Clinical Nuclear Medicine最新文献

{"title":"Diagnostic Value of Surveillance 18F-FDG PET/CT in Head and Neck Squamous Cell Carcinoma After Curative Therapy.","authors":"Wonseok Whi, Seung Hwan Moon, Dongryul Oh, Man Ki Chung, Han-Sin Jeong, Myung Ju Ahn, Joon Young Choi","doi":"10.1097/RLU.0000000000005639","DOIUrl":"https://doi.org/10.1097/RLU.0000000000005639","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the diagnostic performance of surveillance FDG PET/CT for detection of clinically unexpected recurrent disease or second primary malignancy in head and neck squamous cell carcinoma (HNSCC) patients who underwent curative treatment.</p><p><strong>Patients and methods: </strong>We conducted a retrospective analysis of 739 consecutive patients with HNSCC who underwent 2396 surveillance FDG PET/CT scans. Surveillance FDG PET/CT scans were defined as routine follow-up scans after curative therapy without suspicion of recurrence. The diagnostic performance of FDG PET/CT was evaluated based on sensitivity, specificity, positive predictive value, negative predictive value, and accuracy.</p><p><strong>Results: </strong>Of the 2396 surveillance FDG PET/CT scans, 119 (5.0%) showed positive findings, with 93 (78.1%) confirmed as true-positives. True-positive detections included locoregional metastases, distant metastases, or second primary malignancies. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 97.9%, 98.9%, 78.2%, 99.9%, and 98.8%, respectively. The incidence of recurrence was significantly greater in patients initially diagnosed with stage IVA disease (P = 0.03) and for which 5 or more years had elapsed since treatment (P < 0.001) than in other subgroups. However, no significant differences in diagnostic performance were observed across subgroups divided by tumor location, disease stage, treatment modality, or time since treatment.</p><p><strong>Conclusions: </strong>Surveillance FDG PET/CT showed excellent diagnostic performance for detection of clinically unexpected recurrent disease or second primary malignancies in patients with HNSCC after curative therapy. The frequency and duration of surveillance could be adjusted based on the initial disease stage to optimize early detection and intervention.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":"50 4","pages":"301-306"},"PeriodicalIF":9.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604270","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":"Deep Learning-Powered CT-Less Multitracer Organ Segmentation From PET Images: A Solution for Unreliable CT Segmentation in PET/CT Imaging.","authors":"Yazdan Salimi, Zahra Mansouri, Isaac Shiri, Ismini Mainta, Habib Zaidi","doi":"10.1097/RLU.0000000000005685","DOIUrl":"10.1097/RLU.0000000000005685","url":null,"abstract":"<p><strong>Purpose: </strong>The common approach for organ segmentation in hybrid imaging relies on coregistered CT (CTAC) images. This method, however, presents several limitations in real clinical workflows where mismatch between PET and CT images are very common. Moreover, low-dose CTAC images have poor quality, thus challenging the segmentation task. Recent advances in CT-less PET imaging further highlight the necessity for an effective PET organ segmentation pipeline that does not rely on CT images. Therefore, the goal of this study was to develop a CT-less multitracer PET segmentation framework.</p><p><strong>Patients and methods: </strong>We collected 2062 PET/CT images from multiple scanners. The patients were injected with either 18 F-FDG (1487) or 68 Ga-PSMA (575). PET/CT images with any kind of mismatch between PET and CT images were detected through visual assessment and excluded from our study. Multiple organs were delineated on CT components using previously trained in-house developed nnU-Net models. The segmentation masks were resampled to coregistered PET images and used to train 4 different deep learning models using different images as input, including noncorrected PET (PET-NC) and attenuation and scatter-corrected PET (PET-ASC) for 18 F-FDG (tasks 1 and 2, respectively using 22 organs) and PET-NC and PET-ASC for 68 Ga tracers (tasks 3 and 4, respectively, using 15 organs). The models' performance was evaluated in terms of Dice coefficient, Jaccard index, and segment volume difference.</p><p><strong>Results: </strong>The average Dice coefficient over all organs was 0.81 ± 0.15, 0.82 ± 0.14, 0.77 ± 0.17, and 0.79 ± 0.16 for tasks 1, 2, 3, and 4, respectively. PET-ASC models outperformed PET-NC models ( P < 0.05) for most of organs. The highest Dice values were achieved for the brain (0.93 to 0.96 in all 4 tasks), whereas the lowest values were achieved for small organs, such as the adrenal glands. The trained models showed robust performance on dynamic noisy images as well.</p><p><strong>Conclusions: </strong>Deep learning models allow high-performance multiorgan segmentation for 2 popular PET tracers without the use of CT information. These models may tackle the limitations of using CT segmentation in PET/CT image quantification, kinetic modeling, radiomics analysis, dosimetry, or any other tasks that require organ segmentation masks.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"289-300"},"PeriodicalIF":9.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberous Sclerosis Complex Demonstrated on 18 F-FDG PET/CT.","authors":"Selin Kesim, Nuh Filizoglu","doi":"10.1097/RLU.0000000000005625","DOIUrl":"10.1097/RLU.0000000000005625","url":null,"abstract":"<p><strong>Abstract: </strong>Tuberous sclerosis complex is a rare neurocutaneous genetic disorder that can affect multiple organ systems including the skin, eyes, brain, kidneys, heart, and lungs. Herein, we report 18 F-FDG PET/CT findings of brain and skin lesions, bilateral renal angiomyolipomas, and pulmonary lymphangioleiomyomatosis in a patient with tuberous sclerosis complex.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"e229-e231"},"PeriodicalIF":9.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784287","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":"68 Ga-DOTATATE PET/CT Demonstrated More Lesions of Leptomeningeal Metastases Compared With 123 I-MIBG SPECT/CT in a Pediatric Neuroblastoma Patient.","authors":"Lingling Zheng, Siqi Li, Yanfeng Xu, Wei Wang, Jigang Yang","doi":"10.1097/RLU.0000000000005630","DOIUrl":"10.1097/RLU.0000000000005630","url":null,"abstract":"<p><strong>Abstract: </strong>A 5-year-old girl with high-risk neuroblastoma after therapy was evaluated by 123 I-MIBG SPECT/CT and 68 Ga-DOTATATE PET/CT. Contrast-enhancement brain MRI demonstrated 2 metastatic lesions in the right parietal lobe of brain. One lesion showed abnormal MIBG accumulation associated with high density in the right central posterior gyrus, whereas the other lesion did not show MIBG uptake. In contrast, increased 68 Ga-DOTATATE uptake was seen in both lesions. Neuroblastoma cells were found by cytological examination of the cerebrospinal fluid.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"346-348"},"PeriodicalIF":9.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799537","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":"Adult Embryonal Rhabdomyosarcoma of the Prostate Presented on 18 F-FDG and Al 18 F-FAPI-74 PET/CT.","authors":"Xin Cheng, Guozhu Hou, Rong Zheng, Xi Chen, Xuejuan Wang","doi":"10.1097/RLU.0000000000005599","DOIUrl":"10.1097/RLU.0000000000005599","url":null,"abstract":"<p><strong>Abstract: </strong>A 21-year-old man with a 2-week history of abdominal pain and urinary hesitancy was admitted to our hospital. Sarcoma was suspected based on his PSA level, age, and MRI findings. He underwent 18 F-FDG and Al 18 F-FAPI-74 PET/CT scans. The scans revealed an irregularly dense prostate mass with indistinct borders to the rectum. The mass exhibited increased and heterogeneous FDG uptake and FAPI activity, with different distribution patterns between the 2 tracers. Histopathological analysis confirmed the diagnosis of embryonal rhabdomyosarcoma.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"352-353"},"PeriodicalIF":9.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945873","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":"Pineal Gland Activity in Advanced-Stage Pediatric Neuroblastoma Patients on 68 Ga-DOTATATE PET/CT.","authors":"Emine Goknur Isik, Dilara Denizmen, Dilşad Fırat Arslan, Duygu Has Simsek, Zeynep Gözde Özkan","doi":"10.1097/RLU.0000000000005626","DOIUrl":"10.1097/RLU.0000000000005626","url":null,"abstract":"<p><strong>Abstract: </strong>Neuroblastoma is the most common malignancy in infants and the most common extracranial solid tumor accounting for approximately 6% of pediatric cancer. Although surgical intervention serves as the primary treatment for early-stage disease, advanced-stage cases necessitate a variety of oncologic therapeutic approaches, including 131 I-MIBG and peptide receptor radionuclide therapy. Herein we report incidental pineal gland activity, represented in 68 Ga-DOTATATE PET/CT (SSTR-PET) in 3 pediatric patients diagnosed with stage 4 neuroblastoma, related to the physiological distribution of radiopharmaceuticals.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"343-345"},"PeriodicalIF":9.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817345","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":"The Value of Multidisciplinary Neuro-oncological Tumor Boards to Increase the Accuracy of FET PET for Identifying Brain Tumor Relapse.","authors":"Garry S Ceccon, Jan-Michael Werner, Maximilian I Ruge, Roland Goldbrunner, Eren Celik, Christian Baues, Martina Deckert, Anna Brunn, Manuel Montesinos Rongen, Reinhard Büttner, Veronika Dunkl, Lucia Nogova, Marc Schlamann, Christoph Kabbasch, Daniel Rueß, Jürgen Hampl, Michael M Wollring, Elena K Rosen, Caroline Tscherpel, Gabriele Stoffels, Philipp Lohmann, Felix M Mottaghy, Gereon R Fink, Karl-Josef Langen, Norbert Galldiks","doi":"10.1097/RLU.0000000000005634","DOIUrl":"10.1097/RLU.0000000000005634","url":null,"abstract":"<p><strong>Purpose: </strong>Especially in Europe, amino acid PET is increasingly integrated into multidisciplinary neuro-oncological tumor boards (MNTBs) to overcome diagnostic uncertainties such as treatment-related changes. We evaluated the accuracy of MNTB decisions that included the O -(2-[ 18 F]-fluoroethyl)-L-tyrosine (FET) PET information compared with FET PET results alone to differentiate tumor relapse from treatment-related changes.</p><p><strong>Patients and methods: </strong>In a single academic center, we retrospectively evaluated 180 MNTB decisions of 151 patients with CNS WHO grade 3 or 4 gliomas (n = 122) or brain metastases (n = 29) presenting equivocal MRI findings following anticancer treatment. All patients underwent FET PET imaging besides MRI before MNTB discussion. Additionally, the patient's clinical status and pretreatment were considered for decision-making. The diagnostic performance was calculated for FET PET findings alone and MNTB decisions that included FET PET results using 2 × 2 contingency tables. MNTB decisions were validated using the neuropathological result in 43% (n = 78) or clinicoradiologically in 57% (n = 102).</p><p><strong>Results: </strong>FET PET results alone yielded an accuracy of 87% (sensitivity, 90%; specificity, 65%; positive predictive value, 95%). When integrating FET PET results for decision-making in the MNTB setting, the accuracy increased to 95% (sensitivity, 99%; specificity, 70%; positive predictive value, 96%; P = 0.002). In MNTB decisions concerning glioblastoma patients, the median survival was 2.4 times longer when FET PET suggested treatment-related changes (15.6 vs 6.4 months; P = 0.009).</p><p><strong>Conclusions: </strong>Our results suggest that MNTB discussion further enhances the FET PET value for identifying brain tumor relapse. A prospective evaluation of FET PET results with and without integration in an MNTB is warranted.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"307-315"},"PeriodicalIF":9.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977908","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":"A Very Atypical Meckel Diverticulum on 99m TcO 4- Scintigraphy.","authors":"Ann Foran, Pensiree Attaseth, Frederick D Grant, Hongming Zhuang","doi":"10.1097/RLU.0000000000005683","DOIUrl":"10.1097/RLU.0000000000005683","url":null,"abstract":"<p><strong>Abstract: </strong>Typical Meckel diverticulum on 99m TcO 4- scintigraphy usually appears early in the dynamic imaging in the right lower quadrant of the abdomen, without change of location during the study. We report a case of pathology-proven Meckel diverticulum a 7-year-old boy, which appeared only on the later part of the 99m TcO 4- study in the midline upper pelvis which gradually changed location during the study.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"e245-e247"},"PeriodicalIF":9.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032521","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":"FDG PET/CT in a Case of Gardner Syndrome.","authors":"Lili Shan, Aisheng Dong, Yan Han","doi":"10.1097/RLU.0000000000005646","DOIUrl":"10.1097/RLU.0000000000005646","url":null,"abstract":"<p><strong>Abstract: </strong>Gardner syndrome is characterized by multiple intestinal polyps and extraintestinal lesions. We describe FDG PET/CT findings of the extraintestinal lesions in a patient with Gardner syndrome. FDG PET/CT showed 2 hypermetabolic desmoid tumors in the abdominal wall, sclerotic areas with multifocal activity in the maxilla and mandible, multiple osteomas in the bilateral parietal, left frontal, sphenoid and ethmoid bones, an impacted tooth in the right maxilla, and bone islands in the T2 and T5 vertebral bodies. Extraintestinal involvements in Gardner syndrome can precede intestinal polyposis. Therefore, familiarity with FDG PET/CT findings of extraintestinal manifestations is helpful for early diagnosis.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"356-357"},"PeriodicalIF":9.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946021","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":"Gastrin-Releasing Peptide Receptor Targeting PET/CT With 68 Ga-NOTA-RM26 in the Assessment of Glioma and Combined Multiregional Biopsies.","authors":"Rongxi Wang, Yilin Li, Ziyang Li, Jiarou Wang, Linlin Li, Jialin Xiang, Chenhao Jia, Xingtong Peng, Yu Wang, Wenbin Ma, Li'ao Wang, Wang Jia, Xiaoyuan Chen, Deling Li, Zhaohui Zhu, Jingjing Zhang","doi":"10.1097/RLU.0000000000005651","DOIUrl":"10.1097/RLU.0000000000005651","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to investigate the value of 68 Ga-NOTA-RM26 ( 68 Ga-RM26), a gastrin-releasing peptide receptor-targeting antagonist labeled with the radionuclide 68 Ga, in the diagnosis of high-grade gliomas and in combination with multiregional biopsies using PET/CT.</p><p><strong>Patients and methods: </strong>After institutional review board approval and informed consent, a total of 35 patients with suspected glioma lesions were enrolled in this study. All patients underwent 68 Ga-RM26 PET/CT scans within 2 weeks before surgery.</p><p><strong>Results: </strong>There were 8 grade II gliomas, 6 grade III gliomas, and 18 grade IV gliomas in a total of 32 glioma lesions. 68 Ga-RM26 PET/CT diagnosed 74.4% of lesions (27/32) of all glioma tumor types, and almost all high-grade gliomas were successfully diagnosed (23/24, 95.8%). Among the 9 negative glioma lesions, there were 8 low-grade gliomas (grade II). There was a significantly higher SUV max , SUV mean , and the lesion-to-background ratio (T/B ratio) in high-grade gliomas compared with low-grade gliomas ( P < 0.001). In addition, there was a high correlation between the immunohistochemical staining score of gliomas and parameters (SUV max , SUV mean , and T/B ratio) on 68 Ga-RM26 PET/CT ( P < 0.001), and verified by immunohistochemical staining on multiple-point samples of glioma lesions guided by 68 Ga-RM26 PET/CT.</p><p><strong>Conclusions: </strong>68 Ga-RM26 could noninvasively diagnose high-grade gliomas and be a promising PET tracer for predicting glioma grading before surgery. This pilot study indicated that the uptake of 68 Ga-RM26 correlates with WHO grade in glioma, and preoperative 68 Ga-RM26 PET/CT may be helpful to guide multiple-point biopsy of gliomas.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"316-323"},"PeriodicalIF":9.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977902","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}