Diagnostic accuracy of diffusion-weighted imaging in variant Creutzfeldt–Jakob disease

Purpose This study sought to investigate the diagnostic sensitivity of diffusion-weighted imaging (DWI) in variant Creutzfeldt-Jakob disease (vCJD), a prion disease with significant public health implications on account of its transmissibility. The importance of this research stemmed from the first...

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Bibliographic Details
Published in:Neuroradiology 2023-12, Vol.65 (12), p.1715-1727
Main Authors: Mackenzie, G., Summers, D., Mackenzie, J., Knight, R.
Format: Article
Language:English
Subjects:
Basal ganglia
Creutzfeldt-Jakob disease
Diagnosis
Diagnostic Neuroradiology
Diagnostic systems
Ganglia
Imaging
Medical imaging
Medicine
Medicine & Public Health
Neurology
Neuroradiology
Neurosciences
Neurosurgery
Public health
Pulvinar
Radiology
Sensitivity
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Summary:Purpose This study sought to investigate the diagnostic sensitivity of diffusion-weighted imaging (DWI) in variant Creutzfeldt-Jakob disease (vCJD), a prion disease with significant public health implications on account of its transmissibility. The importance of this research stemmed from the first neuropathologically confirmed vCJD case in a PRNP heterozygous individual in 2016, which displayed DWI features typical of sporadic CJD (sCJD). The case was classified as ‘probable’ sCJD in life, predominantly based on these imaging findings. While DWI has proven valuable in diagnosing sCJD, its utility in vCJD diagnosis remains unclear. Methods DWI and Fluid-attenuated inversion recovery (FLAIR) images from probable and definite vCJD cases referred to the National CJD Research and Surveillance Unit (NCJDRSU) were independently analysed by an expert neuroradiologist. Scans were reviewed within a mixed cohort of CJD cases including definite sCJD and non-CJD controls. Results FLAIR sequences demonstrated greater sensitivity in identifying the pulvinar sign in vCJD compared to DWI (73% vs 41%, p-value
ISSN:0028-3940
1432-1920
DOI:10.1007/s00234-023-03230-w