Three-dimensional sonographic examination of the midbrain for computer-aided diagnosis of movement disorders

We present a novel approach to transcranial B-mode sonography for Parkinson's disease (PD) diagnosis by using 3-D ultrasound (3-DUS). We reconstructed bilateral 3-DUS volumes of the midbrain and substantia nigra echogenicities (SNE) and report results of a more objective abnormality detection in (PD). For classification, we analyzed volumetric measurements of midbrain and SNE in subjects with PD and healthy controls (HC). After blinded segmentation of these structures in 22/23 subjects (11 PD, 11 HC) and by two observers with varying prior experience in this technique, the classification algorithm yielded up to 91% sensitivity and 64% specificity using the larger volume of both SNE as a single-dimensional features and up to 90.9% sensitivity and 72.7% specificity using a multidimensional feature set with midbrain and both SNE volumes. This pilot study indicates that our TC-3-D-US approach is technically feasible and less dependent on the investigator's experience and good bone windows. Our pilot study yielded a fairly high sensitivity and specificity in differentiating between subjects with PD and HC.