Clinical Nuclear Medicine最新文献

{"title":"Radiation Exposure to Patients and Others During Therapy for Pediatric Neuroblastoma With Lu-177-DOTATATE.","authors":"Zhaoqi Lu, Yanjinghui Sun, Di Zuo, Pengfei Li, Xiaorong Sun","doi":"10.1097/RLU.0000000000005763","DOIUrl":"10.1097/RLU.0000000000005763","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated Lutetium-177-(DOTA°,Tyr 3 ) octreotate (Lu-177-DOTATATE) clearance in pediatric patients with neuroblastoma and assessed the effective doses received by patients, family caregivers, and medical staff during therapy.</p><p><strong>Patients and methods: </strong>Twenty-three children (3-13 y) who received Lu-177-DOTATATE between 2023 and 2024 were enrolled. External dose rates were measured at 0, 1, 2, 4, 6, 24, 48, and 96 hours post-administration to estimate patients' Lu-177-DOTATATE retention rate, the effective half-life, and the maximum cumulative effective dose around patients. Whole-body and red-marrow absorbed doses were calculated based on multi-time-point whole-body planar and SPECT/CT imaging using HERMES Dosimetry software. Whole-body effective doses to family caregivers and medical personnel were measured using thermoluminescence dosimeters (TLDs), and effective finger doses for medical staff were measured using ring TLDs.</p><p><strong>Results: </strong>The mean administered activity was 3.687±1.545 (range, 1.469-7.368) GBq. Whole-body retention rates at 1-96 hours post-administration ranged from 72.0% to 10.0%, with 99% clearance expected within 11 days. Clearance followed a biexponential decay model, with estimated effective half-lives of 1.4±0.8 and 52.3±18.6 hours for the fast and slow phases, respectively, at 2 m. Estimated maximum cumulative effective doses (within 11 days) at 1 and 2 m were 0.442±0.174 and 0.138±0.058 mSv, respectively. Absorbed doses for children were 0.159±0.076 mGy/MBq (whole body) and 0.611±0.416 mGy/MBq (red-marrow). Whole-body effective doses to family caregivers averaged 0.245±0.063 (range, 0.150-0.390) mSv. The whole-body and finger-effective doses to the radiopharmacists were 3.7±1.8 and 155.3±73.0 μSv/patient, respectively. The mean of whole-body and the median ( P25 , P75 ) of finger-effective doses to nurses were 4.7±1.4 μSv/patient and 16.7 (10, 470) μSv/patient, respectively.</p><p><strong>Conclusions: </strong>Lu-177-DOTATATE was rapidly cleared in children with neuroblastoma. Radiation exposure to others was below personal dose limits.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"480-485"},"PeriodicalIF":9.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491145","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 Role of 18 F-FDG PET/CT Combined With MPI in Cogan's Syndrome With Multiple Arteritis and Coronary Involvement: A Case Report.","authors":"Ying Zhang, Xu Han, Nan Nan, Wei Dong, Hongzhi Mi","doi":"10.1097/RLU.0000000000005788","DOIUrl":"10.1097/RLU.0000000000005788","url":null,"abstract":"<p><p>We present a case of a 49-year-old woman who complained of chest pain after activity for 3 months. She had undergone percutaneous coronary intervention (PCI) on the left main (LM) and right coronary artery (RCA) for acute myocardial infarction (AMI) 1 year ago. At this admission, a coronary angiogram (CAG) revealed stent restenosis. Then, 99m Tc-Sestamibi myocardial perfusion imaging (MPI) and 18 F-FDG PET/CT showed multiple arteritis involving the coronary artery with no obvious myocardial ischemia. This suggests that the patient should be treated with anti-inflammatory measures instead of repeating revascularization caused by persistent stent stenosis, making this an extremely rare case of Cogan's syndrome (CS).</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"553-555"},"PeriodicalIF":9.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499598","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":"Pre-infusion 18 F-FDG PET/CT for Prognostic and Toxicity Prediction in B-cell Non-Hodgkin Lymphoma Patients Undergoing Chimeric Antigen Receptor T-cell Therapy.","authors":"Xilan Yao, Hongrong Wang, Xiao Lei, Shuang Yao, Wei Wang, Jigang Yang","doi":"10.1097/RLU.0000000000005888","DOIUrl":"10.1097/RLU.0000000000005888","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the value of 18 F-FDG PET/CT in predicting outcomes and toxicity for patients with B-cell non-Hodgkin lymphoma (B-NHL) who underwent chimeric antigen receptor T (CAR-T) cell therapy.</p><p><strong>Methods: </strong>This retrospective study included B-NHL patients who underwent CAR-T therapy and had pre-infusion 18 F-FDG PET/CT images. We recorded SUVmax, metabolic tumor volume (MTV), total lesion glycolysis (TLG), and various clinical and laboratory indexes. The primary endpoints were progression-free survival (PFS) and overall survival (OS). PFS and OS were estimated using the Kaplan-Meier method. In addition, we reported the correlation between PET/CT parameters and the objective response (OR), as well as cytokine release syndrome (CRS).</p><p><strong>Results: </strong>A total of 133 patients were enrolled in this study. The median follow-up duration was 20.8 months. SUVmax (with a cutoff value of 15.65) emerged as an independent metabolic parameter associated with PFS, OS, and OR. Patients with SUVmax ≥15.65 had a median PFS of 9.13 months (95% CI: 0.11-18.16), while the PFS for those with SUVmax<15.65 was not reached ( P =0.006). Furthermore, patients with SUVmax ≥15.65 exhibited significantly shorter average OS compared with those with SUVmax<15.65 (26.89 mo vs. 45.14 mo, P =0.010). In addition, the odds ratio for achieving an OR in patients with SUVmax ≥15.65 was found to be lower at 0.173 (95% CI: 0.056-0.539). Other factors associated with PFS included ECOG-PS, B symptoms, bulky mass, and extranodal sites, whereas IPI and LDH were associated with OS. Furthermore, SUVmax and Deauville scores showed a weak positive correlation with the occurrence of CRS.</p><p><strong>Conclusions: </strong>The pretreatment PET/CT parameter SUVmax appears to be a promising predictive factor for efficacy and prognosis, as well as being associated with the occurrence of CRS. Consequently, we can conclude that this metabolic parameter from pretreatment PET/CT scans may serve as a valuable tool in guiding patient selection for CAR-T therapy and predicting potential side effects.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"501-507"},"PeriodicalIF":9.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802806","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":"Prognostic Value of 18 F-FDG PET/CT Metabolic Parameters in Resectable Non-small Cell Lung Cancer Treated With Neoadjuvant Immunotherapy Plus Chemotherapy.","authors":"You Cheng, Zhen-Peng Jiang, Xiao-Bo Chen, Kai-Yu Lu, Zai-Yi Liu, Dan Shao","doi":"10.1097/RLU.0000000000005863","DOIUrl":"10.1097/RLU.0000000000005863","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the predictive value of 18 F-FDG PET/CT metabolic parameters in patients with non-small cell lung cancer (NSCLC) undergoing neoadjuvant immunotherapy plus chemotherapy.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of clinical data from 131 patients with pathologically confirmed NSCLC who were deemed resectable after 3 cycles of neoadjuvant immunotherapy plus chemotherapy. Pretreatment and post-treatment PET metabolic parameters were evaluated. CT assessments based on immune response evaluation criteria in solid tumors (iRECIST) were compared with PET/CT assessments using the response criteria in solid tumors (PERCIST). ROC curve analysis and Kaplan-Meier survival analysis, including univariate and Cox multivariate analyses, were employed to assess the prognostic value of PET metabolic parameters after treatment.</p><p><strong>Results: </strong>The PET/CT assessment based on PERCIST showed high consistency with prognosis, while the CT assessment based on iRECIST demonstrated low consistency. Statistically significant differences were observed between the iRECIST and PERCIST criteria ( P <0.001). ROC curve analysis revealed significant differences in post-treatment PET metabolic parameters (postSUVmax, postSUVmean, postSUVpeak, postMTV, and postTLG) as well as the percentage changes in metabolic parameters before and after treatment(Δ) (ΔSUVmax, ΔSUVmean, ΔSUVpeak, ΔMTV, and ΔTLG) ( P <0.05). Optimal cutoff values enabled stratification into high-risk and low-risk groups. Univariate analysis showed significantly higher survival in the low-risk group for all parameters except ΔMTV ( P =0.311), while Cox multivariate analysis identified ΔSUVmax as the most predictive.</p><p><strong>Conclusions: </strong>The PERCIST is more accurate than iRECIST in evaluating prognosis for NSCLC neoadjuvant immunotherapy plus chemotherapy. PET metabolic parameters, particularly ΔSUVmax, effectively predict prognosis and support clinical decision-making.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"e344-e351"},"PeriodicalIF":9.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662915","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":"Uncommon Breast Metastasis From Rectal Carcinoma Clearly Revealed on 68 Ga-FAPI-04 PET/CT.","authors":"Liu Xiao, Li Li, Lin Li, Wenjie Zhang","doi":"10.1097/RLU.0000000000005667","DOIUrl":"https://doi.org/10.1097/RLU.0000000000005667","url":null,"abstract":"<p><strong>Abstract: </strong>Breast metastasis from rectal carcinoma is very rare. We report a case of imaging findings of breast metastasis in a 31-year-old woman who underwent laparoscopic radical tumor resection 8 months ago. 68 Ga-FAPI-04 PET/CT and 18 F-FDG PET/CT showed 4 small breast nodules with intense 68 Ga-FAPI uptake (SUV max , 9.22) but slight 18 F-FDG uptake (SUV max , 1.95). Needle biopsy supported a diagnosis of metastasis from rectal adenocarcinoma.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":"50 6","pages":"e368-e369"},"PeriodicalIF":9.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987414","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":"99m Tc-FAPI-46 Scan and 177 Lu-FAPI-2286 Treatment in a Patient With Nasopharyngeal Carcinoma.","authors":"Somaye Barashki, Bentolhoda Hadad, Nasrin Raeisi, Kamran Aryana","doi":"10.1097/RLU.0000000000005662","DOIUrl":"10.1097/RLU.0000000000005662","url":null,"abstract":"<p><strong>Abstract: </strong>We present a 24-year-old man with a history of metastatic nasopharyngeal cancer. Despite receiving standard treatments, including surgery, radiotherapy, and chemotherapy, he has shown progression. Consequently, he has been referred to the nuclear medicine department for theranostic purposes. The 99m Tc-FAPI-46 whole-body scan showed tracer uptake in mediastinal large mass, both external lymph nodes and osseous metastases. Treatment with 177 Lu-FAPI-2286 initiated, with subsequent planar scans revealing sustained uptake up to day 10, particularly in the large mediastinal mass. This case indicates promising FAPI-targeted theranostic potential in metastatic nasopharyngeal carcinoma and proper retention of 177 Lu-FAPI-2286 in metastatic lesions.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"e379-e380"},"PeriodicalIF":9.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028092","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":"Primary Pulmonary MALT Lymphoma on 18 F-FDG and 68 Ga-FAPI PET/CT.","authors":"Rongxi Wang, Jingci Chen, Jiarou Wang, Zhaohui Zhu, Jingjing Zhang","doi":"10.1097/RLU.0000000000005687","DOIUrl":"10.1097/RLU.0000000000005687","url":null,"abstract":"<p><strong>Abstract: </strong>Primary pulmonary mucosa-associated lymphoid tissue lymphoma is extremely rare. We present the 18 F-FDG and 68 Ga-FAPI PET/CT findings in a 56-year-old woman with pathologically confirmed primary pulmonary mucosa-associated lymphoid tissue lymphoma. 68 Ga-FAPI PET/CT showed a higher uptake value than 18 F-FDG PET/CT in the pulmonary lesion. This case suggests that 68 Ga-FAPI PET/CT may be a sensitive alternative method to characterize low-grade lymphomas.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"e372-e373"},"PeriodicalIF":9.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028031","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":"Utility of Novel Radiohybrid PSMA Ligands in PET Imaging of Biochemical Recurrence of Prostate Cancer-A Systematic Review and Meta-analysis.","authors":"Kunal Ramesh Chandekar, Swayamjeet Satapathy, Chandrasekhar Bal","doi":"10.1097/RLU.0000000000005641","DOIUrl":"10.1097/RLU.0000000000005641","url":null,"abstract":"<p><strong>Purpose: </strong>Radiohybrid prostate-specific membrane antigen (rhPSMA) ligands are a novel class of radiopharmaceuticals developed for potential theranostic application in prostate cancer (PCa). We aimed to consolidate existing evidence on utility of 18 F-rhPSMA-7/7.3 for PET imaging in PCa in the setting of biochemical recurrence (BCR).</p><p><strong>Patients and methods: </strong>A comprehensive literature search was performed using relevant keywords in PubMed, Scopus, and EMBASE. Articles evaluating utility of 18 F-rhPSMA-7/7.3 PET in PCa BCR, published through September 30, 2024, were included. rhPSMA PET detection rate (DR) in BCR was calculated on a per-patient basis, with pooled proportion and 95% confidence interval. Furthermore, pooled DRs using different cutoff values of serum prostate-specific antigen (PSA) were obtained.</p><p><strong>Results: </strong>Five studies with 1513 patients (overall) were included. The pooled DR of 18 F-rhPSMA-7/7.3 PET in BCR was 81.7% (95% confidence interval: 76.3%-86.5%). The pooled DRs stratified by serum PSA levels were 60.7% for PSA <0.5 ng/mL, 80.1% for PSA between 0.5 and <1.0 ng/mL, 85.9% for PSA between 1.0 and <2.0 ng/mL, and 95.1% for PSA ≥2.0 ng/mL, respectively.</p><p><strong>Conclusions: </strong>Our results suggest that novel radiotracers 18 F-rhPSMA-7/7.3 have excellent diagnostic utility as PET imaging agents in BCR of PCa. Further prospective multicenter studies are required to validate these novel tracers in diverse clinical settings with larger patient cohorts and assess their diagnostic accuracy in comparison to the PSMA ligands in current clinical practice.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"e323-e330"},"PeriodicalIF":9.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028115","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":"Parathyroid Adenoma at the Parapharyngeal Space Detected on 99m Tc-Sestamibi SPECT/CT.","authors":"Wai Ip Li, Tak Kwong Chan, Boom Ting Kung","doi":"10.1097/RLU.0000000000005696","DOIUrl":"10.1097/RLU.0000000000005696","url":null,"abstract":"<p><strong>Abstract: </strong>A 77-year-old woman was diagnosed with primary hyperparathyroidism, and initial cervical ultrasonography found no parathyroid lesion, and she was referred to the nuclear medicine unit for dual-phase 99m Tc-sestamibi (MIBI) scan. The scintigraphy unveiled heterogeneous uptake patterns across bilateral thyroid lobes, corresponding to the thyroid nodules, alongside a marked focal uptake with delayed tracer washout in the right oral region. The SPECT/CT pinpointed a MIBI-avid nodule within the right parapharyngeal space, indicative of parathyroid ectopia. An ectopic parapharyngeal parathyroid adenoma is exceptionally rare. MIBI scan plays a pivotal role in detection of ectopic parathyroid adenoma at unexpected sites.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"e360-e361"},"PeriodicalIF":9.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058433","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":"Response Evaluation Using 68 Ga-DOTA-IBA in a Case of Metastatic Prostate Cancer.","authors":"Linwei Li, Yue Chen","doi":"10.1097/RLU.0000000000005666","DOIUrl":"10.1097/RLU.0000000000005666","url":null,"abstract":"<p><strong>Abstract: </strong>We report a case of a patient with metastatic prostate cancer receiving first-line endocrine therapy. Clinical symptoms, PSA level, and CT confirmed the significant progression of his bone metastatic lesions. In comparison to images at baseline, follow-up bone scan incorrectly showed remission of the bone lesions, whereas follow-up 68 Ga-DOTA-IBA correctly showed disease progression.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"544-546"},"PeriodicalIF":9.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032532","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}