Clinical Nuclear Medicine最新文献

{"title":"Granulocyte Colony-Stimulating Factor-Associated Aortitis Unveiled by 18 F-FDG PET/CT.","authors":"Hélène Artigou, Hervé Foka Tichoue, Cindy Marques, Frédéric Charlotte, P A Vion, Aurélie Kas, Laura Rozenblum","doi":"10.1097/RLU.0000000000005580","DOIUrl":"10.1097/RLU.0000000000005580","url":null,"abstract":"<p><strong>Abstract: </strong>In oncology, G-CSF (granulocyte colony-stimulating factor) is often administered to counteract chemotherapy-induced neutropenia. Recent studies have highlighted a significant side effect, G-CSF-associated aortitis, with an incidence of ~0.4%. Identification of this condition's imaging characteristics is crucial for nuclear medicine specialists, given its substantial impact on clinical decision-making. It is notably prevalent in the follow-up of gynecologic malignancies and lymphoma. We detail a case of G-CSF-related aortitis in a metastatic ovarian cancer patient, diagnosed by increased 18 F-FDG uptake in the aortic arch on PET/CT, confirmed by contrast-enhanced CT and biopsy, which regressed spontaneously in under 5 weeks without corticosteroid treatment.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":"e92-e93"},"PeriodicalIF":9.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845844","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":"68Ga-FAPI-04 Versus 18F-FDG PET/CT in Duodenal Synovial Sarcoma.","authors":"Fenglin Zhan, Xin Liu, Hangcheng Zhou, Xuemei Wang, Xiaobo Yao","doi":"10.1097/RLU.0000000000005706","DOIUrl":"https://doi.org/10.1097/RLU.0000000000005706","url":null,"abstract":"<p><strong>Abstract: </strong>A previously healthy 18-year-old man with a 9-month history of upper abdominal pain and significant weight loss underwent gastroscopy, revealing an ulcerative lesion in the duodenal bulb. Enrolled in a clinical trial, both 18F-FDG and 68Ga-FAPI-04 PET/CT demonstrated similar metabolic activity, though 68Ga-FAPI-04 offered superior lesion delineation. Pathology confirmed synovial sarcoma. This case highlights the potential utility of 68Ga-FAPI-04 as a radiopharmaceutical for evaluating rare gastrointestinal synovial sarcomas.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064143","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":"Tumor Lesion Uptake of [177Lu]Lu-DOTA-Rituximab in Skeletal and Splenic Disease in Diffuse Large B-Cell Lymphoma.","authors":"Yeshwanth Edamadaka, Rahul V Parghane, Sandip Basu","doi":"10.1097/RLU.0000000000005695","DOIUrl":"https://doi.org/10.1097/RLU.0000000000005695","url":null,"abstract":"<p><strong>Abstract: </strong>Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma, and a sizable fraction of the DLBCL patients presents with advanced, relapsed, and refractory disease, demonstrating poor response to standard chemotherapy regimens. Radioimmunotherapy (RIT) has shown to be clinically effective in refractory DLBCL. We present the case of a patient with DLBCL with [18F]FDG-avid widespread skeletal as well as splenic involvement as poor prognostic extranodal disease on FDG PET/CT. RIT based on [177Lu]Lu-DOTA-rituximab was explored to study the biodistribution and dosimetry of [177Lu]Lu-DOTA-rituximab in CD20-positive lymphoma. An exceptionally high tracer concentration in skeletal and splenic disease was observed, supporting its potential RIT application in relapsed and refractory DLBCL patients in the future.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058434","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-Based Precontrast CT Parcellation for MRI-Free Brain Amyloid PET Quantification.","authors":"Kyobin Choo, Jaehoon Joo, Sangwon Lee, Daesung Kim, Hyunkeong Lim, Dongwoo Kim, Seongjin Kang, Seong Jae Hwang, Mijin Yun","doi":"10.1097/RLU.0000000000005652","DOIUrl":"https://doi.org/10.1097/RLU.0000000000005652","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to develop a deep learning (DL) model for brain region parcellation using CT data from PET/CT scans to enable accurate amyloid quantification in 18F-FBB PET/CT without relying on high-resolution MRI.</p><p><strong>Patients and methods: </strong>A retrospective dataset of PET/CT and T1-weighted MRI pairs from 226 individuals (157 with mild cognitive impairment or dementia and 69 healthy controls) was used. The dataset was split into training/validation (60%) and test (40%) sets. Utilizing auto-generated segmentation labels, 3 UNets were independently trained for multiplanar brain parcellation on CT and subsequently ensembled. Amyloid load was measured across 46 volumes of interest (VOIs), derived from the Desikan-Killiany-Tourville atlas. Dice similarity coefficient between the proposed CT-based DL model and MRI-based (FreeSurfer) method was calculated, with SUVR comparison using linear regression analysis and intraclass correlation coefficient. Global SUVRs were also compared within groups with clinical dementia ratings (CDRs) of 0, 0.5, and 1.</p><p><strong>Results: </strong>The DL-based CT parcellation achieved mean Dice similarity coefficients of 0.80 for all 46 VOIs, 0.72 for 16 cortical and limbic VOIs, and 0.83 for 30 subcortical VOIs. For regional and global SUVR comparisons, the linear regression yielded a slope, y-intercept, and R2 of 1 ± 0.027, 0 ± 0.040, and ≧0.976, respectively (P < 0.001), and the intraclass correlation coefficient was ≧0.988 (P < 0.001). For global SUVRs in each CDR group, these values were 1 ± 0.020, 0 ± 0.026, ≧0.993, and ≧0.996, respectively (P < 0.001). Both MRI-based and CT-based global SUVR showed a consistent increase as the CDR score increased.</p><p><strong>Conclusions: </strong>The DL-based CT parcellation agrees strongly with MRI-based methods for amyloid PET quantification.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058415","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":"Head-to-Head Comparison Between [68Ga]Ga-DOTA.SA.FAPi And [18F]F-FDG PET/CT Imaging in Patients With Sarcoma.","authors":"Mohammad Sakir, Sanjana Ballal, Sameer Rastogi, Madhav Prasad Yadav, Frank Roesch, Kunal Chandekar, Priyanka Gb, Madhavi Tripathi, Ayan Dhiman, Mehul Taggar, Marcel Martin, Chandrasekhar Bal","doi":"10.1097/RLU.0000000000005697","DOIUrl":"https://doi.org/10.1097/RLU.0000000000005697","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the diagnostic efficacy of [68Ga]Ga-DOTA.SA.FAPi and [18F]F-FDG PET/CT for detecting primary and metastatic lesions in sarcoma patients.</p><p><strong>Materials and methods: </strong>The analysis included both patient-based and lesion-based comparisons of PET/CT scans in individuals with histologically confirmed sarcoma.</p><p><strong>Results: </strong>A total of 23 sarcoma patients (mean age 43.0 ± 16.5 years; range: 21-76 years) underwent both [18F]F-FDG and [68Ga]Ga-DOTA.SA.FAPi PET/CT scans. Histological distribution included 30% synovial sarcoma, 13% liposarcoma, and 21.7% leiomyosarcoma, with 70% of patients presenting with distant metastases. Detection rates for primary tumors were similar between [68Ga]Ga-DOTA.SA.FAPi and [18F]F-FDG PET/CT (85.7% vs 100%, P = 0.149). Lymph node detection rates were also comparable (80% vs 100%, P = 0.146). Lesion-based analysis revealed that [68Ga]Ga-DOTA.SA.FAPi detected 220 lesions (83% efficiency) compared with 249 lesions (94% efficiency) for [18F]F-FDG (P < 0.0001). Notably, [68Ga]Ga-DOTA.SA.FAPi demonstrated superior detection of liver (54 vs 38 lesions, P < 0.0001) and bone metastases (125 vs 102 lesions, P < 0.0001).</p><p><strong>Conclusion: </strong>Our study shows that although [18F]F-FDG PET/CT offers superior overall lesion detection efficiency, [68Ga]Ga-DOTA.SA.FAPi PET/CT excels in identifying specific metastatic sites, particularly in bone and liver. These findings highlight the complementary roles of both imaging modalities in sarcoma evaluation.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058431","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 99mTc-Sestamibi SPECT/CT.","authors":"Wai Ip Li, Tak Kwong Chan, Boom Ting Kung","doi":"10.1097/RLU.0000000000005696","DOIUrl":"https://doi.org/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 99mTc-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":""},"PeriodicalIF":9.6,"publicationDate":"2025-01-29","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":"Isolated Lymph Node Metastasis as Initial Presentation of Collecting Duct Carcinoma on 68Ga-Pentixafor PET/CT.","authors":"Zibei Wan, Feiyu Zhang, Kan Wang, Ya Liu, Zhanwen Huang","doi":"10.1097/RLU.0000000000005663","DOIUrl":"https://doi.org/10.1097/RLU.0000000000005663","url":null,"abstract":"<p><strong>Abstract: </strong>A 64-year-old man was admitted to the hospital with low back pain. Enhanced CT imaging revealed an isolated retroperitoneal mass. Since primary retroperitoneal lymphoma could not be ruled out, the patient was enrolled in our clinical trial of 68Ga-pentixafor PET/CT. The mass exhibited intense uptake of 68Ga-pentixafor and was subsequently confirmed as lymph node metastasis originating from collecting duct carcinoma. Our case demonstrated that 68Ga-pentixafor may lack specificity in distinguishing primary retroperitoneal lymphomas from other conditions.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058432","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":"https://doi.org/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 18F-FDG (1487) or 68Ga-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 18F-FDG (tasks 1 and 2, respectively using 22 organs) and PET-NC and PET-ASC for 68Ga 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":""},"PeriodicalIF":9.6,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare Neoplastic Meningitis in Cerebellar Medulloblastoma Detected by PET/CT.","authors":"Merve Nur Acar Tayyar, Müge Öner Tamam, Kadir Atakır, İbrahim Köprülü, Ayşe Vergili","doi":"10.1097/RLU.0000000000005693","DOIUrl":"https://doi.org/10.1097/RLU.0000000000005693","url":null,"abstract":"<p><strong>Abstract: </strong>Neoplastic meningitis, also known as leptomeningeal metastases, is a rare clinical entity seen in less than 1%-2% of primary nervous system tumors. Diagnosis of leptomeningeal metastases is difficult and is achieved by cytologic evidence of malignant cells in cerebrospinal fluid, or demonstration of radiologic abnormality. 18F-FDG PET/CT can detect leptomeningeal metastases before anatomical changes. In this case, a 42-year-old man with cerebellar medulloblastoma underwent surgery and radiotherapy and had FDG uptake in 3 separate locations after 3 months. The findings indicated leptomeningeal metastases, confirmed by MRI. This highlights the role of 18F-FDG PET/CT in detecting leptomeningeal disease postmedulloblastoma treatment.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032530","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":"68Ga-FAPI-04 Outperforms 18F-FDG in Detecting Lesions for Primary Leiomyosarcoma of Bone: A Rare Case.","authors":"Yaqun Jiang, Yueli Tian, Yong He","doi":"10.1097/RLU.0000000000005636","DOIUrl":"https://doi.org/10.1097/RLU.0000000000005636","url":null,"abstract":"<p><strong>Abstract: </strong>Primary leiomyosarcoma of bone (PLB) is an ultrarare tumor, characterized by its aggressive clinical behavior, high heterogeneity, and dismal prognosis. Here, we present the 68Ga-FAPI-04 and 18F-FDG PET/CT findings in a case of PLB affecting the left femur. FAPI PET/CT showed more bone lesions and higher uptake in the multiple metastatic lesions compared with FDG PET/CT. More interestingly, FAPI PET/CT could clearly detect the tumor embolus on the left common femoral artery, which was negative on FDG. This case suggests that FAPI PET/CT is a promising method for the primary diagnosis and staging of PLB.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032519","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}