
:   Hoehn and Yahr stage
IPD
:   idiopathic Parkinson disease
MEDIC
:   multiecho data image combination
UPDRS III
:   Unified Parkinson Disease Rating Scale, Part III" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node14288--5" data-node-nid="14288" id="top-node-14288--6817999752" data-pisa="ajnr;36/11/2010" data-pisa-master="ajnr;ajnr.A4412" data-apath="/ajnr/36/11/2010.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">ADULT BRAIN</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Nigrosome 1 Detection at 3T MRI for the Diagnosis of Early-Stage Idiopathic Parkinson Disease: Assessment of Diagnostic Accuracy and Agreement on Imaging Asymmetry and Clinical Laterality</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Y. Noh</span>, <span class="highwire-citation-author" data-delta="1">Y.H. Sung</span>, <span class="highwire-citation-author" data-delta="2">J. Lee</span> and <span class="highwire-citation-author" data-delta="3">E.Y. Kim</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">November 2015,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">36 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">2010-2016; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4412 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-14288--6817999752" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Y. Noh </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Neurology (Y.N., Y.H.S.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Y.%2BNoh%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Noh%20Y&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AY.%2BNoh%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Y.H. Sung </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Neurology (Y.N., Y.H.S.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Y.H.%2BSung%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Sung%20Y&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AY.H.%2BSung%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">J. Lee </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Electrical and Computer Engineering (Jongho Lee), Seoul National University, Seoul, Korea.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.%2BLee%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lee%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJ.%2BLee%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">E.Y. Kim </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Radiology (E.Y.K.), Gachon University Gil Medical Center, Incheon, Korea</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=E.Y.%2BKim%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kim%20E&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AE.Y.%2BKim%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-9579-4098" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for E.Y. Kim</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-2"><h2>Abstract</h2><div id="sec-1" class="subsection"><p id="p-3"><strong>BACKGROUND AND PURPOSE:</strong> In the early stages of idiopathic Parkinson disease, motor symptoms are usually asymmetric. We aimed to assess the feasibility of nigrosome 1 detection at 3T MR imaging to analyze the agreement of its asymmetry and clinical laterality.</p></div><div id="sec-2" class="subsection"><p id="p-4"><strong>MATERIALS AND METHODS:</strong> High-resolution 3D multiecho imaging was performed at 3T MR imaging in 13 healthy subjects and 24 patients with idiopathic Parkinson disease confirmed by N-3-fluoropropyl-2-β-carbomethoxy-3-β-(4-iodophenyl) nortropane (<sup>18</sup>F-FP-CIT) PET. The nigrosome 1 detection findings by using the MR imaging data were rated as “normal,” “possibly abnormal,” and “abnormal” by 2 independent reviewers. The degree of <sup>18</sup>F-FP-CIT binding was visually assessed in the caudate nucleus and putamen on PET images. Clinical laterality was evaluated by scores of the Unified Parkinson Disease Rating Scale, Part III. Asymmetry of the affected nigrosome 1 and the degree of <sup>18</sup>F-FP-CIT binding were analyzed for agreement with clinical laterality.</p></div><div id="sec-3" class="subsection"><p id="p-5"><strong>RESULTS:</strong> The diagnostic sensitivity, specificity, and accuracy of the nigrosome 1 detection at 3T MR imaging was 100%, 84.6%, and 94.6%, respectively. Interrater agreements for the abnormality and asymmetry of nigrosome 1 were excellent (κ = 0.863 and 0.835, respectively). In patients with idiopathic Parkinson disease, the agreement of asymmetry between clinical laterality and nigrosome 1 detection was good (κ = 0.724). The degree of the <sup>18</sup>F-FP-CIT PET binding showed fair agreement (κ = 0.235) with clinical laterality.</p></div><div id="sec-4" class="subsection"><p id="p-6"><strong>CONCLUSIONS:</strong> The abnormality involving nigrosome 1 can be detected at 3T MR imaging with an accuracy of 94.6%. The clinical laterality is in high concordance with the laterality of the nigrosome 1 detection at 3T (κ = 0.724).</p></div></div><div class="section glossary" id="glossary-1"><h2 class="">ABBREVIATIONS:</h2><dl id="def-list-1"><dt id="def-item-1">DAT<span class="def-item-dt-sep"></span></dt><dd>dopamine transporter<span class="def-item-dd-sep"></span></dd><dt id="def-item-2"><sup>18</sup>F-FP-CIT<span class="def-item-dt-sep"></span></dt><dd>N-3-fluoropropyl-2-β-carbomethoxy-3-β-(4-iodophenyl) nortropane<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">H&amp;Y<span class="def-item-dt-sep"></span></dt><dd>Hoehn and Yahr stage<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">IPD<span class="def-item-dt-sep"></span></dt><dd>idiopathic Parkinson disease<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">MEDIC<span class="def-item-dt-sep"></span></dt><dd>multiecho data image combination<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">UPDRS III<span class="def-item-dt-sep"></span></dt><dd>Unified Parkinson Disease Rating Scale, Part III</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2015 by American Journal of Neuroradiology</li></ul><div class="license" id="license-1"><p id="p-1">Indicates open access to non-subscribers at <a href="http://www.ajnr.org" rel="license">www.ajnr.org</a></p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/36/11/2010.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 36</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 11 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Nov 2015 </div></div>
      
      
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