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Research ArticleBrain

Usefulness of Quantitative Susceptibility Mapping for the Diagnosis of Parkinson Disease

Y. Murakami, S. Kakeda, K. Watanabe, I. Ueda, A. Ogasawara, J. Moriya, S. Ide, K. Futatsuya, T. Sato, K. Okada, T. Uozumi, S. Tsuji, T. Liu, Y. Wang and Y. Korogi
American Journal of Neuroradiology June 2015, 36 (6) 1102-1108; DOI: https://doi.org/10.3174/ajnr.A4260
Y. Murakami
aFrom the Departments of Radiology (Y.M., S.K., K.W., I.U., A.O., J.M., S.I., K.F., T.S., Y.K.)
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S. Kakeda
aFrom the Departments of Radiology (Y.M., S.K., K.W., I.U., A.O., J.M., S.I., K.F., T.S., Y.K.)
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K. Watanabe
aFrom the Departments of Radiology (Y.M., S.K., K.W., I.U., A.O., J.M., S.I., K.F., T.S., Y.K.)
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I. Ueda
aFrom the Departments of Radiology (Y.M., S.K., K.W., I.U., A.O., J.M., S.I., K.F., T.S., Y.K.)
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A. Ogasawara
aFrom the Departments of Radiology (Y.M., S.K., K.W., I.U., A.O., J.M., S.I., K.F., T.S., Y.K.)
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J. Moriya
aFrom the Departments of Radiology (Y.M., S.K., K.W., I.U., A.O., J.M., S.I., K.F., T.S., Y.K.)
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S. Ide
aFrom the Departments of Radiology (Y.M., S.K., K.W., I.U., A.O., J.M., S.I., K.F., T.S., Y.K.)
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K. Futatsuya
aFrom the Departments of Radiology (Y.M., S.K., K.W., I.U., A.O., J.M., S.I., K.F., T.S., Y.K.)
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T. Sato
aFrom the Departments of Radiology (Y.M., S.K., K.W., I.U., A.O., J.M., S.I., K.F., T.S., Y.K.)
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K. Okada
bNeurology (K.O., T.U., S.T.), University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
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T. Uozumi
bNeurology (K.O., T.U., S.T.), University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
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S. Tsuji
bNeurology (K.O., T.U., S.T.), University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
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T. Liu
cDepartments of Biomedical Engineering and Radiology (T.L., Y.W.), Cornell University, New York, New York.
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Y. Wang
cDepartments of Biomedical Engineering and Radiology (T.L., Y.W.), Cornell University, New York, New York.
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Y. Korogi
aFrom the Departments of Radiology (Y.M., S.K., K.W., I.U., A.O., J.M., S.I., K.F., T.S., Y.K.)
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    Fig 1.

    QSM images (A and B) and selected regions of interest (C and D). CA indicates caudate nucleus; GP, globus pallidus; PU, putamen; RN, red nucleus; SN, substantia nigra; TH, thalamus.

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    Fig 2.

    R2* (top row) and QSM maps (bottom row) of 2 subjects, a 68-year-old control subject (A and C) and a 66-year-old patient with PD (B and D). Both the R2* and the QSM maps show higher paramagnetic susceptibility in the substantia nigra of the patient with PD than in the control (arrows).

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    Fig 3.

    Graphs of the ROC curves for discriminating patients with PD and the controls. The Az value was 0.91 for QSMaverage, 0.90 for QSMmaximum, 0.69 for R2*average, and 0.71 for R2*maximum. Pair-wise comparisons showed that the Az for QSMaverage and QSMmaximum was significantly larger than that for R2*average and R2*maximum (P < .05).

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    Table 1:

    Demographic and clinical data of subjects studied

    Patients with PD (n = 21)Controls (n = 21)P
    Sex (M/F)9:129:121.00
    Age (yr) (mean)72.0 ± 7.569.7 ± 8.6.54
    Onset (yr) (mean)69.0 ± 8.3
    Disease duration (mo) (mean)32.7 ± 27.1
    H & Y stage (median) (range)2 (1–3)
    • Note:—H & Y stage indicates Hoehn and Yahr stage.

    • View popup
    Table 2:

    Regional QSM and R2* values

    QSM (ppm)R2* Value (1/SE)
    Patients with PDControlsP ValuePatients with PDControlsP Value
    Substantia nigra0.224 ± 0.014a0.199 ± 0.014.01 × 10−330.1 ± 1.5b29.0 ± 2.0.01
    Red nucleus0.188 ± 0.0210.195 ± 0.019.1527.0 ± 1.727.8 ± 2.2.08
    Globus pallidus0.200 ± 0.0140.205 ± 0.029.8229.7 ± 1.829.5 ± 2.1.36
    Head of caudate0.166 ± 0.0130.166 ± 0.013.9725.2 ± 1.424.6 ± 1.7.19
    Putamen0.168 ± 0.0130.170 ± 0.009.1726.4 ± 0.926.7 ± 1.6.44
    Thalamus0.127 ± 0.0590.126 ± 0.007.5322.4 ± 1.022.8 ± 1.2.25
    • Note:—SE indicates standard error.

    • ↵a Significantly different from controls (P < .01).

    • ↵b Significantly different from controls (P < .05).

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    Table 3:

    Mean number of sections and mean volume for the ROI measurements

    Mean No. of SectionsMean Volume (mm3)
    Patients with PDControlsPatients with PDControlsP Value
    Substantia nigra9.69.7598.2 ± 88.0612.5 ± 66.3.59
    Red nucleus4.84.7187.9 ± 15.3189.3 ± 16.6.87
    Globus pallidus19.019.12734.7 ± 263.02667.1 ± 241.6.54
    Head of caudate14.914.81529.9 ± 115.71564.6 ± 121.5.47
    Putamen18.418.44964.5 ± 505.25127.1 ± 718.4.62
    Thalamus15.215.11770.4 ± 89.71750.5 ± 118.4.63
    • View popup
    Table 4:

    Sensitivity, specificity, accuracy, and Az value of analyses of data in patients with PD and control subjectsa

    QSM AverageR2* Average
    Sensitivity90% (19/21)81% (17/21)
    Specificity86% (18/21)52% (11/21)
    Accuracy88% (37/42)67% (28/42)
    Az value0.91b0.69
    • ↵a Numbers in parentheses are raw data.

    • ↵b Significantly different from R2* (P < .05).

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American Journal of Neuroradiology: 36 (6)
American Journal of Neuroradiology
Vol. 36, Issue 6
1 Jun 2015
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Cite this article
Y. Murakami, S. Kakeda, K. Watanabe, I. Ueda, A. Ogasawara, J. Moriya, S. Ide, K. Futatsuya, T. Sato, K. Okada, T. Uozumi, S. Tsuji, T. Liu, Y. Wang, Y. Korogi
Usefulness of Quantitative Susceptibility Mapping for the Diagnosis of Parkinson Disease
American Journal of Neuroradiology Jun 2015, 36 (6) 1102-1108; DOI: 10.3174/ajnr.A4260

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Usefulness of Quantitative Susceptibility Mapping for the Diagnosis of Parkinson Disease
Y. Murakami, S. Kakeda, K. Watanabe, I. Ueda, A. Ogasawara, J. Moriya, S. Ide, K. Futatsuya, T. Sato, K. Okada, T. Uozumi, S. Tsuji, T. Liu, Y. Wang, Y. Korogi
American Journal of Neuroradiology Jun 2015, 36 (6) 1102-1108; DOI: 10.3174/ajnr.A4260
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