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EEG, PET and MR scanners join forces to better diagnose schizophrenia

One of the longest-standing challenges in the fight against schizophrenia is undoubtedly the lack of an imaging tool able to accurately diagnose the disease in its earliest stages of development. The TRIMAGE project has been developing such a device since 2013. It aims to create a combination of neuroimaging modalities, Positron Emission Tomography (PET), Magnetic Resonance Imaging (MRI) and Electroencephalography (EEG) in a single instrument to improve diagnosis and, ultimately, treatment.
EEG, PET and MR scanners join forces to better diagnose schizophrenia
“Prior to our project, PET, MR and EEG had been used independently to study the outcome of schizophrenia or psychosis prodrome, but the problem was never tackled in-depth using the three techniques simultaneously,” explains Alberto Del Guerra, Professor of Medical Physics at the University of Pisa and coordinator of TRIMAGE (A dedicated trimodality (PET/MR/EEG) imaging tool for schizophrenia).

Prof. Del Guerra believes that such a combination, however, would enable clinicians to: analyse the response of the neurotransmitter system; detect the hemodynamics response that accompanies neural activity; and measure potential parameters – all at the same time. “The three imaging techniques address different responses of the brain: a fast one (milliseconds) from EEG, a medium one (seconds to minutes) from MRI and a slow one (tens of minutes) from PET. By combining the three techniques, we can obtain anatomical and temporally correlated physiological and functional information about the brain, which is ideal for the early diagnosis of schizophrenia,” he says.

There is just one problem: doing this requires a novel scanner specifically designed and built to study the brain. And this is where TRIMAGE comes into play: the device combines an MR-compatible EEG cap, a cryogen-free MRI scanner large enough to scan a human head, and a fully integrated PET scanner with twice the sensitivity of state-of-the-art PET/MR systems.

“The benefits are both technological and economical,” Prof. Del Guerra explains. “First of all, having neither liquid nitrogen nor liquid helium makes installation and maintenance simpler and cheaper. Then, the MR magnet is shorter in its axial length, meaning that the patient’s shoulders are outside the magnet and that claustrophobic effects are reduced. The higher spatial resolution and sensitivity of the PET scanner also allows for much better quantitative analysis, which is an absolute must for diagnostic purposes. Finally, the scanner was designed to be cost-effective, so that even small departments that cannot afford to buy a conventional PET/MR whole-body scanner can consider it.”

The TRIMAGE scanner is currently in its final assembly and commissioning stage and it will be installed at the University Hospital in Pisa, Italy. Since it does not have CE certification yet, it will be used according to the new European implementing directives for medical devices, the so-called MEDDEV. Pilot clinical research studies are planned, and several potential customers are already interested in using the scanner on patients for the likes of mental disorders, neurology, neuro-oncology, head and neck angiology, and neurodegenerative diseases.

When the time comes, and CE certification is acquired, TRIMAGE will be commercialised by partner SMEs as well as spin-off SMEs supported by the research institutions involved in the project. As Prof. Del Guerra points out, “the aim is to put the device on the market as a dedicated brain scanner at a price that should be much lower than that of a whole-body PET-MR scanner, and with superior performance for brain imaging.”


Life Sciences


TRIMAGE, MRI, PET, EEG, imaging, scanner, schizophrenia, brain
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