{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T16:04:20Z","timestamp":1784563460241,"version":"3.55.0"},"reference-count":33,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS\u20102025\u201000559394"],"award-info":[{"award-number":["RS\u20102025\u201000559394"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS\u20102025\u201002216928"],"award-info":[{"award-number":["RS\u20102025\u201002216928"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005006","name":"Asan Institute for Life Sciences, Asan Medical Center","doi-asserted-by":"publisher","award":["2023IP0110"],"award-info":[{"award-number":["2023IP0110"]}],"id":[{"id":"10.13039\/501100005006","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Progressive supranuclear palsy (PSP) is both an underdiagnosed and a frequently misdiagnosed disorder. To remedy these diagnostic limitations, MRI has been used to investigate brain morphology to differentiate PSP from Parkinson's disease (PD) and multiple system atrophy (MSA). However, while nigrostriatal degeneration and tau aggregation are prominent in PSP, and result in iron accumulation and atrophy in the region, substantia nigra (SN) atrophy remains an underexplored diagnostic marker.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the diagnostic utility of QSM\u2010derived SN parameters for PSP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Type<\/jats:title>\n                    <jats:p>Retrospective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>123 (59 Males\/64 Females) PD patients, 48 (26\u2009M\/22 F) MSA patients, and 22 (11\u2009M\/11 F) PSP patients were included in the main dataset. MSA patients include 20 parkinsonian type (MSA\u2010P) (11\u2009M\/9 F) and 18 cerebellar type (MSA\u2010C) (9\u2009M\/9 F) of MSA with 10 undetermined subtype. The external validation set included 12 (6\u2009M\/6 F) healthy controls, 13 PD (7\u2009M\/6 F), and 10 PSP (6\u2009M\/4 F) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Field Strength and Sequence<\/jats:title>\n                    <jats:p>\n                      3\u2009T, MPRAGE T\n                      <jats:sub>1<\/jats:sub>\n                      \u2010weighted imaging and multi\u2010echo gradient echo imaging (mGRE) for QSM.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Assessment<\/jats:title>\n                    <jats:p>\n                      Group level differences of SN volume, magnetic susceptibility, and susceptibility\u2010to\u2010volume ratio (SVR) among PSP, PD, and MSA groups, and these metrics' differentiating power are measured. Bivariate logistic regression with T\n                      <jats:sub>1<\/jats:sub>\n                      \u2010based morphological markers alongside SN metrics is performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Statistical Tests<\/jats:title>\n                    <jats:p>\n                      Mann\u2013Whitney U test for group comparisons. Receiver operating characteristic analysis with bootstrapping.\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 after Bonferroni correction is defined as statistically significant result.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The SN SVR was significantly higher in the PSP group compared to the MSA group and the MSA\u2010P group. Moreover, using pons measurements with SN SVR in a bivariate model resulted in the highest differentiation between the PSP and MSA groups (AUC\u2009=\u20090.88, 95% CI: [0.78\u20130.95]), particularly driven by the increased differentiation between the PSP and MSA\u2010P groups (AUC\u2009=\u20090.88, 95% CI: [0.75\u20130.98]). External validation supported the generalizability of SN SVR, yielding 100% sensitivity and 80% specificity for differentiating PSP from HC and PD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Conclusion<\/jats:title>\n                    <jats:p>\n                      QSM\u2010based SN morphometry can complement T\n                      <jats:sub>1<\/jats:sub>\n                      \u2010weighted imaging for Parkinsonism assessment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Evidence Level<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Technical Efficacy<\/jats:title>\n                    <jats:p>Stage 2.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jmri.70459","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T15:19:23Z","timestamp":1784560763000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Substantia Nigra Susceptibility\u2010To\u2010Volume Ratio Derived From QSM as a Marker for Discrimination of Progressive Supranuclear Palsy From Parkinson's Disease and Multiple System Atrophy"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6894-7569","authenticated-orcid":false,"given":"Huseyin Enes","family":"Candan","sequence":"first","affiliation":[{"name":"Graduate School of Health Science and Technology Ulsan National Institute of Science and Technology  Ulsan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sungyang","family":"Jo","sequence":"additional","affiliation":[{"name":"Department of Neurology Asan Medical Center, University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3357-3501","authenticated-orcid":false,"given":"Nepes","family":"Myratgeldyyev","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Ulsan National Institute of Science and Technology  Ulsan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7674-4351","authenticated-orcid":false,"given":"Abel Worku","family":"Tessema","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Ulsan National Institute of Science and Technology  Ulsan Republic of Korea"},{"name":"School of Biomedical Engineering, Jimma Institute of Technology Jimma University  Jimma Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2112-1197","authenticated-orcid":false,"given":"Hansol","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Ulsan National Institute of Science and Technology  Ulsan Republic of Korea"},{"name":"Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology Massachusetts General Hospital  Charlestown Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4274-7415","authenticated-orcid":false,"given":"Jae\u2010Hyeok","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology Pusan National University School of Medicine, Pusan National University Yangsan Hospital  Yangsan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyoyoung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology Asan Medical Center, University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5600-0834","authenticated-orcid":false,"given":"Grace Yoojin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medical Science, Asan Medical Institute of Convergence Science and Technology Asan Medical Center, University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong Hyun","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Radiology and Research Institute of Radiology Asan Medical Center, University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihong","family":"Ryu","sequence":"additional","affiliation":[{"name":"Department of Neurology Asan Medical Center, University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4118-8233","authenticated-orcid":false,"given":"Sun Ju","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Neurology Asan Medical Center, University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyemyung","family":"Park","sequence":"additional","affiliation":[{"name":"Graduate School of Health Science and Technology Ulsan National Institute of Science and Technology  Ulsan Republic of Korea"},{"name":"Department of Biomedical Engineering Ulsan National Institute of Science and Technology  Ulsan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun\u2010Jae","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology Asan Medical Center, University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5380-7674","authenticated-orcid":false,"given":"HyungJoon","family":"Cho","sequence":"additional","affiliation":[{"name":"Graduate School of Health Science and Technology Ulsan National Institute of Science and Technology  Ulsan Republic of Korea"},{"name":"Department of Biomedical Engineering Ulsan National Institute of Science and Technology  Ulsan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1016\/S1474-4422(17)30157-6","article-title":"Advances in Progressive Supranuclear Palsy: New Diagnostic Criteria, Biomarkers, and Therapeutic Approaches","volume":"16","author":"Boxer A. 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