Brain SPECT imaging can provide clinically meaningful, long-term prediction of suicide risk and its temporal evolution, according to research presented at the recent Society of Nuclear Medicine and Molecular Imaging (SNMMI) annual meeting.
Results from a study showed that a single resting-state SPECT scan yielded “individualized risk trajectories that identified high-risk patients months to years before suicide,” noted a team led by David Bryant Keator, PhD, CRO of Change Your Brain Change Your Life Foundation in Costa Mesa, CA.
Keator’s team explained that although suicide continues to be a leading cause of death, “current clinical risk assessments rely largely on self-report and clinician judgment, which have limited ability to identify who is at greatest risk and when intervention is most needed.” The group suggested that objective, biologically grounded markers that can help predict long-term risk are needed, writing that “functional brain imaging has demonstrated alterations associated with suicidal behavior.” However, as brain imaging’s potential role in long-term clinical prediction requires more research, the group conducted a study to assess whether quantitative, resting-state brain SPECT imaging could offer individualized, time-resolved estimates of suicide risk over extended follow-up.
The study included 23,769 patients who underwent resting-state brain SPECT imaging in routine clinical care; they were followed for up to 15 years after baseline imaging. During the follow-up period, 178 individuals died by suicide.
The team found the following:
- Resting-state brain perfusion showed significant associations with suicide hazard across distributed cortical and subcortical regions rather than isolated focal abnormalities.
- Identified regions spanned networks involved in affect regulation, impulse control, and self-referential processing.
- More than 80% of individuals who died by suicide were identified as high risk within six to 24 months prior to death.
- Focusing on the top 5% of individuals at increased suicide risk concentrated one-third of suicide deaths into a “clinically actionable subgroup” compared with the full study cohort.
“Many individuals exhibited sustained increases in predicted risk six to 12 months before death, supporting the potential utility of SPECT-based biomarkers for early clinical warning rather than crisis-only detection,” the investigators noted.
David Bryant Keator, PhD, and SNMMI
The findings support the role of functional nuclear imaging as “an objective adjunct to clinical assessment, with potential to shift suicide prevention toward earlier, proactive, and biologically informed intervention strategies,” they concluded.
Check out AuntMinnie’s full coverage of SNMMI 2026 on our ShowCast.