{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T02:29:04Z","timestamp":1786328944814,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T00:00:00Z","timestamp":1786233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T00:00:00Z","timestamp":1786233600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005230","name":"Natural Science Foundation of Chongqing Municipality","doi-asserted-by":"publisher","award":["CSTB2024NSCQ\u2010MSX1024"],"award-info":[{"award-number":["CSTB2024NSCQ\u2010MSX1024"]}],"id":[{"id":"10.13039\/501100005230","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n Accurate differentiation between Parkinson's disease (PD) and atypical parkinsonian syndromes (APS) remains challenging where dual\u2010tracer (\n 11<\/jats:sup>\n C\u20102\u03b2\u2010carbomethoxy\u20103\u03b2\u2010(4\u2010fluorophenyl) tropane [[\n 11<\/jats:sup>\n C]CFT] and\n 18<\/jats:sup>\n F\u2010fluorodeoxyglucose [[\n 18<\/jats:sup>\n F]FDG]) positron emission tomography\/computed tomography (PET\/CT) access is limited.\n <\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n \n The aim was to investigate whether transcranial sonography (TCS) of the substantia nigra (SN) can replace [\n 11<\/jats:sup>\n C]CFT PET when combined with [\n 18<\/jats:sup>\n F]FDG PET for diagnosing early PD and differentiating PD from APS.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Totally 160 patients with suspected PD or APS underwent clinical assessment, SN\u2010TCS, and PET\/CT. PET\/CT images were evaluated by visual assessment based on predetermined disease\u2010specific patterns. Diagnoses of TCS\u2010SN were performed according to predefined criteria. Diagnostic performance was evaluated using 2 binary comparisons: PD versus non\u2010PD and APS versus non\u2010APS.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n After a median follow\u2010up period of 23\u2009months, the final clinical diagnoses were PD (n\u2009=\u200972), APS (n\u2009=\u200950), and parkinsonian syndromes other than PD or APS (n\u2009=\u200933). For diagnosis of PD, combined SN\u2010TCS with [\n 18<\/jats:sup>\n F]FDG PET\/CT strategy exhibited comparable specificity to dual\u2010tracer PET\/CT (90.4% vs. 95.2%,\n P<\/jats:italic>\n \u2009=\u20090.344) but significantly lower sensitivity (34.7% vs. 84.7%,\n P<\/jats:italic>\n \u2009<\u20090.001). Compared to TCS alone, the combined approach yielded similar sensitivity (34.7% vs. 36.1%,\n P<\/jats:italic>\n \u2009=\u20091.000) and higher specificity (90.4% vs. 72.3%,\n P<\/jats:italic>\n \u2009<\u20090.001). For APS diagnosis, this combined approach achieved comparable sensitivity (76.0% vs. 86.0%,\n P<\/jats:italic>\n \u2009=\u20090.180), specificity (86.7% vs. 86.7%,\n P<\/jats:italic>\n \u2009=\u20091.000), accuracy (83.2% vs. 86.5%,\n P<\/jats:italic>\n \u2009=\u20090.302), and the area under the curve (0.81 vs. 0.86,\n P<\/jats:italic>\n \u2009=\u20090.115) relative to dual\u2010tracer PET\/CT.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n The combination of SN\u2010TCS and [\n 18<\/jats:sup>\n F]FDG PET\/CT may serve as an effective triage tool for PD with high specificity. For APS, this combined strategy may provide a feasible diagnostic option in settings with limited access to dual\u2010tracer PET\/CT.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/mdc3.70769","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T01:54:46Z","timestamp":1786326886000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined Transcranial Sonography of the\n Substantia<\/scp>\n Nigra and\n 18<\/sup>\n F\u2010Fluorodeoxyglucose\n Positron<\/scp>\n Emission Tomography\/Computed Tomography in the Diagnosis of Parkinson's Disease and Atypical Parkinsonian Syndromes"],"prefix":"10.1002","author":[{"given":"Tong","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine, Daping Hospital Army Medical University Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziwei","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Daping Hospital Army Medical University Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjie","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Daping Hospital Army Medical University Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinju","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Daping Hospital Army Medical University Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weicheng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Daping Hospital Army Medical University Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Daping Hospital Army Medical University Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5521-1778","authenticated-orcid":false,"given":"Jingqin","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Daping Hospital Army Medical University Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8647-0614","authenticated-orcid":false,"given":"Xiao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Daping Hospital Army Medical University Chongqing China"},{"name":"Chongqing Clinical Research Center for Imaging and Nuclear Medicine Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1002\/mds.23713","article-title":"Milestones in atypical and secondary Parkinsonisms","volume":"26","author":"Wenning GK","year":"2011","journal-title":"Mov Disord"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1212\/WNL.0000000000000641","article-title":"Low clinical diagnostic accuracy of early vs advanced Parkinson disease: clinicopathologic study","volume":"83","author":"Adler CH","year":"2014","journal-title":"Neurology"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"169","DOI":"10.4103\/tcmj.tcmj_218_20","article-title":"Epidemiology of atypical parkinsonian syndromes","volume":"34","author":"Lo RY","year":"2022","journal-title":"Tzu Chi Med 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