Clinical Nuclear MedicinePub Date : 2025-10-01Epub Date: 2025-07-17DOI: 10.1097/RLU.0000000000006033
Yeongjoo Lee, Tae-Kyu Lee, Yoon-Sang Oh, Eun Ji Han, Sae Jung Na
{"title":"Association Between Dopamine Transporter Activity in the Striatum on 18 F-FP-CIT PET and Overall Survival of Patients With Parkinsonism.","authors":"Yeongjoo Lee, Tae-Kyu Lee, Yoon-Sang Oh, Eun Ji Han, Sae Jung Na","doi":"10.1097/RLU.0000000000006033","DOIUrl":"10.1097/RLU.0000000000006033","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate whether the overall survival (OS) of patients with parkinsonism is associated with dopamine transporter activity in the striatum measured by 18 F-N-(3-fluoropropyl)-2β-carbon ethoxy-3β-(4-iodophenyl) nortropane positron emission tomography ( 18 F-FP-CIT PET).</p><p><strong>Methods: </strong>From March 2021 to December 2021, 18 F-FP-CIT PET images from patients with Parkinsonism were retrospectively reviewed. Dopamine transporter activity in each striatal region was automatically measured as striatal binding ratio (BR) from PET DICOM files using AI-based quantification (BTXBrain, v1.1.1). Mortality data were obtained from the National Health Insurance system in South Korea. Independent t test was performed to compare regional BRs between nonsurvivor and survivor groups. OS was then compared between low BR and high BR groups for each brain region using Kaplan-Meier curves and the log-rank test. Both univariate and multivariate Cox regression analyses were conducted to calculate hazard ratios (HRs).</p><p><strong>Results: </strong>The final cohort comprised 125 patients (mean age: 73.1 ± 9.4 y) with a median follow-up period of 37 months (range: 31-41 mo). Twenty-six (20.8%) patients died during the follow-up period. Nonsurvivors showed significantly lower BRs in the dorsal striatum ( p =0.03), caudates ( p ≤ 0.001), ventroanterior putamen ( p =0.029), anterior pallidum ( p =0.030), ventral striatum ( p =0.002), and subthalamic nucleus ( p =0.032). Patients with low caudate BR (≤1.63) demonstrated poorer OS than those with high caudate BR (>1.63) (HR: 5.48, 95% CI: 1.27-23.59, p <0.001). In multivariate analysis, old age (HR: 3.136; 95% CI: 1.356-7.251; p =0.008) and low caudate BR (HR: 5.360; 95% CI: 2.310-12.438; p <0.001) were significantly associated with higher mortality.</p><p><strong>Conclusions: </strong>In FP-CIT PET of patients with parkinsonism, the binding ratio of the caudate nucleus rather than that of the putamen can serve as a significant prognostic indicator for overall survival. Dopamine transporter activity of the caudate should receive more attention from a prognostic perspective, both in quantified data and visual analysis.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"912-920"},"PeriodicalIF":9.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical Nuclear MedicinePub Date : 2025-10-01Epub Date: 2025-03-10DOI: 10.1097/RLU.0000000000005825
Margaux Brument, Sylvie Zanetta, Clément Drouet
{"title":"18F-Fluorocholine PET/CT for the Staging and Follow-up of a Patient Suffering From Metastatic Parathyroid Carcinoma.","authors":"Margaux Brument, Sylvie Zanetta, Clément Drouet","doi":"10.1097/RLU.0000000000005825","DOIUrl":"https://doi.org/10.1097/RLU.0000000000005825","url":null,"abstract":"<p><p>Parathyroid carcinoma (PC) is a rare disease, with a frequency of 0.005% of all malignancies. Approximately 30% of patients will develop metastases at some point in the disease. Nonsecreting PC represents <10% of all PC and is harder to diagnose. Here, we report the case of a patient suffering from metastatic nonsecreting PC who has been (and still is) monitored for 4.5 years with 18F-fluorocholine PET/CT.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":"50 10","pages":"e617-e620"},"PeriodicalIF":9.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical Nuclear MedicinePub Date : 2025-10-01Epub Date: 2025-03-11DOI: 10.1097/RLU.0000000000005834
Hongzhe Zhang, Qingqing Pan, Silu Liu, Jie Feng, Yaping Luo
{"title":"Intense Uptake of 68 Ga-exendin-4 in a Patient With WHO Grade 3 Insulinoma and Extensive Intrahepatic Metastases.","authors":"Hongzhe Zhang, Qingqing Pan, Silu Liu, Jie Feng, Yaping Luo","doi":"10.1097/RLU.0000000000005834","DOIUrl":"10.1097/RLU.0000000000005834","url":null,"abstract":"<p><p>A 24-year-old woman with hyperinsulinemic hypoglycemia was found with a pancreatic mass and multiple intrahepatic lesions in CT and MRI. 68 Ga-exendin-4 PET/CT showed intense radioactivity in the pancreatic mass and all the intrahepatic lesions, suggesting a malignant insulinoma with multiple intrahepatic metastases. Subsequent fine needle biopsy confirmed the diagnosis of WHO grade 3 insulinoma. This case with extensive glucagon-like peptide-1 receptor (GLP-1R) expression in a high-grade malignant insulinoma highlighted the potential of GLP-1R-targeted PRRT in future clinical studies.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"978-980"},"PeriodicalIF":9.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical Nuclear MedicinePub Date : 2025-10-01Epub Date: 2025-03-17DOI: 10.1097/RLU.0000000000005847
Bastien Jamet, Cyrille Touzeau, Chloe Antier, Philippe Moreau, Françoise Kraeber-Bodéré
{"title":"Unusual Sole Extramedullary Diffuse Kidney Involvement in Multiple Myeloma Initial Workup Using 2-[ 18 F]FDG-PET/CT Imaging.","authors":"Bastien Jamet, Cyrille Touzeau, Chloe Antier, Philippe Moreau, Françoise Kraeber-Bodéré","doi":"10.1097/RLU.0000000000005847","DOIUrl":"10.1097/RLU.0000000000005847","url":null,"abstract":"<p><p>2-[ 18 F]fluorodeoxyglucose-positron emission tomography with computed tomography (2-[ 18 F]FDG-PET/CT) in multiple myeloma (MM) allows the detection of extramedullary disease (EMD), which is scarce at initial workup. We report here for the first time uncommon 2-[ 18 F]FDG-PET/CT imaging results of a 63-year-old woman with newly diagnosed MM and sole diffuse kidney EMD revealed by a significantly increased renal volume and intense/diffuse bilateral renal cortical uptake without visualization of the urinary excretory cavities then confirmed by kidney biopsy. This case highlights the possibility of a diffuse organ involvement different from the typical imaging pattern of nodular plasmacytoma lesions in soft tissues.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"e624-e625"},"PeriodicalIF":9.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical Nuclear MedicinePub Date : 2025-10-01Epub Date: 2025-05-13DOI: 10.1097/RLU.0000000000005967
Nghi C Nguyen, Jun Luo, Dooman Arefan, Anil K Vasireddi, Shandong Wu
{"title":"Artificial Intelligence in Sincalide-Stimulated Cholescintigraphy: A Pilot Study.","authors":"Nghi C Nguyen, Jun Luo, Dooman Arefan, Anil K Vasireddi, Shandong Wu","doi":"10.1097/RLU.0000000000005967","DOIUrl":"10.1097/RLU.0000000000005967","url":null,"abstract":"<p><strong>Purpose: </strong>Sincalide-stimulated cholescintigraphy (SSC) calculates the gallbladder ejection fraction (GBEF) to diagnose functional gallbladder disorder. Currently, artificial intelligence (AI)-driven workflows that integrate real-time image processing and organ function calculation remain unexplored in nuclear medicine practice. This pilot study explored an AI-based application for gallbladder radioactivity tracking.</p><p><strong>Methods: </strong>We retrospectively analyzed 20 SSC exams, categorized into 10 easy and 10 challenging cases. Two human operators (H1 and H2) independently annotated the gallbladder regions of interest manually over the course of the 60-minute SSC. A U-Net-based deep learning model was developed to automatically segment gallbladder masks, and a 10-fold cross-validation was performed for both easy and challenging cases. The AI-generated masks were compared with human-annotated ones, with Dice similarity coefficients (DICE) used to assess agreement.</p><p><strong>Results: </strong>AI achieved an average DICE of 0.746 against H1 and 0.676 against H2, performing better in easy cases (0.781) than in challenging ones (0.641). Visual inspection showed AI was prone to errors with patient motion or low-count activity.</p><p><strong>Conclusions: </strong>This study highlights AI's potential in real-time gallbladder tracking and GBEF calculation during SSC. AI-enabled real-time evaluation of nuclear imaging data holds promise for advancing clinical workflows by providing instantaneous organ function assessments and feedback to technologists. This AI-enabled workflow could enhance diagnostic efficiency, reduce scan duration, and improve patient comfort by alleviating symptoms associated with SSC, such as abdominal discomfort due to sincalide administration.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"e575-e579"},"PeriodicalIF":9.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical Nuclear MedicinePub Date : 2025-10-01Epub Date: 2025-06-17DOI: 10.1097/RLU.0000000000006029
Xingyao Sun, Fei Zheng, Yuxuan Liu, Yingying Sun, Han Wang, Hao Yang, Pengfei Li, Xiaorong Sun
{"title":"Feasibility of Single Time Point Dosimetry Application in 177 Lu-DOTATATE/DOTATOC-treated Pediatric Neuroblastoma.","authors":"Xingyao Sun, Fei Zheng, Yuxuan Liu, Yingying Sun, Han Wang, Hao Yang, Pengfei Li, Xiaorong Sun","doi":"10.1097/RLU.0000000000006029","DOIUrl":"10.1097/RLU.0000000000006029","url":null,"abstract":"<p><strong>Background: </strong>177 Lu-DOTATATE/DOTATOC peptide receptor radionuclide therapy (PRRT) has demonstrated potential for treating pediatric neuroblastoma (NB), and in clinical practice can be measured dosimetry by multi-time point (MTP) dosimetry. However, the high workload and limited patient compliance associated with MTP restrict its application. Consequently, single time point (STP) dosimetry approaches have emerged as a promising alternative, though their effectiveness in pediatric populations has not been thoroughly investigated. This study aimed to assess the dosimetric determination of 177 Lu-DOTATATE/DOTATOC in pediatric neuroblastoma patients to determine whether STP could serve as a viable replacement for MTP.</p><p><strong>Patients and methods: </strong>A total of 24 pediatric NB patients who received 1 to 2 cycles of 177 Lu-DOTATATE or 177 Lu-DOTATOC underwent dosimetric measurement of lesions and critical organs using the 96 hours single time point (STP H ) dosimetry method proposed by Hänscheid and colleagues. The results were compared with those obtained from standard MTP.</p><p><strong>Results: </strong>In patients treated with 177 Lu-DOTATATE, the mean relative deviation absolute values of the STP H -calculated absorbed dose from MTP were <10% for lesions, kidneys, bone marrow, liver, and spleen, with Pearson correlation coefficients of 0.99, 0.93, 0.97, 0.84, and 0.84, respectively. In patients treated with 177 Lu-DOTATOC, the mean relative deviation absolute values for kidneys, spleen, and bone marrow were <10%, with Pearson correlation coefficients of 0.97, 0.77, 0.35, 0.48, and 0.93 for lesions, kidneys, bone marrow, liver, and spleen, respectively.</p><p><strong>Conclusions: </strong>The findings confirm that the 96 hours STP H method can reliably replace MTP for dosimetric assessment in pediatric NB patients treated with 177 Lu-DOTATATE and performed well in renal dosimetry for 177 Lu-DOTATOC therapy.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"921-926"},"PeriodicalIF":9.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical Nuclear MedicinePub Date : 2025-10-01Epub Date: 2025-07-04DOI: 10.1097/RLU.0000000000005794
Haniye Elahifard, Mohammad Hadi Samadi, Kamran Aryana, Hassan Kamali, Somaye Barashki
{"title":"Enhancing Initial Staging of a Gastric Cancer Patient: The Advantage of [ 99m Tc]-FAPI-46 SPECT/CT Over Conventional CT.","authors":"Haniye Elahifard, Mohammad Hadi Samadi, Kamran Aryana, Hassan Kamali, Somaye Barashki","doi":"10.1097/RLU.0000000000005794","DOIUrl":"10.1097/RLU.0000000000005794","url":null,"abstract":"<p><p>We present a 59-year-old man with gastric signet-ring cell carcinoma, initially staged with contrast-enhanced CT (CECT), revealing gastric wall thickening, lymph nodes, and lung metastases. Subsequently, [ 99m Tc]-FAPI-46 SPECT/CT demonstrated increased tracer uptake in the gastric lesion, pulmonary nodule, and lymph nodes, alongside new findings of skeletal metastasis, omental and peritoneal deposits, altering the staging and clinical management. Our findings highlight the superior utility of [ 99m Tc]-FAPI-46 in accurately staging gastric cancer and detecting occult metastatic lesions, which is critical for effective treatment planning, despite some limitations compared which diagnostic laparoscopy.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"e602-e604"},"PeriodicalIF":9.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Lincoln Sign in a Case of Langerhans Cell Histiocytosis on Bone Scintigraphy.","authors":"Huan Liang, Ziqian Dong, Feilong Chen, Lingge Wei, Peng Xie","doi":"10.1097/RLU.0000000000006065","DOIUrl":"https://doi.org/10.1097/RLU.0000000000006065","url":null,"abstract":"<p><p>Lincoln sign, also known as the black beard sign, is considered the classic manifestation of monostotic Paget disease of the mandible on bone scintigraphy. Here we report the bone scintigraphy findings in a case of Langerhans cell histiocytosis in a 32-year-old man. The images showed intense uptake of MDP in the mandible, which could also be described as the Lincoln sign.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":"50 10","pages":"943-945"},"PeriodicalIF":9.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Squamous Cell Carcinoma of the Tonsil Unmasked by 68 Ga-FAPI-46 PET/CT.","authors":"Jiaqing Liu, Xiyi Liao, Yizhen Pang, Qin Lin, Haojun Chen","doi":"10.1097/RLU.0000000000005866","DOIUrl":"10.1097/RLU.0000000000005866","url":null,"abstract":"<p><p>We reported 18 F-FDG and 68 Ga-FAPI-46 PET/CT findings in a 55-year-old woman with metastatic squamous cell carcinoma of the left neck. 18 F-FDG PET/CT was negative for the detection of primary malignancy. On 68 Ga-FAPI PET/CT, increased radiotracer uptake was noted in the left palatine tonsil, whereas low background uptake was observed in the right palatine tonsil. Based on the PET/CT findings, the patient underwent clinical examination and biopsy of the left tonsil. Histology demonstrated the presence of a squamous cell carcinoma of the tonsil. The case demonstrated the added value of 68 Ga-FAPI-46 PET/CT for locating the primary malignancy in cancer of unknown primary.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"953-955"},"PeriodicalIF":9.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Intense FDG Activity of Renal Granuloma Following Intravesical Bacillus Calmette-Guérin Therapy for Bladder Cancer Mimicking Malignancy.","authors":"Xiaojun Man, Changming Dong, Xiandong Song, Aisheng Dong","doi":"10.1097/RLU.0000000000005810","DOIUrl":"10.1097/RLU.0000000000005810","url":null,"abstract":"<p><p>Intravesical bacillus Calmette-Guérin (BCG) therapy is an effective immunotherapy for superficial bladder cancer. BCG-related infectious complications may occur following intravesical BCG instillation. We describe contrast-enhanced CT, FDG PET/CT, and delayed abdominal FDG PET/MRI findings in a case of BCG-related renal granulomas following intravesical BCG therapy for bladder cancer. The renal lesions showed ill-defined margins with progressive enhancement on postcontrast CT, hypointensity on T2-weighted images, and variable FDG activity on both PET/CT and delayed PET/MRI. This case indicates that BCG-related renal granuloma should be included in the differential diagnosis of FDG-avid renal lesions in patients with BCG therapy for bladder cancer.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"960-962"},"PeriodicalIF":9.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}