Differential diagnosis value of single-case statistical parametric mapping analysis with ¹⁸F-FDG PET imaging for Parkinsonism

Objective: To investigate the value of statistical parametric mapping (SPM) analysis of ¹⁸F-fluorodeoxyglucose (FDG) PET imaging in the differential diagnosis of Parkinsonism in single-case level. Methods: SPM software was used to retrospectively analyze the ¹⁸F-FDG PET images of 160 patients (104 males, 56 females, age: 30-82 years) who were suspected with Parkinsonism at baseline and were clinical confirmed by follow-up from April 2010 to December 2017. ¹⁸F-FDG PET images of patients was compared with those of age-matched healthy controls in single-case level using two-sample t test in SPM software to obtain the imaging diagnosis. By comparing imaging diagnosis with the final clinical diagnosis, the diagnostic accuracy of SPM in the overall cohort as well as the early subcohort (duration of disease less than 2 years (56 males, 22 females, age: 50-82 years)) were calculated respectively. Results: Among 160 patients with Parkinsonism, 146 (91.2%) had the same ¹⁸F-FDG PET diagnosis as their final clinical diagnosis. The diagnostic sensitivity for Parkinson's disease (PD), multiple system atrophy (MSA), progressive supranuclear palsy (PSP) and cortical basal ganglia degeneration (CBD) were 93.5% (86/92), 92.3% (24/26), 84.0% (21/25) and 15/17, respectively. The specificity were 95.6% (65/68), 95.5% (128/134), 96.3% (130/135) and 100% (143/143), respectively. In the early subcohort, the analysis also achieved similar differential diagnosis effectiveness (92.3%). Conclusion: The single-case ¹⁸F-FDG PET imaging SPM analysis can be helpful in the early differential diagnosis of Parkinsonism effectively. (authors)