TSPO PET/MR in neuropsychiatric lupus: neuroinflammatory metabolic signatures and diagnostic biomarkers.

IF 3.5 2区 医学 Q1 RHEUMATOLOGY
Jing Huang, Jiyuan Wang, Bixiao Cui, Li Su, Hongwei Yang, Yu Liu, Hongxing Wang, Jie Lu
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引用次数: 0

Abstract

Background: Neuropsychiatric SLE (NPSLE) is a clinically challenging subset of SLE, marked by heterogeneous central nervous system involvement. Diagnosis relies on clinical symptoms and exclusionary criteria, lacking objective biomarker.

Purpose: To investigate metabolic patterns of intracerebral lesions and identify diagnostic biomarkers for NPSLE using translocator protein (TSPO) positron emission tomography (PET)/magnetic resonance (MR).

Methods: A retrospective analysis was conducted on 19 patients with NPSLE and 10 patients with non-NPSLE, who underwent [18F] DPA-714 PET/MRI. Diagnoses of SLE and NPSLE followed American College of Rheumatology (ACR) classification and Systemic Lupus International Collaborating Clinics (SLICC) Model B criteria. T2-weighted MRI lesions served as regions of interest (ROI), coregistered to PET for cross-modality quantitative analysis. The maximum uptake (SUVmax) and mean uptake (SUVmean) of brain lesions for each patient was measured. Group differences in SUVmax and SUVmean were compared. Clinical associations were conducted using Pearson correlation, and differentiation between non-NPSLE and NPSLE was performed by logistic regression analysis.

Results: SUVmax was significantly higher in the NPSLE group than in the non-NPSLE group (p<0.01), while there was no significant difference in SUVmean (p>0.05). SUVmax was correlated with clinical assessment scores (SLICC/ACR: r=0.43, p=0.02; modified Rankin Scale: r=0.41, p=0.04; SLE Disease Activity Index: r=0.41, p=0.03), and no significant correlation was found for SUVmean. In logistic regression analysis, only the model based on SUVmax alone was significant (p=0.01). In ROC analysis, the area under the curve (AUC) of SUVmax (0.83) was higher than that of SUVmean (0.68), and Model 4 (SUVmax+SUVmean + Interaction) showed the best diagnostic performance (AUC=0.94).

Conclusions: Patients with NPSLE and non-NPSLE showed distinct TSPO uptake in brain lesions, indicating different pathophysiology. TSPO PET/MR may serve as a potential imaging biomarker for differentiating NPSLE, providing insights for clinical diagnosis and mechanistic stratification in SLE.

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神经精神性狼疮的TSPO PET/MR:神经炎症代谢特征和诊断生物标志物。
背景:神经精神性SLE (NPSLE)是SLE的一个临床挑战性亚群,以异质性中枢神经系统受累为特征。诊断依赖于临床症状和排除标准,缺乏客观的生物标志物。目的:利用转运蛋白(TSPO)正电子发射断层扫描(PET)/磁共振(MR)技术研究脑内病变的代谢模式,并确定NPSLE的诊断生物标志物。方法:回顾性分析19例NPSLE患者和10例非NPSLE患者进行[18F] DPA-714 PET/MRI检查。SLE和NPSLE的诊断遵循美国风湿病学会(ACR)分类和系统性狼疮国际合作诊所(SLICC) B型标准。t2加权MRI病变作为感兴趣区域(ROI),共同登记到PET进行跨模态定量分析。测量每位患者脑病变的最大摄食量(SUVmax)和平均摄食量(SUVmean)。比较SUVmax和SUVmean的组间差异。临床相关性采用Pearson相关分析,非NPSLE与NPSLE之间的差异采用logistic回归分析。结果:NPSLE组的SUVmax明显高于非NPSLE组(p0.05)。SUVmax与临床评估评分相关(SLICC/ACR: r=0.43, p=0.02;改良Rankin量表:r=0.41, p=0.04; SLE疾病活动指数:r=0.41, p=0.03),与SUVmean无显著相关。在logistic回归分析中,只有单独基于SUVmax的模型具有显著性(p=0.01)。在ROC分析中,SUVmax(0.83)的曲线下面积(AUC)高于SUVmean(0.68),模型4 (SUVmax+SUVmean + Interaction)的诊断效果最佳(AUC=0.94)。结论:NPSLE患者和非NPSLE患者在脑病变中表现出明显的TSPO摄取,提示不同的病理生理。TSPO PET/MR可能作为鉴别NPSLE的潜在成像生物标志物,为SLE的临床诊断和机制分层提供见解。
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来源期刊
Lupus Science & Medicine
Lupus Science & Medicine RHEUMATOLOGY-
CiteScore
5.30
自引率
7.70%
发文量
88
审稿时长
15 weeks
期刊介绍: Lupus Science & Medicine is a global, peer reviewed, open access online journal that provides a central point for publication of basic, clinical, translational, and epidemiological studies of all aspects of lupus and related diseases. It is the first lupus-specific open access journal in the world and was developed in response to the need for a barrier-free forum for publication of groundbreaking studies in lupus. The journal publishes research on lupus from fields including, but not limited to: rheumatology, dermatology, nephrology, immunology, pediatrics, cardiology, hepatology, pulmonology, obstetrics and gynecology, and psychiatry.
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