Article Figures & Data
Figures
- FIGURE 1.
Study profile, showing a Chinese cohort (Huashan parkinsonian PET imaging dataset) and a German cohort. Clinically definite diagnoses = diagnoses by clinical experts after return visit but without a formal clinical follow-up; clinically confirmative diagnoses = diagnoses resulting from at least 1 formal clinical follow-up over 1 y after PET imaging.
- FIGURE 2.
Accuracy of DMI indices in development phase in training cohort and blind-test phase on both Chinese and German test cohorts. Results in cross-validation were plotted using receiver-operating-characteristic curves. Results in Chinese blind-test cohort were illustrated as single points, where overall represents results of all tested 330 patients. One hundred eight patients in blind test underwent follow-up scanning, and performance of these at baseline and follow-up was plotted. Blind-test results in German cohort (90 patients) are also included and denoted with black rectangle for easy comparison.
- FIGURE 3.
3D plot of probabilities of IPD, MSA, and PSP of DMI indices in training cohort. (A) Patients with short symptom duration (≤2 y). (B) Patients with long symptom duration (>2 y).
- FIGURE 4.
Comparison of probabilities of IPD (A), MSA (B), and PSP (C) of DMI indices on the 108 patients in blind-test cohort with repeated PET scans. (Left column) Comparison of the probability of DMI indices extracted from baseline and follow-up PET for individuals. (Right column) Violin plots demonstrate statistical distribution of probabilities of DMI indices. *P ≤ 0.05. **P ≤ 0.01. ns = no significance.
Tables
Clinical parameters Huashan parkinsonian PET imaging dataset (Chinese cohort) German cohort Pretraining cohort Training cohort Blind-test cohort Overall Short symptom duration (≤2 y) Long symptom duration (>2 y) Overall Baseline Follow-up IPD* Patient (n) 241 299 136 163 211 66 66 34 Sex (male/female) 154/87 166/133 73/63 93/70 130/81 43/23 43/23 21/13 (34/34) Age at PET (y) 50.0 ± 15.5 60.2 ± 8.5 59.1 ± 9.0 61.0 ± 8.0 60.0 ± 7.6 60.0 ± 7.9 62.1 ± 7.9 72.9 ± 9.5 (34/34) Symptom duration at PET (mo) – 45.3 ± 46.0 13.0 ± 5.9 72.3 ± 47.4 39.0 ± 41.3 26.0 ± 24.1 53.4 ± 24.2 44.5 ± 32.9 (18/34) Hoehn and Yahr stage† – 2.2 ± 1.0 1.7 ± 0.6 2.7 ± 1.0 1.9 ± 0.9 1.6 ± 0.7 1.9 ± 0.6 1.6 ± 0.8 (22/34) UPDRS III – 27.0 ± 14.3 18.9 ± 8.9 33.8 ± 14.5 22.8 ± 12.1 19.6 ± 9.1 24.2 ± 10.1 12.0 ± 3.6 (3/34) Clinical follow-up (mo) – – – – 46.8 ± 30.4 – 64.5 ± 25.3 19.1 ± 21.8 (14/34) MSA* Patient (n) (MSA-C/MSA-P) 79 150 (57/93) 90 (39/51) 60 (18/42) 61 (21/40) 22 (8/14) 22 (8/14) 17 (8/8/1) Sex (male/female) 42/37 78/72 47/43 31/29 32/29 14/8 14/8 10/7 (17/17) Age at PET (y) 57.5 ± 10.6 57.8 ± 8.0 56.5 ± 8.1 59.6 ± 7.4 58.5 ± 6.3 58.3 ± 7.4 60.3 ± 7.3 61.3 ± 8.3 (17/17) Symptom duration at PET (mo) – 24.3 ± 17.1 13.9 ± 6.0 39.9 ± 16.5 27.0 ± 20.1 22.1 ± 11.8 45.6 ± 12.5 30.0 ± 22.2 (17/17) Hoehn and Yahr stage† – 3.1 ± 0.8 3.0 ± 0.8 3.5 ± 0.7 2.9 ± 0.8 2.6 ± 0.6 3.4 ± 0.8 2.4 ± 1.1 (15/17) UPDRS III – 30.6 ± 14.5 25.9 ± 12.4 37.6 ± 14.7 29.3 ± 14.4 23.5 ± 8.2 36.4 ± 11.1 34.6 ± 12.8 (11/17) Clinical follow-up (mo) – – – – 30.7 ± 18.2 – 41.7 ± 16.4 22.6 ± 22.4 (17/17) PSP* Patient (n) 78 98 34 64 58 20 20 39 Sex (male/female) 45/33 60/38 23/11 37/27 39/19 17/3 17/3 21/18 (39/39) Age at PET (y) 64.6 ± 8.6 67.2 ± 8.0 65.0 ± 9.3 68.5 ± 6.9 65.1 ± 6.6 64.8 ± 7.5 67.0 ± 7.2 70.0 ± 7.1 (39/39) Symptom duration at PET (mo) – 35.0 ± 20.7 15.3 ± 5.4 45.5 ± 18.0 34.1 ± 22.7 32.4 ± 22.0 58.8 ± 22.8 22.4 ± 15.7 (37/39) Hoehn and Yahr stage† – 3.2 ± 0.8 2.9 ± 0.6 3.4 ± 0.8 3.0 ± 0.8 2.7 ± 1.0 3.6 ± 0.8 2.6 ± 1.1 (37/39) UPDRS III – 30.1 ± 13.5 28.0 ± 11.0 31.2 ± 14.6 26.8 ± 11.0 23.0 ± 10.4 34.6 ± 15.9 37.0 ± 15.9 (20/39) Clinical follow-up (mo) – – – – 25.1 ± 15.7 – 37.5 ± 12.9 22.2 ± 13.8 (17/39) ↵* Diagnosis information: Supplemental Table 1.
↵† Detailed Hoehn and Yahr stage information: Supplemental Table 2.
Data are shown as mean ± SD. In German cohort, associated numbers of subjects with these items are provided together with statistics information (subject number with certain item/total subject number).
UPDRS = Unified Parkinson’s Disease Rating Scale; MSA-C/MSA-P = MSA-cerebellar/MSA-parkinsonian.
Diagnosis Metrics Overall Short symptom duration (≤2 y) Long symptom duration (>2 y) IPD AUC 0.986 (0.977–0.996) 0.981 (0.965–0.997) 0.991 (0.981–1.000) Sensitivity 95.7% (92.7%–97.7%) 94.9% (89.7%–97.9%) 95.7% (91.4%–98.3%) Specificity 97.6% (94.8%–99.1%) 97.6% (93.1%–99.5%) 98.4% (94.3%–99.8%) PPV 97.9% (95.6%–98.9%) 97.7% (93.5%–99.1%) 98.7% (95.5%–99.5%) NPV 94.9% (91.5%–98.1%) 94.5% (89.1%–98.8%) 94.6% (89.2%–99.3%) MSA AUC 0.997 (0.994–1.000) 0.996 (0.988–1.000) 0.998 (0.995–1.000) Sensitivity 97.3% (93.3%–99.3%) 100% (96.0%–100%) 98.3% (91.1%–100%) Specificity 99.5% (98.2%–99.9%) 98.2% (94.9%–99.6%) 99.6% (97.6%–100%) PPV 98.6% (95.3%–99.6%) 96.8% (91.0%–100%) 98.3% (91.3%–100%) NPV 99.0% (97.4%–99.9%) 100% (97.8%–100%) 99.6% (97.5%–100%) PSP AUC 0.982 (0.965–0.998) 0.968 (0.925–1.000) 0.990 (0.980–1.000) Sensitivity 91.8% (84.5%–96.4%) 88.2% (72.5%–96.7%) 93.8% (84.8%–98.3%) Specificity 98.2% (96.5%–99.2%) 98.2% (95.5%–99.5%) 98.2% (95.5%–99.5%) PPV 91.8% (85.0%–96.4%) 88.2% (74.3%–96.7%) 93.7% (85.2%–98.3%) NPV 98.2% (96.4%–99.2%) 98.2% (95.1%–99.5%) 98.2% (95.3%–99.5%) AUC = area under the curve.
- TABLE 3.
Accuracy of DMI Indices on Blind-Test Cohort from Huashan Parkinsonian PET Imaging Dataset (Chinese Cohort) and German Cohort
Diagnosis Metrics Huashan parkinsonian PET imaging dataset (Chinese cohort) German cohort Overall Baseline Follow-up IPD Sensitivity 98.1% 98.5% 95.5% 94.1% Specificity 90.0% 88.1% 97.6% 84.0% PPV 94.5% 92.9% 98.4% 78.0% NPV 96.4% 97.4% 93.2% 95.9% MSA Sensitivity 88.5% 81.8% 95.4% 82.4% Specificity 99.2% 99.9% 98.8% 99.9% PPV 96.4% 99.9% 95.5% 99.9% NPV 97.4% 95.6% 98.8% 96.1% PSP Sensitivity 84.5% 90.0% 95.0% 82.1% Specificity 97.8% 97.7% 96.6% 94.1% PPV 89.1% 90.0% 86.4% 91.4% NPV 97.0% 97.7% 98.8% 87.3%
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