Guan Xiao-Jun, Guo Tao, Zhou Cheng, Gao Ting, Wu Jing-Jing, Han Victor, Cao Steven, Wei Hong-Jiang, Zhang Yu-Yao, Xuan Min, Gu Quan-Quan, Huang Pei-Yu, Liu Chun-Lei, Pu Jia-Li, Zhang Bao-Rong, Cui Feng, Xu Xiao-Jun, Zhang Min-Ming
Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Department of Neurology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Neural Regen Res. 2022 Dec;17(12):2743-2749. doi: 10.4103/1673-5374.339493.
Brain radiomics can reflect the characteristics of brain pathophysiology. However, the value of T1-weighted images, quantitative susceptibility mapping, and R2* mapping in the diagnosis of Parkinson's disease (PD) was underestimated in previous studies. In this prospective study to establish a model for PD diagnosis based on brain imaging information, we collected high-resolution T1-weighted images, R2* mapping, and quantitative susceptibility imaging data from 171 patients with PD and 179 healthy controls recruited from August 2014 to August 2019. According to the inclusion time, 123 PD patients and 121 healthy controls were assigned to train the diagnostic model, while the remaining 106 subjects were assigned to the external validation dataset. We extracted 1408 radiomics features, and then used data-driven feature selection to identify informative features that were significant for discriminating patients with PD from normal controls on the training dataset. The informative features so identified were then used to construct a diagnostic model for PD. The constructed model contained 36 informative radiomics features, mainly representing abnormal subcortical iron distribution (especially in the substantia nigra), structural disorganization (e.g., in the inferior temporal, paracentral, precuneus, insula, and precentral gyri), and texture misalignment in the subcortical nuclei (e.g., caudate, globus pallidus, and thalamus). The predictive accuracy of the established model was 81.1 ± 8.0% in the training dataset. On the external validation dataset, the established model showed predictive accuracy of 78.5 ± 2.1%. In the tests of identifying early and drug-naïve PD patients from healthy controls, the accuracies of the model constructed on the same 36 informative features were 80.3 ± 7.1% and 79.1 ± 6.5%, respectively, while the accuracies were 80.4 ± 6.3% and 82.9 ± 5.8% for diagnosing middle-to-late PD and those receiving drug management, respectively. The accuracies for predicting tremor-dominant and non-tremor-dominant PD were 79.8 ± 6.9% and 79.1 ± 6.5%, respectively. In conclusion, the multiple-tissue-specific brain radiomics model constructed from magnetic resonance imaging has the ability to discriminate PD and exhibits the advantages for improving PD diagnosis.
脑影像组学能够反映脑病理生理学特征。然而,在以往研究中,T1加权像、定量磁化率图和R2图在帕金森病(PD)诊断中的价值被低估。在这项基于脑成像信息建立PD诊断模型的前瞻性研究中,我们收集了2014年8月至2019年8月招募的171例PD患者和179例健康对照的高分辨率T1加权像、R2图和定量磁化率成像数据。根据纳入时间,将123例PD患者和121例健康对照分配到训练诊断模型组,其余106例受试者分配到外部验证数据集。我们提取了1408个影像组学特征,然后使用数据驱动的特征选择来识别对训练数据集中区分PD患者和正常对照有显著意义的信息性特征。然后将如此识别出的信息性特征用于构建PD诊断模型。构建的模型包含36个信息性影像组学特征,主要代表皮质下铁分布异常(尤其是黑质)、结构紊乱(如颞下回、中央旁小叶、楔前叶、脑岛和中央前回)以及皮质下核团(如尾状核、苍白球和丘脑)的纹理错位。在训练数据集中,所建立模型的预测准确率为81.1±8.0%。在外部验证数据集中,所建立模型的预测准确率为78.5±2.1%。在从健康对照中识别早期和未用药的PD患者的测试中,基于相同36个信息性特征构建的模型准确率分别为80.3±7.1%和79.1±6.5%,而诊断中晚期PD患者和接受药物治疗患者的准确率分别为80.4±6.3%和82.9±5.8%。预测震颤为主型和非震颤为主型PD的准确率分别为79.8±6.9%和79.1±6.5%。总之,由磁共振成像构建的多组织特异性脑影像组学模型具有区分PD的能力,并在改善PD诊断方面展现出优势。