Objective: We aimed to directly compare middle cerebellar peduncle (MCP) width, apparent diffusion coefficient (ADC) value of the putamen and cerebellum, and 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy images, and to determine the optimal tool for differential diagnosis between multiple system atrophy with predominant Parkinsonian features (MSA-P) and Parkinson’s disease (PD).

Background: There are many tools for differentiating between MSA-P and PD. These include MCP width, ADC value of the putamen and cerebellum, and MIBG myocardial scintigraphy images. However, the optimal method is unknown.

Methods: Eleven patients with MSA-P and 36 patients with PD were enrolled in the study; a 3.0- or 1.5-tesla magnetic resonance imaging (MRI) was used for patient examination. Of these, 7 patients with MSA-P and 14 patients with PD were chosen as background-matched using 3.0-tesla MRI. We measured MCP width, ADC value of the putamen and cerebellum, and MIBG myocardial scintigraphy images. Area under curve (AUC) of receiver operating characteristic (ROC) was assessed to compare the above-mentioned methods.

Results: MCP width and ADC value of the putamen may be helpful for differentiating between MSA-P and PD relative to other methods in background-matched patients (MCP width, AUC = 0.95; ADC value of the putamen, AUC = 0.88; ADC value of the cerebellum, AUC = 0.70; MIBG uptake in the early phase, AUC = 0.76; MIBG uptake in the delayed phase, AUC = 0.78). Similar AUCs were seen in all patients with different backgrounds.

Conclusions: Our findings suggested that MCP width and ADC value of the putamen could be superior to ADC value of the cerebellum and MIBG uptake for differentiating between MSA-P and PD.

« Back to 2016 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/imaging-based-differential-diagnosis-between-multiple-system-atrophy-and-parkinsons-disease/