18F-FDOPA PET/CT定量分析提高早期帕金森病的诊断效能
18F-FDOPA PET/CT Semi-Quantitative Analysis in Improving the Diagnostic Efficacy of Parkinson's Disease
武婕 1周蕾蕾 2张逸悦 3蒋腾 1徐志宏 4张思伟 4白侠 5王峰3
作者信息
- 1. 南京医科大学附属南京医院(南京市第一医院)神经内科,江苏 南京 210006
- 2. 南京医科大学附属南京医院(南京市第一医院)医学影像科,江苏 南京 210006
- 3. 南京医科大学附属南京医院(南京市第一医院)核医学科,江苏 南京 210006
- 4. 江苏华益科技有限公司药物研发部,江苏 常熟 215522
- 5. 内蒙古医科大学附属医院核医学科,内蒙古自治区分子影像学重点实验室,内蒙古 呼和浩特 010050
- 折叠
摘要
目的 探讨6-18F氟-L-多巴(18F-FDOPA)PET/CT半定量分析及人工智能平台对帕金森病(PD)的诊断价值.资料与方法 回顾性分析2018年 1 月—2019年12 月南京医科大学附属南京医院经临床确诊的56例PD患者,其中33例早期(Hoehn-Yahr Ⅰ～Ⅱ级),23例晚期(Hoehn-Yahr Ⅲ～Ⅳ级);选取本院体检中心同期健康对照者27例,行 18F-FDOPA PET/CT.于HERMES BRASS平台计算受试者纹状体各亚区与枕叶体积计数比(SORs),完成基于感兴趣区的脑半定量分析,观察早期和晚期PD患者纹状体各亚区不对称性.使用人工智能技术对PD组和健康对照组纹状体各亚区SORs行主成分分析,观察数据聚集度和组间区分度.结果 与健康对照组相比,晚期PD患者尾状体、前壳核、后壳核和纹状体整体SORs显著降低(t=9.02～11.72,P<0.000 1),对应的曲线下面积分别为0.952、0.973、0.995和0.982.早期PD患者纹状体各亚区不对称指数分别为尾状核(7.61±5.50)%、前壳核(11.43±8.97)%、后壳核(17.17±11.63)%、纹状体(10.65±7.46)%.PD组和健康对照组相比,主成分分析有显著区分度,PD组纹状体 18F-FDOPA摄取显著降低,早期PD患者对侧后壳核损失最显著,下降百分比为 34%.结论 平台半定量分析 18F-FDOPA PET/CT图像,为PD早期诊断和鉴别诊断提供客观半定量数值,纹状体特别是壳核的不对称性可能是PD早期诊断的重要参数.
Abstract
Purpose To investigate the diagnostic value of 18F-FDOPA PET/CT imaging and semi-quantitative analysis platform for the diagnosis of Parkinson's disease(PD).Materials and Methods There were 27 healthy controls and 56 clinically diagnosed PD patients,including 33 early PD(Hoehn-Yahr class Ⅰ-Ⅱ)and 23 advanced PD(Hoehn-Yahr class Ⅲ-Ⅳ),underwent 18F-FDOPA PET imaging in Nanjing First Hospital,Nanjing Medical University were consecutively enrolled from January 2018 to December 2019.The striatal to occipital ratio(SORs)in radioactivity was calculated by HERMES BRASS platform,thereby completing the semi-quantitative analysis of the brain based on regions of interest and observing the asymmetry of the striatal subregions in early-stage PD and late-stage PD patients.Using artificial intelligence techniques to perform principal component analysis on the SORs of the striatal subregions in PD group and healthy control group,the degree of data aggregation and the distinguishability between groups were observed.Results The SORs was significantly reduced in the whole caudate,anterior,posterior putamen and striatum of advanced PD patients(t=9.02-11.72,P<0.000 1).The area under the curve was 0.952,0.973,0.995 and 0.982,respectively.Compared with the healthy control group,the loss of striatal asymmetry index(mean)in each subregion of the striatum in early PD group was caudate(7.61±5.50)%,anterior putamen(11.43±8.97)%,posterior putamen(17.17±11.63)%,and whole striatum(10.65±7.46)%,respectively.The uptake of 18F-FDOPA in the striatum of PD patients was significantly reduced,and the most obvious loss of early PD patients was contralateral posterior putamen,with a decrease of 34%.Conclusion The platform semi-quantitative analysis of 18F-FDOPA PET/CT images provides objective semi-quantitative values for early diagnosis and differential diagnosis of PD.Asymmetry in the striatum,especially in the putamen,may be an important parameter for early diagnosis of PD..
关键词
帕金森病/18F-FDOPA/PET图像/正电子发射断层摄影术/半定量分析/人工智能Key words
Parkinson's disease/18F-FDOPA/PET image/Positron-emission tomography/Semi-quanti-cation/Artificial intelligence引用本文复制引用
基金项目
国家重点研发计划(2022YFC2406900)
江苏省社会发展项目(BE2017612)
江苏省医学重点学科建设单位项目(JSDW202247)
内蒙古自治区高等学校自然科学重点项目(2021)(NJZZ21039)
出版年
2024
NETL
NSTL
万方数据