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oai:figshare.com:article/33992866 2026-09-25T05:17:32Z category_15 portal_316 item_type_3 month_year_09_2026

Table 1_Differentiating early Parkinson’s disease from multiple system atrophy on multimodal PET/MRI using atlas-guided segmentation and vision transformer classification.docx Chao Cong (14577518) Xuewei Zhang (1408315) Shams Tabrez Rifat (25107508) Hongyun Tan (25107511) Jinju Sun (10322066) Wenping Peng (25107514) Xiao Chen (260187) Neuroscience computer assisted diagnosis deep learning multimodal imaging multiple system atrophy Parkinson’s disease Introduction<p>Early differentiation between Parkinson’s disease (PD) and multiple system atrophy-parkinsonian type (MSA-P) remains clinically challenging because of overlapping motor symptoms and subtle imaging abnormalities.</p>Methods<p>We developed a fully automated multimodal PET/MRI framework for early PD–MSA-P differentiation that integrates atlas-guided subject-specific label generation, nnU-Net segmentation of the caudate nuclei and putamina, multimodal image fusion, and Vision Transformer classification with multi-slice voting (ViT+MSV). A total of 155 early-stage patients, including 121 with PD and 34 with MSA-P, were evaluated using patient-level stratified 4-fold cross-validation.</p>Results<p>The segmentation model achieved an overall Dice score of 0.853 (95% CI, 0.830–0.877) and an IoU of 0.747 (95% CI, 0.725–0.770). ViT+MSV achieved a cross-validated AUC of 0.947 (95% CI, 0.905–0.981), an accuracy of 0.929 (95% CI, 0.890–0.968), a sensitivity of 0.942 (95% CI, 0.900–0.982), and a specificity of 0.882 (95% CI, 0.765–0.974). The combination of [¹⁸F]fluorodeoxyglucose (FDG) PET, [¹¹C]CFT dopamine-transporter PET, and T2-weighted imaging (T2WI) showed the best overall classification performance. Grad-CAM visualizations showed that class-discriminative gradient-based saliency was mainly concentrated on the bilateral putamen.</p>Discussion<p>These findings suggest that anatomically guided multimodal PET/MRI analysis with transformer-based classification may support early PD–MSA-P differentiation while providing spatially interpretable evidence for model decisions.</p> 2026-09-25T05:17:32Z Dataset Dataset 10.3389/fnagi.2026.1928959.s001 https://figshare.com/articles/dataset/Table_1_Differentiating_early_Parkinson_s_disease_from_multiple_system_atrophy_on_multimodal_PET_MRI_using_atlas-guided_segmentation_and_vision_transformer_classification_docx/33992866 CC BY 4.0