{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T07:40:46Z","timestamp":1772696446643,"version":"3.50.1"},"reference-count":32,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T00:00:00Z","timestamp":1678924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>The interpretation of 18F-DOPA PET\/CT performed for assessing nigrostriatal dysfunction (NSD) is usually based on visual assessment of the uptake in the basal ganglia (VA-BG). In the present study, we evaluate the diagnostic performance of an automated method that assesses BG uptake (AM-BG) and of methods that assess pineal body uptake, and examine whether these methods can enhance the diagnostic performance of VA-BG alone. We retrospectively included 112 scans performed in patients with clinically suspected NSD who also had a subsequent final clinical diagnosis provided by a movement disorder specialist (69 NSD and 43 non-NSD patients). All scans were categorized as positive or negative based on (1) VA-BG, (2) AM-BG, and (3) qualitative and semiquantitative assessment of pineal body uptake. VA-BG, AM-BG, assessment of pineal body 18F-DOPA uptake by VA (uptake &gt; background), by SUVmax (\u22650.72), and by pineal to occipital ratio (POR \u2265 1.57) could all significantly differentiate NSD from non-NSD patients (Pv &lt; 0.01 for all five methods). Of these methods, VA-BG provided the highest sensitivity (88.4%) and accuracy (90.2%). Combining VA-BG with AM-BG did not improve diagnostic accuracy. An interpretation algorithm that combines VA-BG with pineal body uptake assessment by POR calculation increased sensitivity to 98.5%, at the expense of decreased specificity. In conclusion, an automated method that assesses 18F-DOPA uptake in the BG and assessment of pineal body 18F-DOPA uptake can significantly separate NSD from non-NSD patients, with apparent inferior diagnostic performance when applied alone compared with VA-BG. When VA-BG categorizes a scan as negative or equivocal, assessment of the 18F-DOPA uptake in the pineal body has the potential to minimize the rate of false negative reports. Further research is essential to validate this approach and to study the pathophysiologic relationship between 18F-DOPA uptake in the pineal body and nigrostriatal dysfunction.<\/jats:p>","DOI":"10.3390\/ijms24065683","type":"journal-article","created":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T03:33:57Z","timestamp":1679024037000},"page":"5683","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Beyond Visual Assessment of Basal Ganglia Uptake: Can Automated Method and Pineal Body Uptake Assessment Improve Identification of Nigrostriatal Dysfunction on 18F-DOPA PET\/CT?"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8165-3019","authenticated-orcid":false,"given":"Shir","family":"Hazut Krauthammer","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine, Tel-Aviv Sourasky Medical Center, 6 Weizmann St., Tel Aviv 6423906, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8804-4806","authenticated-orcid":false,"given":"Dan","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Tel-Aviv Sourasky Medical Center, 6 Weizmann St., Tel Aviv 6423906, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2487-0310","authenticated-orcid":false,"given":"Einat","family":"Even-Sapir","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Tel-Aviv Sourasky Medical Center, 6 Weizmann St., Tel Aviv 6423906, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hedva","family":"Lerman","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Tel-Aviv Sourasky Medical Center, 6 Weizmann St., Tel Aviv 6423906, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1212\/WNL.0000000000002350","article-title":"Accuracy of clinical diagnosis of Parkinson disease: A systematic review and meta-analysis","volume":"86","author":"Rizzo","year":"2016","journal-title":"Neurology"},{"key":"ref_2","first-page":"183","article-title":"Parkinsonism plus syndrome\u2014A review","volume":"51","author":"Mitra","year":"2003","journal-title":"Neurol. 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