PENCIL imaging: A novel approach for neuromelanin sensitive MRI in Parkinson's disease
Peng Liu,
Xinhui Wang,
Youmin Zhang,
Pei Huang,
Zhijia Jin,
Zenghui Cheng,
Yongsheng Chen,
Qiuyun Xu,
Kiarash Ghassaban,
Yu Liu,
Shengdi Chen,
Naying He,
Fuhua Yan,
E. Mark Haacke
Affiliations
Peng Liu
Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
Xinhui Wang
Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
Youmin Zhang
Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
Pei Huang
Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
Zhijia Jin
Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
Zenghui Cheng
Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
Yongsheng Chen
Department of Neurology, Wayne State University School of Medicine, 4201St. Antoine, Detroit, MI 48201, USA
Qiuyun Xu
SpinTech MRI, Bingham Farms, MI 48025, USA
Kiarash Ghassaban
SpinTech MRI, Bingham Farms, MI 48025, USA
Yu Liu
Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
Shengdi Chen
Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
Naying He
Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China; Corresponding authors at: No.197 Ruijin Er Road, Shanghai 200025, China.
Fuhua Yan
Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China; Faculty of Medical Imaging Technology, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Corresponding authors at: No.197 Ruijin Er Road, Shanghai 200025, China.
E. Mark Haacke
Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China; Department of Neurology, Wayne State University School of Medicine, 4201St. Antoine, Detroit, MI 48201, USA; Department of Radiology, Wayne State University School of Medicine, 3990 John R Street, MRI Concourse, Detroit, MI 48201, USA; Corresponding authors at: No.197 Ruijin Er Road, Shanghai 200025, China.
Background: Parkinson's disease (PD) is associated with the loss of neuromelanin (NM) and increased iron in the substantia nigra (SN). Magnetization transfer contrast (MTC) is widely used for NM visualization but has limitations in brain coverage and scan time. This study aimed to develop a new approach called Proton-density Enhanced Neuromelanin Contrast in Low flip angle gradient echo (PENCIL) imaging to visualize NM in the SN. Methods: This study included 30 PD subjects and 50 healthy controls (HCs) scanned at 3T. PENCIL and MTC images were acquired. NM volume in the SN pars compacta (SNpc), normalized image contrast (Cnorm), and contrast-to-noise ratio (CNR) were calculated. The change of NM volume in the SNpc with age was analyzed using the HC data. A group analysis compared differences between PD subjects and HCs. Receiver operating characteristic (ROC) analysis and area under the curve (AUC) calculations were used to evaluate the diagnostic performance of NM volume and CNR in the SNpc. Results: PENCIL provided similar visualization and structural information of NM compared to MTC. In HCs, PENCIL showed higher NM volume in the SNpc than MTC, but this difference was not observed in PD subjects. PENCIL had higher CNR, while MTC had higher Cnorm. Both methods revealed a similar pattern of NM volume in SNpc changes with age. There were no significant differences in AUCs between NM volume in SNpc measured by PENCIL and MTC. Both methods exhibited comparable diagnostic performance in this regard. Conclusions: PENCIL imaging provided improved CNR compared to MTC and showed similar diagnostic performance for differentiating PD subjects from HCs. The major advantage is PENCIL has rapid whole-brain coverage and, when using STAGE imaging, offers a one-stop quantitative assessment of tissue properties.
