Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
School of Medical Psychology, Fourth Military Medical University, Xi'an, China.
Schizophr Bull. 2018 Aug 20;44(5):1053-1059. doi: 10.1093/schbul/sby007.
Specific biomarker reflecting neurobiological substrates of schizophrenia (SZ) is required for its diagnosis and treatment selection of SZ. Evidence from neuroimaging has implicated disrupted functional connectivity in the pathophysiology. We aimed to develop and validate a method of disease definition for SZ by resting-state functional connectivity using radiomics strategy. This study included 2 data sets collected with different scanners. A total of 108 first-episode SZ patients and 121 healthy controls (HCs) participated in the current study, among which 80% patients and HCs (n = 183) and 20% (n = 46) were selected for training and testing in intra-data set validation and 1 of the 2 data sets was selected for training and the other for testing in inter-data set validation, respectively. Functional connectivity was calculated for both groups, features were selected by Least Absolute Shrinkage and Selection Operator (LASSO) method, and the clinical utility of its features and the generalizability of effects across samples were assessed using machine learning by training and validating multivariate classifiers in the independent samples. We found that the accuracy of intra-data set training was 87.09% for diagnosing SZ patients by applying functional connectivity features, with a validation in the independent replication data set (accuracy = 82.61%). The inter-data set validation further confirmed the disease definition by functional connectivity features (accuracy = 83.15% for training and 80.07% for testing). Our findings demonstrate a valid radiomics approach by functional connectivity to diagnose SZ, which is helpful to facilitate objective SZ individualized diagnosis using quantitative and specific functional connectivity biomarker.
用于精神分裂症 (SZ) 的诊断和治疗选择需要特定的反映神经生物学基础的生物标志物。神经影像学的证据表明,功能连接的中断与病理生理学有关。我们旨在通过使用放射组学策略的静息状态功能连接来开发和验证 SZ 的疾病定义方法。这项研究包括使用不同扫描仪收集的 2 个数据集。共有 108 名首发 SZ 患者和 121 名健康对照者 (HCs) 参与了本研究,其中 80%的患者和 HCs(n=183)和 20%(n=46)被选入内部数据集验证中的训练和测试,2 个数据集中的 1 个用于训练,另 1 个用于测试。对两组进行功能连接计算,使用最小绝对收缩和选择算子 (LASSO) 方法选择特征,并通过在独立样本中训练和验证多变量分类器,使用机器学习评估其特征的临床效用及其在样本间的泛化效果。我们发现,通过功能连接特征诊断 SZ 患者的内部数据集训练的准确率为 87.09%,在独立复制数据集的验证中准确率为 82.61%。跨数据集验证进一步通过功能连接特征证实了疾病的定义(训练准确率为 83.15%,测试准确率为 80.07%)。我们的研究结果表明,功能连接的放射组学方法是一种有效的 SZ 诊断方法,有助于使用定量和特定的功能连接生物标志物促进客观的 SZ 个体化诊断。