TY - JOUR
T1 - EANM perspective on clinical PET and SPECT imaging in schizophrenia-spectrum disorders
T2 - a systematic review of longitudinal studies
AU - EANM Neuroimaging Committee
AU - Rogeau, Antoine
AU - Boer, Anne Jetske
AU - Guedj, Eric
AU - Sala, Arianna
AU - Sommer, Iris E.
AU - Veronese, Mattia
AU - van der Weijden-Germann, Monique
AU - Tolboom, Nelleke
AU - Barthel, Henryk
AU - Traub-Weidinger, Tatjana
AU - Yakushev, Igor
AU - Brendel, Matthias
AU - Albert, Nathalie L.
AU - Verger, Antoine
AU - Cecchin, Diego
AU - Van Weehaeghe, Donatienne
AU - Fraioli, Francesco
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2025/2
Y1 - 2025/2
N2 - 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.
AB - 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.
KW - Molecular imaging
KW - Nuclear medicine
KW - PET
KW - Psychiatry
KW - Psychosis
KW - Schizophrenia
KW - SPECT
KW - SSD
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=85210428426&partnerID=8YFLogxK
U2 - 10.1007/s00259-024-06987-1
DO - 10.1007/s00259-024-06987-1
M3 - Review article
AN - SCOPUS:85210428426
SN - 1619-7070
VL - 52
SP - 876
EP - 899
JO - European Journal of Nuclear Medicine and Molecular Imaging
JF - European Journal of Nuclear Medicine and Molecular Imaging
ER -