Clinical Nuclear Medicine最新文献

{"title":"Diagnostic Accuracy of 18 F-FES PET/CT for the Detection of Recurrent and Metastatic Breast Cancer.","authors":"Eonwoo Shin, Sangwon Han, Jeongryul Ryu, Hye-Joung Eom, Woo Jung Choi, Jin-Hee Ahn, Byung Ho Son, Seung Do Ahn, Gyungyub Gong, Dae Hyuk Moon","doi":"10.1097/RLU.0000000000005447","DOIUrl":"10.1097/RLU.0000000000005447","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the diagnostic value of 16α- 18 F-fluoro-17β-fluoroestradiol ( 18 F-FES) PET/CT for distant metastasis or recurrence in patients with estrogen receptor (ER)-positive breast cancer.</p><p><strong>Methods: </strong>Patients with ER-positive breast cancer and suspected of de novo metastasis or recurrence were retrospectively identified from a prospective cohort enrolled for a postmarketing surveillance study of 18 F-FES at our institution. Per-patient diagnostic accuracy was assessed using pathology or 2 or more standard-of-care imaging procedures with a minimum of 6 months of follow-up as the reference standard. The per-region detection rate of 18 F-FES PET/CT was evaluated and compared with that of standard-of-care imaging.</p><p><strong>Results: </strong>Of the 162 included patients, 104 and 58 were suspected to have recurrence or de novo metastasis, respectively. The overall sensitivity and specificity of 18 F-FES PET/CT were 95% (95% confidence interval [CI], 89%-98%) and 89% (95% CI, 76%-96%), respectively. When stratified according to clinical settings, the sensitivity and specificity were 95% (95% CI, 88%-99%) and 96% (95% CI, 78%-100%), respectively, for detecting recurrence, and 94% (95% CI, 81%-99%) and 82% (95% CI, 60%-95%) for detecting distant metastasis. In region-based analysis, the overall detection rate of 18 F-FES PET/CT was significantly higher than that of standard-of-care imaging (92% [95% CI, 89%-94%] vs 83% [95% CI, 79%-87%], P < 0.001).</p><p><strong>Conclusions: </strong>18 F-FES PET/CT showed excellent diagnostic performance in patients with ER-positive breast cancer suspected of de novo metastasis or recurrence.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"31-37"},"PeriodicalIF":9.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388721","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":"Tracer-Separator: A Deep Learning Model for Brain PET Dual-Tracer ( 18 F-FDG and Amyloid) Separation.","authors":"Amirhossein Sanaat, Yiyi Hu, Cecilia Boccalini, Yazdan Salimi, Zahra Mansouri, Eliluane Pirazzo Andrade Teixeira, Gregory Mathoux, Valentina Garibotto, Habib Zaidi","doi":"10.1097/RLU.0000000000005511","DOIUrl":"10.1097/RLU.0000000000005511","url":null,"abstract":"<p><strong>Introduction: </strong>Multiplexed PET imaging revolutionized clinical decision-making by simultaneously capturing various radiotracer data in a single scan, enhancing diagnostic accuracy and patient comfort. Through a transformer-based deep learning, this study underscores the potential of advanced imaging techniques to streamline diagnosis and improve patient outcomes.</p><p><strong>Patients and methods: </strong>The research cohort consisted of 120 patients spanning from cognitively unimpaired individuals to those with mild cognitive impairment, dementia, and other mental disorders. Patients underwent various imaging assessments, including 3D T1-weighted MRI, amyloid PET scans using either 18 F-florbetapir (FBP) or 18 F-flutemetamol (FMM), and 18 F-FDG PET. Summed images of FMM/FBP and FDG were used as proxy for simultaneous scanning of 2 different tracers. A SwinUNETR model, a convolution-free transformer architecture, was trained for image translation. The model was trained using mean square error loss function and 5-fold cross-validation. Visual evaluation involved assessing image similarity and amyloid status, comparing synthesized images with actual ones. Statistical analysis was conducted to determine the significance of differences.</p><p><strong>Results: </strong>Visual inspection of synthesized images revealed remarkable similarity to reference images across various clinical statuses. The mean centiloid bias for dementia, mild cognitive impairment, and healthy control subjects and for FBP tracers is 15.70 ± 29.78, 0.35 ± 33.68, and 6.52 ± 25.19, respectively, whereas for FMM, it is -6.85 ± 25.02, 4.23 ± 23.78, and 5.71 ± 21.72, respectively. Clinical evaluation by 2 readers further confirmed the model's efficiency, with 97 FBP/FMM and 63 FDG synthesized images (from 120 subjects) found similar to ground truth diagnoses (rank 3), whereas 3 FBP/FMM and 15 FDG synthesized images were considered nonsimilar (rank 1). Promising sensitivity, specificity, and accuracy were achieved in amyloid status assessment based on synthesized images, with an average sensitivity of 95 ± 2.5, specificity of 72.5 ± 12.5, and accuracy of 87.5 ± 2.5. Error distribution analyses provided valuable insights into error levels across brain regions, with most falling between -0.1 and +0.2 SUV ratio. Correlation analyses demonstrated strong associations between actual and synthesized images, particularly for FMM images (FBP: Y = 0.72X + 20.95, R2 = 0.54; FMM: Y = 0.65X + 22.77, R2 = 0.77).</p><p><strong>Conclusions: </strong>This study demonstrated the potential of a novel convolution-free transformer architecture, SwinUNETR, for synthesizing realistic FDG and FBP/FMM images from summation scans mimicking simultaneous dual-tracer imaging.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":9.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521237","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-FAPI-04 PET/CT Imaging in a Patient With Psoriatic Arthritis.","authors":"Zitong Zhang, Lixiang Yang, Lisha Jiang, Rong Tian, Qianrui Li","doi":"10.1097/RLU.0000000000005417","DOIUrl":"10.1097/RLU.0000000000005417","url":null,"abstract":"<p><strong>Abstract: </strong>We described the findings of 68 Ga-FAPI-04 PET/CT of psoriatic arthritis in a 56-year-old man. Intense FAPI uptake was observed alongside the spine and in the joints of bilateral feet and the right hip. 68 Ga-FAPI PET/CT is potentially valuable for the evaluation of join involvement and disease activity in patients with psoriasis.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"83-84"},"PeriodicalIF":9.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079427","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":"Bilateral Internal Auditory Canal Metastasis From Lung Cancer on FDG PET/CT.","authors":"Liu Xiao, Lin Li, Chunyan Wu, Wenjie Zhang","doi":"10.1097/RLU.0000000000005421","DOIUrl":"10.1097/RLU.0000000000005421","url":null,"abstract":"<p><strong>Abstract: </strong>The occurrence of metastatic tumor in the internal auditory canal is very rare. Thus, we report FDG PET/CT findings of bilateral Internal auditory canal metastasis from lung cancer in a 67-year-old man. FDG PET/CT and MRI showed nodules in the bilateral internal auditory canal with an SUV max of 5.2. This case hints us that bilateral metastasis should be considered as differential diagnosis when we encounter bilateral nodule in the internal auditory.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"e55-e56"},"PeriodicalIF":9.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079429","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-FAPI PET in Visualizing Acute Ischemic Stroke at Risk of Hemorrhagic Transformation.","authors":"Jahae Kim, Hye-Jin Park, Sang-Geon Cho, Ki-Seong Park, Kang-Ho Choi","doi":"10.1097/RLU.0000000000005458","DOIUrl":"10.1097/RLU.0000000000005458","url":null,"abstract":"<p><strong>Abstract: </strong>Hemorrhagic transformation is a serious complication of ischemic stroke, which occurs at a rate of between 18% and 42%. 68 Ga-FAPI PET can visualize acute cerebral infarction at risk of hemorrhagic transformation in the brain. We report a case of 68 Ga-FAPI PET imaging in a patient with recurrent ischemic stroke. 68 Ga-FAPI PET imaging revealed FAPI uptake in acute ischemic stroke with hemorrhagic transformation, but did not in some acute infarction and chronic infarction without hemorrhagic transformation. These findings suggest potential role of 68 Ga-FAPI PET in the evaluation of acute ischemic stroke with the risk of hemorrhagic transformation.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"56-57"},"PeriodicalIF":9.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361257","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":"Retroperitoneal Malakoplakia Mimicking Metastatic Disease.","authors":"Dylan Dominguez, Joshua Eichhorn, Fathima Fijula Palot Manzil","doi":"10.1097/RLU.0000000000005536","DOIUrl":"10.1097/RLU.0000000000005536","url":null,"abstract":"<p><strong>Abstract: </strong>Malakoplakia is a rare inflammatory granulomatous disease that can produce a tumor-like appearance in nearly any organ system. Imaging findings of malakoplakia overlap with malignancy and tissue sampling are typically required for definitive diagnosis. We present a case of a 66-year-old woman with a previous history of liver adenocarcinoma status post resection that subsequently developed an intensely FDG-avid retroperitoneal mass on surveillance imaging. CT-guided biopsy of the mass demonstrated Michaelis-Gutmann bodies, supporting the diagnosis of malakoplakia. The patient underwent antibiotic treatment with complete resolution of the mass.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"75-76"},"PeriodicalIF":9.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544220","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":"Efficiency and Safety of Targeted Alpha Therapy in Metastatic Neuroendocrine Tumors: A Meta-analysis.","authors":"Dong Yun Lee, Yong-Il Kim","doi":"10.1097/RLU.0000000000005404","DOIUrl":"10.1097/RLU.0000000000005404","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the effectiveness of 177 Lu-based peptide receptor radionuclide therapy in treating metastatic neuroendocrine tumors (NETs), disease progression posttreatment remains a significant challenge. Targeted alpha therapy (TAT) has emerged as a promising option for patients experiencing such progression. This study aims to assess the therapeutic efficiency and toxicity of TAT in patients with metastatic NET through a meta-analysis.</p><p><strong>Patients and methods: </strong>We conducted a comprehensive search of PubMed, Embase, Cochrane Library, and CINAHL using relevant keywords. The analysis focused on the pooled proportions of objective response rate (ORR) and disease control rate (DCR) to determine therapeutic efficiency. We also evaluated the incidence of serious hematologic and renal adverse events (grade 3 or 4) to assess toxicity. A subgroup analysis was performed to identify factors influencing therapeutic outcomes.</p><p><strong>Results: </strong>Our meta-analysis included 7 studies comprising 162 patients. The results showed that TAT achieved ORR of 49.5% (95% confidence interval [CI]: 41.7%-57.4%) and DCR of 87.0% (95% CI: 72.1%-96.8%). The incidences of hematologic and renal toxicities were low, at 2.1% (95% CI: 0.5%-5.5%) and 3.4% (95% CI: 1.2%-7.3%), respectively. Subgroup analysis indicated consistent therapeutic efficiency across different variables, including prior 177 Lu-based peptide receptor radionuclide therapy treatment, 225 Ac-based TAT, absence of radiosensitizer, and methods of response evaluation, with ORR ranging from 46.6% to 57.1% and DCR from 82.0% to 91.5%.</p><p><strong>Conclusions: </strong>TAT is an effective treatment for metastatic NET, demonstrating substantial disease control and response rates with minimal toxicity. These findings suggest that TAT is a viable therapeutic alternative for patients with metastatic NET.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"e1-e6"},"PeriodicalIF":9.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016643","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":"Atypical Foot Swelling in Metastatic Endometrial Carcinoma: Role of FDG PET/CT.","authors":"Tzyy-Ling Chuang, Yuh-Feng Wang","doi":"10.1097/RLU.0000000000005561","DOIUrl":"10.1097/RLU.0000000000005561","url":null,"abstract":"<p><strong>Abstract: </strong>An 83-year-old woman with a history of endometrial carcinoma (EMC), treated with surgery and chemotherapy in August 2020, presented with a 1-year history of left foot swelling, tenderness, and heat. Despite multiple consultations, no diagnosis was made, and she developed painful swelling with a limping gait. A biopsy was done on July 14, 2023, confirmed metastatic EMC. FDG PET/CT revealed widespread metastases, including in the lungs, pleura, mediastinal, hilar, inguinal, right external iliac nodes, left labia majora, left iliac bone, left tibia, and left foot. Excision of left inguinal and vulvar tumors also confirmed metastatic EMC.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"64-65"},"PeriodicalIF":9.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496485","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":"High 18 F-FDG Uptake in Phosphoglyceride Crystal Deposition Disease of the Humerus Mimicking Chondrosarcoma.","authors":"Hiroki Matsutani, Tsuyoshi Komori, Ichiro Baba, Yoshitaka Kurisu, Kazuhiro Yamamoto, Keigo Osuga","doi":"10.1097/RLU.0000000000005543","DOIUrl":"10.1097/RLU.0000000000005543","url":null,"abstract":"<p><strong>Abstract: </strong>A 82-year-old man presented with left humerus pain. MRI revealed a lesion in the left humerus appearing hyperintense on T2WI and hyperintense on DWI. 18 F-FDG PET/CT demonstrated high FDG uptake in the lesion. Surgical resection was performed under the preoperative diagnosis of chondrosarcoma. However, a histopathological analysis confirmed the diagnosis of phosphoglyceride crystal deposition disease (PGDD). PGDD is an extremely rare disease, and this is the first report of PGDD occurring in the humerus. Bone lesions showing high uptake of FDG are usually malignant lesions; however, it is important to consider the possibility of benign diseases such as PGDD.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"54-55"},"PeriodicalIF":9.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496486","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":"Uptake of 68 Ga-DOTA-FAPI-04 in a Case of Gynecomastia.","authors":"Tingting Xu, Feiyu Zhang, Shiyu Zheng, Yue Chen","doi":"10.1097/RLU.0000000000005420","DOIUrl":"10.1097/RLU.0000000000005420","url":null,"abstract":"<p><strong>Abstract: </strong>Herein, we report a case of a man with malignant melanoma exhibiting thickened right breast with increased tracer uptake on 68 Ga-DOTA-FAPI-04 PET/CT. Subsequent ultrasound confirmed there was no sign of malignancy and consistent with benign gynecomastia.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"94-95"},"PeriodicalIF":9.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079443","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}