University of Pisa: New trimodal imaging device to advance early diagnosis of schizophrenia

TRIMAGE plans to find an interdisciplinary solution for the early diagnosis of schizophrenia. An international team of researchers will build a trimodal imaging device that simultaneously collects data from three existing technologies: positron emission tomography (PET), magnetic resonance (MR) and electro-encephalography (EEG). From a clinical point of view, the goal is to make use of the collected data in order to define specific biomarkers for early diagnosis of schizophrenia.

Schizophrenia is a severe mental disorder that manifests early in life and poses a high social and economic burden on Europe. In order to make the management of the disease more effective, the clinical community needs an imaging tool that enables the early diagnosis of schizophrenia.

TRIMAGE aims to optimise and validate an integrated diagnostic solution including simultaneous PET, MR and EEG imaging and specific biomarkers to provide clinicians with a cost-effective diagnosis tool for schizophrenia and other mental health disorders.

The project, coordinated by the department of physics at the University of Pisa, is run by a European consortium of seven universities and research institutes and four small and medium enterprises:

• Department of Physics of the University of Pisa (Italy)
• Technological Educational Institute of Athens (Greece)
• Forschungszentrum Juelich GmbH (Germany)
• JARA BRAIN, Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH, Aachen (Germany)
• Technische Universitat Munich (Germany)
• Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich (Switzerland)
• Istituto Nazionale di Fisica Nucleare,Sezione di Torino (Italy)
• AdvanSiD (Italy)
• WeeROC (France)
• Raytest GmbH (Germany)
• RS2D (France)

Geographical distribution of the TRIMAGE consortium

Finding new biomarkers

In the first stage of the project, researchers will look for new biomarkers and define a suitable multimodal paradigm with PET, MR, EEG and PET/MR systems so they can provide clinical evidence on the feasibility of early schizophrenia diagnosis.

The clinical recruitment will incorporate 40 patients with schizophrenia diagnosis and 40 gender-matched healthy controls, who will examined with EEG, PET, MR and MR/PET available systems. This first clinical phase should provide biomarkers and will allow establishing a multimodal paradigm.

Building the trimodal imaging instrument

The trimodal imaging instrument will be built in the second stage of the project. Researchers will conduct tests and optimise the instrument for cost-effective diagnosis and monitoring of schizophrenia and related mental disorders. The imaging instrument will be made of a cryogen-free superconducting magnet, a PET scanner based
on silicon photomultipliers with better performances compared to clinical PET scanners, and a fully integrated EEG. The adopted technology will reduce cost, simplify safety management and improve patient comfort.

Cryogen free superconducting magnet 1.2 m long, weighing only 1.5 tons: (1) Magnet; (2) Gradient coils; (3) RF coil; (4) Technical room, e.g. Gradient Amplifier, Electronics, RF Amplifier

PET brain scanner inserted into the MR system

Finally, in the last three months of the project, the trimodal system will be clinically validated against the defined paradigm on a cohort of 15 schizophrenia patient, 15 prodromal individuals and 15 healthy controls.