Adjustment for the Age-and Gender-Related Metabolic Changes Improves the Differential Diagnosis of Parkinsonism  

作　　者：Jiaying Lu Min Wang Ping Wu Igor Yakushev Huiwei Zhang Sibylle Ziegler Jiehui Jiang Stefan Förster Jian Wang Markus Schwaiger Axel Rominger Sung-Cheng Huang Fengtao Liu Chuantao Zuo Kuangyu Shi 

机构地区：[1]Department of Nuclear Medicine and PET Center,Huashan Hospital,Fudan University,518 East Wuzhong Road,Shanghai 200235,China [2]Department of Nuclear Medicine,Inselspital,Bern University Hospital,University of Bern,3010 Bern,Switzerland [3]Institute of Biomedical Engineering,School of Life Sciences,Shanghai University,Shanghai 200444,China [4]Department of Informatics,Technische Universität München,80333 Munich,Germany [5]National Research Center for Aging and Medicine and National Center for Neurological Disorders,Huashan Hospital,Fudan University,Shanghai 200040,China [6]Department of Nuclear Medicine,Technische Universität München,80333 Munich,Germany [7]Department of Nuclear Medicine,University Hospital LMU Munich,80539 Munich,Germany [8]Department of Nuclear Medicine,Klinikum Bayreuth,95445 Bayreuth,Germany [9]Department of Neurology,Huashan Hospital,Fudan University,12 Middle Wulumuqi Road,Shanghai 200040,China [10]Klinikum r.d.Isar,Technische Universität München,95445 Munich,Germany [11]Department of Molecular and Medical Pharmacology,David Geffen School of Medicine,University of California,Los Angeles 90095,USA [12]Human Phenome Institute,Fudan University,Shanghai 200433,China

出　　处：《Phenomics》2023年第1期50-63,共14页表型组学（英文）

基　　金：supported by National Natural Science Foundation of China(81671239,81361120393,82171252,81701250,81401135,81971641,91949118,81771372,82021002);the Ministry of Science and Technology of China(2016YFC1306504);Shanghai Municipal Science and Technology Major Project(2017SHZDZX01,2018SHZDZX03);ZJ Lab,Shanghai Aging and Maternal and Child Health Research Special Project(2020YJZX0111);Clinical Research Plan of Shanghai Hospital Development Center(SHDC-2020CR1038B),Science and Technology Innovation 2030 Major Projects(2022ZD0211600);Youth Medical Talents-Medical Imaging Practitioner Program by Shanghai Municipal Health Commission and Shanghai Medical and Health Development Foundation(SHWRS(2020)_087);the Swiss National Science Foundation(188350);Jacques&Gloria Gossweiler Foundation and Siemens Healthineers.

摘　　要：Age and gender are the important factors for brain metabolic declines in both normal aging and neurodegeneration,and the confounding effects may influence early and differential diagnosis of neurodegenerative diseases based on the[^(18)F]fluorodeoxyglucose positron emission tomography([^(18)F]FDG PET).We aimed to explore the potential of the adjustment of age-and gender-related confounding factors on[^(18)F]FDG PET images in differentiation of Parkinson’s disease(PD),multiple system atrophy(MSA)and progressive supra-nuclear palsy(PSP).Eight hundred and seventy-seven clinically definitely diagnosed Parkinsonian patients from a benchmark Huashan Parkinsonian PET imaging database were included.An age-and gender-adjusted Z(AGAZ)score was established based on the gender-specific longitudinal metabolic changes on healthy subjects.AGAZ scores and standardized uptake value ratio(SUVR)values were quantified at regional-level and support vector machine-based error-correcting output codes method was applied for classification.Additional references of the classifications based on metabolic pattern scores were included.The feature-based AGAZ score showed the best performance in classification(accuracy for PD,MSA,PSP:93.1%,96.3%,94.8%).In both genders,the AGAZ score con-sistently achieved the best efficiency,and the improvements compared to the conventional SUVR value for PD,MSA,and PSP mainly laid in specificity(Male:5.7%;Female:11.1%),sensitivity(Male:7.2%;Female:7.3%),and sensitivity(Male:7.3%;Female:17.2%).Female patients benefited more from the adjustment on[^(18)F]FDG PET in MSA and PSP groups(absolute net reclassification index,p<0.001).Collectively,the adjustment of age-and gender-related confounding factors may improve the differential diagnosis of Parkinsonism.Particularly,the diagnosis of female Parkinsonian population has the best improvement from this correction.

关 键 词：Age-and gender-adjustment [^(18)F]FDG PET Differential diagnosis PARKINSONISM 

分 类 号：R742.5[医药卫生—神经病学与精神病学]