Radiomic Analysis of Striatal [¹⁸F]FDOPA PET Imaging in Patients with Psychosis for the Identification of Antipsychotic Response.

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Molecular Imaging and Biology Pub Date : 2025-06-01 Epub Date: 2025-05-05 DOI:10.1007/s11307-025-02014-3

Astrid Schiulaz, Giovanna Nordio, Alessio Giacomel, Rubaida Easmin, Andrea Bettinelli, Pierluigi Selvaggi, Steven Williams, Federico Turkheimer, Sameer Jauhar, Oliver Howes, Mattia Veronese

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引用次数: 0

Abstract

Purpose: Schizophrenia (SCZ) is a severe psychiatric disorder marked by abnormal dopamine synthesis, measurable through [¹⁸F]FDOPA PET imaging. This imaging technique has been proposed as a biomarker for treatment stratification in SCZ, where one-third of patients respond poorly to standard antipsychotics. This study explores the use of radiomics on [¹⁸F]FDOPA PET data to examine dopamine synthesis in SCZ and predict antipsychotic response.

Methods: We analysed 273 [¹⁸F]FDOPA PET scans from healthy controls (n = 138) and SCZ patients (n = 135) from multiple cohorts, including first-episode psychosis cases. Radiomic features from striatal regions were extracted using the MIRP Python package. Reproducibility was assessed with test-retest scans, selecting features with an intraclass correlation coefficient (ICC) > 0.80. These features were grouped via hierarchical clustering based on Spearman correlation. Regression analysis evaluated sex and age effects on radiomic features. Predictive power for treatment response was tested and compared to standard imaging analysis obtained from the Standardised Uptake Value ratio (SUVr) of striatal over cerebellar tracer activity.

Results: Out of 177 features, 15 met the ICC criteria (ICC: 0.81-0.99). Age and sex influenced features in patients but not in controls. The best performance were was by the GLCM joint maximum feature, which effectively differentiated responders from non-responders (AUC: 0.66-0.87), but did not reach statistical significance in classification over SUVr.

Conclusion: Radiomic analysis of [¹⁸F]FDOPA PET supports its use as a biomarker for assessing antipsychotic efficacy in schizophrenia, highlighting differential striatal tracer uptake based on patient response. While it provides modest classification improvements over standard imaging, further validation in larger datasets and integration with multivariate classification algorithms are needed.

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精神病患者纹状体[18F]FDOPA PET成像的放射组学分析及其对抗精神病药物反应的鉴别。

目的：精神分裂症（Schizophrenia， SCZ）是一种以多巴胺合成异常为特征的严重精神障碍，可通过[18F]FDOPA PET显像测量。该成像技术已被提议作为SCZ治疗分层的生物标志物，其中三分之一的患者对标准抗精神病药物反应不佳。本研究探讨了放射组学在[18F]FDOPA PET数据上的应用，以检测SCZ中的多巴胺合成并预测抗精神病反应。方法：我们分析了来自多个队列的健康对照（n = 138）和SCZ患者（n = 135）的273张[18F]FDOPA PET扫描，包括首发精神病患者。使用MIRP Python包提取纹状体区域的放射学特征。通过重测扫描评估再现性，选择类内相关系数(ICC) > 0.80的特征。这些特征通过基于Spearman相关的分层聚类进行分组。回归分析评估了性别和年龄对放射学特征的影响。对治疗反应的预测能力进行了测试，并与从纹状体与小脑示踪剂活性的标准化摄取值比（SUVr）获得的标准成像分析进行了比较。结果：177个特征中有15个符合ICC标准（ICC: 0.81-0.99）。年龄和性别对患者的特征有影响，而对对照组没有影响。GLCM联合最大特征表现最佳，能有效区分反应者和无反应者（AUC: 0.66-0.87），但在SUVr分类上无统计学意义。结论：[18F]FDOPA PET放射组学分析支持其作为评估精神分裂症抗精神病疗效的生物标志物，强调基于患者反应的纹状体示踪剂摄取差异。虽然与标准成像相比，它提供了适度的分类改进，但需要在更大的数据集上进一步验证并与多元分类算法集成。

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来源期刊

Molecular Imaging and Biology 医学-核医学

CiteScore

6.90

自引率

3.20%

发文量

审稿时长

3 months

期刊介绍： Molecular Imaging and Biology (MIB) invites original contributions (research articles, review articles, commentaries, etc.) on the utilization of molecular imaging (i.e., nuclear imaging, optical imaging, autoradiography and pathology, MRI, MPI, ultrasound imaging, radiomics/genomics etc.) to investigate questions related to biology and health. The objective of MIB is to provide a forum to the discovery of molecular mechanisms of disease through the use of imaging techniques. We aim to investigate the biological nature of disease in patients and establish new molecular imaging diagnostic and therapy procedures. Some areas that are covered are: Preclinical and clinical imaging of macromolecular targets (e.g., genes, receptors, enzymes) involved in significant biological processes. The design, characterization, and study of new molecular imaging probes and contrast agents for the functional interrogation of macromolecular targets. Development and evaluation of imaging systems including instrumentation, image reconstruction algorithms, image analysis, and display. Development of molecular assay approaches leading to quantification of the biological information obtained in molecular imaging. Study of in vivo animal models of disease for the development of new molecular diagnostics and therapeutics. Extension of in vitro and in vivo discoveries using disease models, into well designed clinical research investigations. Clinical molecular imaging involving clinical investigations, clinical trials and medical management or cost-effectiveness studies.