Clinical Nuclear Medicine最新文献

{"title":"Potential Utility of SPECT/CT for Early Detection of Scapular Stress Reaction Following Reverse Total Shoulder Arthroplasty.","authors":"Chul-Hyun Cho, Du-Han Kim, Kyoung Sook Won","doi":"10.1097/RLU.0000000000005438","DOIUrl":"10.1097/RLU.0000000000005438","url":null,"abstract":"<p><strong>Abstract: </strong>Scapular stress fracture (SSF) after reverse total shoulder arthroplasty is a unique and common complication that may have negative impact for long-term outcomes. Scapular stress reaction (SSR), characterized by pain and tenderness without radiographic evidence of fracture, can be precursor of SSF. We believe that early detection using SPECT/CT with proper management for SSRs including acromion, scapular spine, and coracoid process is crucial for better prognosis without additional complications by preventing SSFs. Therefore, we present 3 typical cases with SSR following reverse total shoulder arthroplasty with the findings of SPECT/CT.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"66-69"},"PeriodicalIF":9.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343075","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":"Detection and Response Evaluation of Extramedullary and Medullary Blast Crisis in Chronic Myeloid Leukemia on 18 F-FDG PET/CT.","authors":"Abhishek Behera, Meghana Prabhu, Gaurav Khanna, Shikhar Sawhney, Pravas Chandra Mishra","doi":"10.1097/RLU.0000000000005451","DOIUrl":"10.1097/RLU.0000000000005451","url":null,"abstract":"<p><strong>Abstract: </strong>FDG PET/CT imaging is usually not routinely undertaken in patients of chronic myeloid leukemia (CML). We present a case of CML on tyrosine kinase inhibitor treatment with disease control indicated by BCR-ABL1 quantitative reverse transcription-polymerase chain reaction, who underwent PET/CT for evaluation of recent onset vision deterioration with subretinal exudates on ophthalmological examination. PET CT detected FDG-avid sinonasal thickening and bilateral marrow lesions. These lesions on histopathological sampling, examination revealed extramedullary and intramedullary CML blast crisis. Patient was then treated with steroids and change of tyrosine kinase inhibitor for the CML blast crisis. FDG PET/CT done subsequently was able to demonstrate morphological and metabolic response in the lesions.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"e66-e67"},"PeriodicalIF":9.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361259","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":"To Perform, or Not to Perform Interim PET: Questioning the Impact of Midtherapy Evaluation During PRRT in GEP-NET Patients.","authors":"Christoph Wetz, Tristan Ruhwedel, Julian M M Rogasch, Peter R Steinhagen, Felix Bolduan, Holger Amthauer, Imke Schatka","doi":"10.1097/RLU.0000000000005479","DOIUrl":"10.1097/RLU.0000000000005479","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to analyze the impact of interim evaluation on the continuation of 177 Lu-based peptide receptor radionuclide therapy (PRRT) in gastroenteropancreatic neuroendocrine tumors (GEP-NETs) and to survey its usage across German university hospitals.</p><p><strong>Patients and methods: </strong>In 119 GEP-NET patients who underwent PRRT, we retrospectively assessed the results and therapeutic impact of restaging performed after 2 cycles using MRI/CT/somatostatin receptor imaging. Therapeutic decisions based on interim PET results were made in multidisciplinary tumor board meetings. Additionally, an online survey was conducted among 37 German university hospitals regarding their interim evaluation practices, focusing on the change in management.</p><p><strong>Results: </strong>Of 119 patients, 83 completed 4 PRRT cycles; 36 stopped after 2: 27 showed PD, 3 had PR leading to surgery, 5 experienced toxicity, and 1 died. Those completing 4 cycles showed a median PFS of 38.0 months (95% confidence interval, 32.2-43.8). Seventeen of 37 surveyed hospitals routinely used interim evaluation. In a survey among 37 German university hospitals, 62% reported offering PRRT for GEP-NET patients, with 74% of these performing a routinely interim evaluation after 2 cycles of PRRT, primarily using PET/CT imaging techniques.</p><p><strong>Conclusions: </strong>Interim PET after 2 PRRT cycles helps to identify early progression in GEP-NET patients. Standardizing interim evaluation practices could enhance the comparability of clinical outcomes and optimize patient management.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"19-24"},"PeriodicalIF":9.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399657","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":"Apparently Benign 131 I Adrenal Uptake.","authors":"Daniela Travaglio Morales, Michael C Kreissl, Florian Fischer, Alexander Heinzel","doi":"10.1097/RLU.0000000000005398","DOIUrl":"10.1097/RLU.0000000000005398","url":null,"abstract":"<p><strong>Abstract: </strong>A 60-year-old man suffering from papillary thyroid cancer (pT2 pN0 (0/21) cM0) underwent diagnostic 131 I whole-body scintigraphy with recombinant thyroid-stimulating hormone for follow-up after thyroidectomy and adjuvant 131 I therapy with 4.2 GBq. A focal uptake of radioiodine was found in the right adrenal gland, which had not been seen on the initial posttherapeutic images; therefore, an adrenal metastasis was suspected. However, the diagnostic workup including contrast-enhanced MRI as well as endocrine laboratory tests indicated a benign etiology showcasing a very rare case of false-positive radioiodine uptake in the adrenal gland. The imaging follow-up after 1 year showed no significant changes.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"77-79"},"PeriodicalIF":9.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874369","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":"Glucagon-Like Peptide-1 Receptor-Targeted PET/CT With 68 Ga-HBED-CC-Exendin-4 in Localizing Insulinoma : A Head-to-Head Comparison to 68 Ga-NOTA-Exendin-4.","authors":"Linlin Li, Guochang Wang, Jiarou Wang, Heng Ma, Jingci Chen, Rongxi Wang, Qingqing Pan, Haiyan Hong, Wenbin Jin, Hank F Kung, Lin Zhu, Yaping Luo, Zhaohui Zhu","doi":"10.1097/RLU.0000000000005533","DOIUrl":"10.1097/RLU.0000000000005533","url":null,"abstract":"<p><strong>Purpose: </strong>Modifying glucagon-like peptide-1 receptor (GLP-1R)-targeted PET agent to achieve faster renal clearance and preserved high affinity to GLP-1R is clinically relevant. The aim of this study is to assess the performance of a newly developed GLP-1R-targeted agent, 68 Ga-HBED-CC-exendin-4 in localizing insulinoma, and its biodistribution, as compared with previously introduced 68 Ga-NOTA-exendin-4.</p><p><strong>Patients and methods: </strong>Nineteen patients with endogenous hyperinsulinemic hypoglycemia were enrolled and referred for 68 Ga-HBED-CC-exendin-4 PET/CT and 68 Ga-NOTA-exendin-4 PET/CT within 2 consecutive days. Diagnostic performance of the 2 tracers in localizing insulinoma was evaluated, and SUV of the lesion, normal pancreas background, kidneys, and bladder were measured.</p><p><strong>Results: </strong>68 Ga-HBED-CC-exendin-4 and 68 Ga-NOTA-exendin-4 PET/CT exhibited an equivalent efficacy in detection rate (both sensitivity of 100%). Although SUV max of the tumor in 68 Ga-HBED-CC-exendin-4 was significantly lower than that in 68 Ga-NOTA-exendin-4 (20.01 ± 9.41 vs 31.78 ± 15.46, P < 0.001) at 50 minutes postinjection, there was no significant difference in the tumor-to-background ratio between the 2 agents (8.61 ± 3.57 vs 8.18 ± 3.38, P = 0.326), and the lesions could be visible as early as 4 minutes postinjection for both agents in patients who underwent dynamic PET/CT. In addition, 68 Ga-HBED-CC-exendin-4 exhibited approximately 30% decrease of the renal accumulation compared with 68 Ga-NOTA-exendin-4 (SUV mean , 42.21 ± 5.79 vs 58.58 ± 10.06 at 50 minutes, P < 0.001).</p><p><strong>Conclusions: </strong>68 Ga-HBED-CC-exendin-4 is an effective agent for localizing insulinoma showing similar detectability and tumor-to-background ratio compared with 68 Ga-NOTA-exendin-4. Notably, 68 Ga-HBED-CC-exendin-4 exhibits significantly lower renal uptake than 68 Ga-NOTA-exendin-4, which might potentially benefit the detection of the tumors adjacent to the left kidneys.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"38-43"},"PeriodicalIF":9.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581671","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":"Norepinephrine Transporter-Targeted Cancer Theranostics-New Horizons.","authors":"Takahiro Higuchi, Konrad Klimek, Daniel Groener, Xinyu Chen, Rudolf A Werner","doi":"10.1097/RLU.0000000000005567","DOIUrl":"10.1097/RLU.0000000000005567","url":null,"abstract":"<p><strong>Abstract: </strong>In the evolving landscape of precision oncology, this review delineates the role of radiopharmaceuticals targeting the norepinephrine transporter (NET), with a particular focus on the current clinical application of 123 I-MIBG diagnostic imaging and 131 I-MIBG therapeutics, in particular for pheochromocytoma, neuroblastoma, or paraganglioma. We will also highlight recently introduced 18 F-labeled NET targeting imaging radiotracers, which would offer unparalleled resolution, enhanced tumor localization, and staging properties. Complementing these novel second-generation PET agents in a theranostic approach, astatine-211 meta-astatobenzylguanidine ( 211 At-MABG) would leverage the advantages of alpha-particles to selectively target and eradicate NET-expressing tumor cells with minimal off-target effects.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"44-51"},"PeriodicalIF":9.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681263","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":"Increase 68 Ga-FAPI Uptake in Urogenital Tuberculosis.","authors":"Qiuming Yu, Qiang Xie, Xingxing Zhu, Xuemei Wang, Ming Ni","doi":"10.1097/RLU.0000000000005418","DOIUrl":"10.1097/RLU.0000000000005418","url":null,"abstract":"<p><strong>Abstract: </strong>Urogenital tuberculosis is one of common sites of extrapulmonary tuberculosis. A 60-year-old man with an elevated prostate-specific antigen level underwent multiparametric MRI, which revealed abnormal signals in the prostate. However, the 68 Ga-PSMA PET/CT results were unrevealing. Subsequent 68 Ga-FAPI PET/CT imaging revealed intense radioactivity uptake in the prostate and mild radioactivity uptake in the left kidney, which was eventually proven due to tuberculosis.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"98-100"},"PeriodicalIF":9.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079437","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":"False-Positive Radioiodine Uptake Related to Posttraumatic Scab Demonstrated by SPECT/CT in a Patient With Differentiated Thyroid Cancer.","authors":"Romane Mostowski, Michel de Pontville, Stéphane Bardet, Renaud Ciappuccini","doi":"10.1097/RLU.0000000000005563","DOIUrl":"10.1097/RLU.0000000000005563","url":null,"abstract":"<p><strong>Abstract: </strong>A 20-year-old man with papillary thyroid cancer received a fourth radioiodine regimen to treat 131 I-avid lung metastases. Posttherapeutic whole-body scan revealed focal radioiodine uptake on the anterior region of the left lower limb that was not visible on previous whole-body scan and which suggested skin contamination. Visual examination of the left leg evidenced a posttraumatic scab caused by a fall 2 weeks before. Skin metastasis was ruled out. 131 I SPECT/CT acquisition ruled out bony uptake and confirmed that the skin uptake was related to the superficial scab.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"88-90"},"PeriodicalIF":9.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616325","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":"Exploring the Potential Value of [ 68 Ga]Ga-FAPI-46 PET/CT for Molecular Assessment of Fibroblast Activation in Interstitial Lung Disease : A Single-Center Pilot Study.","authors":"Mehrzad Bahtouee, Esmail Jafari, Mehdi Khazaei, Nahid Aram, Azam Amini, Narges Jokar, Hojjat Ahmadzadehfar, Ali Gholamrezanezhad, Majid Assadi","doi":"10.1097/RLU.0000000000005505","DOIUrl":"10.1097/RLU.0000000000005505","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The aim of the study was to evaluate the association of high-resolution computed tomography (HRCT) findings with pulmonary fibrotic activity in the corresponding regions using [ 68 Ga]Ga-fibroblast activation fibroblast inhibitor (FAPI) PET/CT in patients with interstitial lung disease (ILD). Additionally, the potential of [ 68 Ga]Ga-FAPI-46 PET/CT for evaluating the active fibrosis process and 99m Tc-MIBI scintigraphy for assessing the inflammatory process in ILD patients was also assessed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this pilot study, 20 ILD patients underwent [ 68 Ga]Ga-FAPI-46 PET/CT and 99m Tc-MIBI SPECT/CT. Additionally, 10 patients without lung or thoracic involvement who were undergoing [ 68 Ga]Ga-FAPI PET/CT for cancer detection were enrolled in the control group. The images were evaluated both visually and semiquantitatively and also compared with HRCT and pulmonary function tests. Multiple quantitative parameters were derived from the lung segments in the PET scan, including SUV max , SUV mean , maximum target-to-liver ratio, mean target-to-liver ratio (TLR mean ), and total lesion FAPI expression for the entire lung, as well as its lobes and zones. Additionally, the maximum Hounsfield unit (HU) and mean HU in HRCT were calculated for the whole lung as well as its lobes and zones. Furthermore, an HRCT fibrosis score (HFS) was defined according to the HRCT findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twenty ILD patients with a mean age of 58.70 (SD, 11.09) years were enrolled. Additionally, 10 control patients were enrolled with a mean age of 57.70 (SD, 15.19) years. Based on visual assessment, the FAPI scan was positive in 12 (60%) patients. Similarly, the MIBI scan was positive in 12 (60%) patients. In the 20 ILD cases, both scans were positive in 6 cases, and both were negative in 2 cases. Six cases showed FAPI-negative and MIBI-positive results, whereas another 6 cases showed FAPI-positive and MIBI-negative results. Comparing the control and ILD patients, there was a significant difference in SUV max , SUV mean , total lesion FAPI expression, TLR mean , maximum HU, and mean HU ( P &lt; 0.05). When comparing HFS with PET-derived parameters in zones, a significant positive correlation was found between HFS and SUV mean , SUV max , maximum target-to-liver ratio, and TLR mean ( P &lt; 0.05). Additionally, a significant difference was noted between FAPI results and HFS ( P = 0.003). An ancillary finding, 9 of 20 (45%) ILD patients showed intense FAPI uptakes in gallbladder, whereas none of the 10 in the control group showed such uptake.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The present study may suggest that combining [ 68 Ga]Ga-FAPI PET/CT and 99m Tc-MIBI SPECT/CT yields an additive effect for evaluating ILD-related fibrosis and inflammatory processes over using either modality alone. Furthermore, it appears that [ 68 Ga]Ga-FAPI PET/CT has the potential to ascertain levels of fibrotic activity from population ","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"e17-e25"},"PeriodicalIF":9.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521232","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":"Solitary Peritoneal Metastasis in Case of Osteosarcoma Detected by FDG PET/CT.","authors":"Ujjwal Subedi, Raza Abbas Mahdi, Bhagwant Rai Mittal, Harmandeep Singh, Rajender Kumar, Vikas Bachhal","doi":"10.1097/RLU.0000000000005498","DOIUrl":"10.1097/RLU.0000000000005498","url":null,"abstract":"<p><strong>Abstract: </strong>Primary osteosarcomas predominantly originate in the metaphyseal region of long bones. The introduction of 18 F-FDG PET/CT imaging has revealed unusual and often rare sites of metastatic spread. Peritoneal deposits in osteosarcoma are not a commonly reported finding in the literature. The present case highlights the 18 F-FDG PET/CT findings in a case of osteosarcoma of the left fibula with isolated peritoneal metastasis with no regional or distant metastases.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"e62-e63"},"PeriodicalIF":9.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399656","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}