The utility of cerebral perfusion SPECT analysis using SPM8, eZIS and vbSEE for the diagnosis of multiple system atrophy-parkinsonism

Keita Sakurai, Etsuko Imabayashi, Kimiteru Ito, Aya M. Tokumaru, Yoshiyuki Ozawa, Masahiro Muto, Motoo Nakagawa, Kenji Okita, Noriyuki Matsukawa, Yuta Shibamoto

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Objective: Although a correct diagnosis is important for appropriate management, accurately differentiating between multiple system atrophy with predominant parkinsonism (MSA-P) and Parkinson’s disease (PD) is often difficult because of similarities in the early-stage symptoms. The aim of this study was to evaluate the diagnostic value of cerebral perfusion single photon emission computed tomography (SPECT) and voxel-based analysis for diagnosing MSA-P patients.Methods: Thirty-eight subjects (9 with early-stage MSA-P, 11 with PD, and 18 controls) were included in this study. Z-scores suggestive of hypoperfusion were calculated between patients and controls using statistical parametric mapping (SPM) 8 and easy Z-score imaging system (eZIS) programs. A voxel-based stereotactic extraction estimation (vbSEE) program was performed to determine the target volumes of interest (VOIs) in the putamen, pons, and cerebellum, and quantify Z-scores as “extent” (the rate of voxels with a Z-score >2.0 in these VOIs) and “severity” (average Z-scores in these VOIs). These parameters were used as the determinant in receiver operating characteristic (ROC) analyses.Results: The extent and severity of the cerebellar VOIs were higher in MSA-P patients than in PD patients. In ROC analyses, the extent and severity of the cerebellar VOI exhibited the highest areas under the curves of 0.86 and 0.84, and accuracies of 90 and 90 %, respectively.Conclusions: The diagnostic value of significant cerebellar hypoperfusion was the highest for differentiating MSA-P from PD. This voxel-based analysis of cerebral perfusion SPECT using the SPM8, eZIS, and vbSEE programs is useful for clinically diagnosing MSA-P.

Original languageEnglish
Pages (from-to)206-213
Number of pages8
JournalAnnals of Nuclear Medicine
Issue number2
Publication statusPublished - 02-2014
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging


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