2023 ARRS ANNUAL MEETING - ABSTRACTS

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1102. The Utility of Susceptibility Weighted Imaging in Parkinson's Disease: A Correlation Study With 18F-FP-CIT PET
Authors * Denotes Presenting Author
  1. Hyunkoo Kang *; Soul Veterans Hospital
Objective:
Our study was intended to demonstrate the different signal intensity (SI) pattern of the basal ganglia seen on susceptibility-weighted imaging (SWI) between that of Parkinson’s disease (PD) and normal control groups, and to correlate it with 18F fluorinated-N-3-fluoropropyl-2-b-carboxymethoxy-3-b-(4-iodophenyl) nortropane positron emission tomography (18F-FP-CIT PET).

Materials and Methods:
A total of 21 normal controls and 39 patients with PD underwent SWI, and 18F-FP-CIT PET were included. The SI was measured on SWI in the caudate nucleus head, anterior and posterior halves of the putamen using a region-of-interest (ROI) on both sides. The normalized regional glucose metabolism (standardized uptake value, SUV) was measured on coregistered 18F-FP-CIT PET images using the ROI obtained with SWI. Analysis included a group-level comparison of the SI values obtained on SWI, and these results were correlated with the SUV on 18F-FP-CIT PET.

Results:
The mean SI of the anterior half of the right putamen and the posterior half of the left putamen on SWI differed significantly between the two groups (p < 0.0083, respectively). The SUV on coregistered 18F-FP-CIT PET images of all locations also differed significantly between normal controls and PD (p < 0.0083, respectively). There was a moderate degree of positive correlation between the SI on SWI and the SUV on coregistered 18F-FP-CIT PET of the left caudate nucleus head in PD (r = 0.401, p = 0.011). There was a moderate degree of positive correlation between the SI on SWI and the SUV on coregistered 18F-FP-CIT PET the whole basal ganglia regions except right caudate nucleus head in total. In this study, we investigated the value of SWI for differentiating the PD and normal controls. We found that the greater hypointensity of the anterior half of the right putamen and the posterior half of the left putamen on SWI could differentiate PD from normal controls. Furthermore, there was a moderate positive correlation between the SI on the SWI image and the SUV on coregistered 18F-FP-CIT PET of the left caudate nucleus head in PD.

Conclusion:
Regarding the hypointensity of the putamen, there have been several histopathologic studies showing increased iron concentration and subsequent neurodegeneration in the putamen in PD. Especially, higher iron deposition causes a SI loss in the putamen, predominantly in the dorsolateral or posterior side, and may show the differentiation of PD from normal controls using SWI or T2*-weighted sequences. These results are similar to those of our proir study that demonstrates hypointensity in the putamen in patients with PD on SWI images. In conclusion, the low SI seen in the putamen on SWI may differentiate PD from normal controls. Furthermore, low SI in the basal ganglia on SWI correlated with hypometabolism on 18F-FP-CIT PET. Therefore, SWI could be a potential complementary diagnostic tool to 18F-FP-CIT PET for differentiating these conditions.