[en] [en] PURPOSE: There is a need for biomarkers in psychiatry to improve diagnosis, prognosis and management, and with confirmed value in follow-up care. Radionuclide imaging, given its molecular imaging characteristics, is well-positioned for translation to the clinic. This systematic review lays the groundwork for integrating PET and SPECT imaging in the clinical management of schizophrenia-spectrum disorders.
METHODS: Systematic search of PubMed, Embase, Web of Science and Cochrane library databases was conducted from the earliest date available until February 2024. The focus was on longitudinal studies evaluating PET or SPECT imaging in individuals with a schizophrenia-spectrum or another psychotic disorders. Quality assessment was done using the Newcastle-Ottawa Scale (NOS), NIH scale for before-after studies and Cochrane Risk of Bias tool version 2 (Cochrane RoB2). Studies were further categorised into three groups: preclinical and diagnosis, predicting disease course or personalising treatment.
RESULTS: Fifty-six studies were included in the systematic review investigating in total 1329 patients over a median of 3 months. Over two-thirds used PET tracers, whereas the remaining studies employed SPECT tracers. The most frequently investigated system was dopaminergic transmission, followed by cerebral metabolism and blood flow. [18F]FDOPA demonstrated large effect size in predicting conversion of subjects at risk and treatment response. Additionally, treatment dosage could be optimised to reduce side effects using [123I]IBZM or [11C]raclopride.
CONCLUSION: Molecular imaging holds significant promise for real-life application in schizophrenia, with two particularly encouraging avenues being the prediction of conversion/response to antipsychotic medication and the improved management of antipsychotic dosage. Further longitudinal studies and clinical trials will be essential for validating both the clinical effectiveness and economic sustainability, as well as for exploring new applications.
Disciplines :
Radiology, nuclear medicine & imaging
Author, co-author :
Rogeau, Antoine ; Department of Nuclear Medicine, Lille University Hospital, Lille, France. arogeau.pro@gmail.com
Boer, Anne Jetske; Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
Guedj, Eric; Department of Nuclear Medicine, Aix Marseille Univ, APHM, CNRS, Centrale Marseille, Institut Fresnel, Hôpital de La Timone, CERIMED, Marseille, France
Sala, Arianna ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group
Sommer, Iris E; Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
Veronese, Mattia; Department of Information Engineering, University of Padua, Padua, Italy ; Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
van der Weijden-Germann, Monique; Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
EANM Neuroimaging Committee
Fraioli, Francesco; Institute of Nuclear Medicine, University College London Hospitals NHS Foundation Trust, London, UK
Language :
English
Title :
EANM perspective on clinical PET and SPECT imaging in schizophrenia-spectrum disorders: a systematic review of longitudinal studies.
Publication date :
22 November 2024
Journal title :
European Journal of Nuclear Medicine and Molecular Imaging
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