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.
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.