Evaluating the Swallow-Tail Sign on susceptibility-weighted imaging (SWI) for Parkinson's disease diagnosis: A bivariate meta-analysis.
Evaluating the Swallow-Tail Sign on susceptibility-weighted imaging (SWI) for Parkinson's disease diagnosis: A bivariate meta-analysis.
Where did the research take place?
The study site has not been established. Author addresses may differ from where the research occurred.
São Paulo, BR · Author affiliation
Einstein Israeli Faculty of Health Sciences, São Paulo, Brazil; Department of Radiology and Diagnostic Imaging, Hospital Israelita Albert Einstein (HIAE), São Paulo, Brazil; Center of Interventional Radiology, Albert Einstein Israeli Faculty of Health Sciences (FICSAE), São Paulo, Brazil.Location evidence
São Leopoldo, BR · Author affiliation
University of Vale do Rio dos Sinos, São Leopoldo, Rio Grande do Sul, Brazil.Location evidence
Rio Grande, BR · Author affiliation
University of Vale do Rio dos Sinos, São Leopoldo, Rio Grande do Sul, Brazil.Location evidence
Salvador, BR · Author affiliation
Bahiana School of Medicine and Public Health, Salvador, Brazil.Location evidence
Miami, US · Author affiliation
Department of Radiology, Baptist Health South Florida and Florida International University, Miami, FL, USA; Radiology Associates of South Florida (RASF), Miami, FL, USA.Location evidence
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Original abstract
BACKGROUND AND PURPOSE: The Swallow-Tail Sign (STS), reflecting nigrosome-1 integrity in the substantia nigra, is a magnetic resonance imaging biomarker for Parkinson's disease (PD). Although susceptibility-weighted imaging (SWI) is widely available, the diagnostic performance of STS on SWI has not been comprehensively quantified. This study evaluated the diagnostic accuracy of STS on SWI for identifying PD. MATERIALS AND METHODS: MEDLINE, Embase, and Web of Science were searched for studies assessing STS on SWI in adults with clinically diagnosed PD and healthy controls. Eligible studies provided data to construct 2 × 2 tables. Methodological quality was assessed with QUADAS-2. A bivariate random-effects model estimated pooled sensitivity, specificity, likelihood ratios, and diagnostic odds ratio. RESULTS: Seventeen studies including 1008 PD patients and 944 controls were analyzed. Pooled sensitivity was 0.91 (95% CI: 0.83-0.96) and specificity 0.89 (95% CI: 0.82-0.93). The positive likelihood ratio was 8.1 and the negative likelihood ratio 0.10. The diagnostic odds ratio was 83, and the area under the curve was 0.95. Substantial heterogeneity was observed without evidence of publication bias. CONCLUSIONS: STS on SWI demonstrates high diagnostic accuracy for PD and represents a reliable, non-invasive adjunct to clinical diagnosis.