A prospective multi-centre study of susceptibility map-weighted MRI for the diagnosis of neurodegenerative parkinsonism

Young Hee Sung, Joong Seok Kim, Sang Won Yoo, Na Young Shin, Yoonho Nam, Tae Beom Ahn, Dallah Yoo, Kyung Mi Lee, Hyug Gi Kim, Seong Beom Koh, Jinhee Kim, Ilsoo Kim, Do Young Kwon, Younghen Lee, Chulhan Kim, Sun Ju Chung, Sungyang Jo, Seung Hyun Lee, Sang Joon Kim, Minjae KimChul Hyoung Lyoo, Min Seok Baek, Suk Yun Kang, Suk Ki Chang, Sang Won Jo, Seun Ah Lee, Hyeo il Ma, Young Eun Kim, Eun Soo Kim, Yun Joong Kim, Hyun Sook Kim, Min Hee Woo, Hye Jeong Choi, Eung Yeop Kim

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Objectives: This study aimed to compare susceptibility map-weighted imaging (SMwI) using various MRI machines (three vendors) with N-3-fluoropropyl-2-β-carbomethoxy-3-β-(4-iodophenyl)nortropane (18F-FP-CIT) PET in the diagnosis of neurodegenerative parkinsonism in a multi-centre setting. Methods: We prospectively recruited 257 subjects, including 157 patients with neurodegenerative parkinsonism, 54 patients with non-neurodegenerative parkinsonism, and 46 healthy subjects from 10 hospitals between November 2019 and October 2020. All participants underwent both SMwI and 18F-FP-CIT PET. SMwI was interpreted by two independent reviewers for the presence or absence of abnormalities in nigrosome 1, and discrepancies were resolved by consensus. 18F-FP-CIT PET was used as the reference standard. Inter-observer agreement was tested using Cohen’s kappa coefficient. McNemar’s test was used to test the agreement between the interpretations of SMwI and 18F-FP-CIT PET per participant and substantia nigra (SN). Results: The inter-observer agreement was 0.924 and 0.942 per SN and participant, respectively. The diagnostic sensitivity of SMwI was 97.9% and 99.4% per SN and participant, respectively; its specificity was 95.9% and 95.2%, respectively, and its accuracy was 97.1% and 97.7%, respectively. There was no significant difference between the results of SMwI and 18F-FP-CIT PET (p > 0.05, for both SN and participant). Conclusions: This study demonstrated that the high diagnostic performance of SMwI was maintained in a multi-centre setting with various MRI scanners, suggesting the generalisability of SMwI for determining nigrostriatal degeneration in patients with parkinsonism. Key Points: • Susceptibility map-weighted imaging helps clinicians to predict nigrostriatal degeneration. • The protocol for susceptibility map-weighted imaging can be standardised across MRI vendors. • Susceptibility map-weighted imaging showed diagnostic performance comparable to that of dopamine transporter PET in a multi-centre setting with various MRI scanners.

Original languageEnglish
Pages (from-to)3597-3608
Number of pages12
JournalEuropean Radiology
Issue number5
Publication statusPublished - 2022 May

Bibliographical note

Funding Information:
This work was supported by a grant from the Heuron Co., Ltd; and a grant from the Basic Research in Science and Engineering Program through the National Research Foundation (NRF) funded by the Korean government (MSIT) (No. 2021R1C1C1003676).

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to European Society of Radiology.

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging


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