Transcranial Ultrasonographic Image Analysis System for Decision Support in Parkinson Disease

J Ultrasound Med. 2018 Jul;37(7):1753-1761. doi: 10.1002/jum.14528. Epub 2018 Jan 13.

Abstract

Objectives: Transcranial ultrasonography (US) is a relatively new neuroimaging modality proposed for early diagnostics of Parkinson disease (PD). The main limitation of transcranial US image-based diagnostics is a high degree of subjectivity caused by low quality of the transcranial images. The article presents a developed image analysis system and evaluates the potential of automated image analysis on transcranial US.

Methods: The system consists of algorithms for the segmentation and assessment of informative brain regions (midbrain and substantia nigra) and a decision support subsystem, which is equipped with 64 classification algorithms. Transcranial US images of 191 participants (118 patients with a clinical PD diagnosis and 73 healthy control participants) were analyzed.

Results: The diagnostic sensitivity and specificity achieved by the proposed system were 85% and 75%, respectively.

Conclusions: Digital transcranial US image analysis is challenging, and the application of a such system as the sole instrument for decisions in clinical practice remains inconclusive. However, the proposed system could be used as a supplementary tool for automated assessment of US parameters for decision support in PD diagnostics and to reduce observer variability.

Keywords: decision support; image segmentation; informatics/image processing; midbrain; neurosonology (adult); transcranial ultrasonography.

MeSH terms

  • Brain / diagnostic imaging
  • Decision Support Systems, Clinical*
  • Female
  • Humans
  • Image Processing, Computer-Assisted / methods*
  • Male
  • Middle Aged
  • Parkinson Disease / diagnostic imaging*
  • Sensitivity and Specificity
  • Ultrasonography, Doppler, Transcranial / methods*