EJNMMI Research最新文献

{"title":"Integrated ⁶⁸Ga-PSMA PET/MRI models improve prostate cancer diagnosis and ISUP stratification, especially in the low-PSA cohort.","authors":"Zhibo Dai, Yuhu Lv, Weiwei Ruan, Yongkang Gai, Xiaoli Lan, Chunxia Qin","doi":"10.1186/s13550-026-01445-5","DOIUrl":"https://doi.org/10.1186/s13550-026-01445-5","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the diagnostic efficacy of ⁶⁸Ga-PSMA PET/MRI-derived parameters in prostate cancer and their significance in risk stratification.</p><p><strong>Methods: </strong>A retrospective study was performed on patients who underwent ⁶⁸Ga-PSMA PET/MRI from November 2020 to April 2024, all with histopathological confirmation obtained from biopsy or prostatectomy. Parameters analyzed included SUV_max, PSMA tumor volume at a 40% SUV_max threshold (PTV40%), mean uptake in this volume (SUV_40%mean), and uptake ratios to the liver (PLR), blood pool (PBpR), and parotid gland (PPgR). MRI was evaluated using PI-RADS v2.1 (scores ≥ 4 were defined as positive), and ADC_mean and ADC_min were recorded. Diagnostic performance of PET and MRI parameters was compared using ROC analysis. Two logistic regression model sets were constructed: one for improved diagnosis performance in the low-PSA subgroup (PSA < 20 ng/mL) and one for International Society of Urological Pathology (ISUP) Grade Group (GG) stratification (GG 1-2 vs. GG 3-5). Model performance was assessed via LOOCV, 1,000 bootstrap resamples, and decision curve analysis.</p><p><strong>Results: </strong>Of the 74 patients (mean age 65.9 ± 7.4 years), 52 had prostate cancer and 22 had benign lesions. PET parameters (SUV_max, PLR, PBpR, PPgR) and MRI-derived ADC values differed significantly between groups. An SUV_max cut-off of 7.665 yielded 76.9% sensitivity, 100% specificity (AUC = 0.920), while a PLR cut-off of 1.551 showed higher sensitivity (92.3%) and specificity (86.4%) (AUC = 0.907). In patients with PSA < 20 ng/mL, PLR showed higher sensitivity (84.6%) than SUV_max (53.8%). For the low-PSA subgroup, the Clinical+ADC_mean+SUV_max model yielded a LOOCV AUC of 0.795, as opposed to 0.449 for the clinical-only model and 0.733 for the clinical+ADC_mean model. For ISUP stratification, the ADC_mean+SUV_max model reached a LOOCV AUC of 0.906. DCA validated the clinical utility of the optimal models.</p><p><strong>Conclusions: </strong>⁶⁸Ga-PSMA PET/MRI-derived parameters exhibit excellent diagnostic performance for prostate cancer. PLR demonstrates the highest sensitivity, especially in patients with low PSA. Combining PET and MR parameters-especially PET-guided ADC_mean with SUV_max and PLR-improves diagnosis, potentially enables non-invasive ISUP Grade Group stratification, and may facilitate personalized management.</p><p><strong>Trial registration: </strong>NCT03756077. Registered 27 November 2018-Retrospectively registered, https://clinicaltrials.gov/show/NCT03756077.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863808","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-pentixafor PET/CT imaging characteristics in primary aldosteronism with coexisting subclinical cushing syndrome: a retrospective cohort study.","authors":"Shuang Liu, Rui Zuo, Mengdan Li, Jing Chen, Jia Li, Xiaoyang Zhang, Qifu Li, Hua Pang, Lu Xu","doi":"10.1186/s13550-026-01444-6","DOIUrl":"https://doi.org/10.1186/s13550-026-01444-6","url":null,"abstract":"<p><strong>Background: </strong>Primary aldosteronism (PA) accompanied by subclinical Cushing's syndrome (SCS) complicates both diagnosis and clinical management. This study aimed to investigate the endocrine and metabolic profiles as well as the ⁶⁸Ga‑pentixafor PET/CT imaging features of PA‑SCS, and to evaluate its diagnostic performance for PA‑SCS.</p><p><strong>Results: </strong>A total of 52 patients with primary aldosteronism who underwent ⁶⁸Ga-pentixafor PET/CT were retrospectively enrolled, including 25 patients with PA complicated by subclinical Cushing's syndrome (PA-SCS) and 27 patients with isolated PA. Adrenal lesions in PA-SCS patients were significantly larger than those in patients with isolated PA (1.10 ± 0.56 cm vs. 2.24 ± 0.69 cm, P < 0.0001). The lesion-to-contralateral ratio (LCR) at both early and delayed phases was significantly higher in the PA-SCS group (10 min: 1.41 [1.02, 2.65] vs. 2.90 [2.01, 3.77], P = 0.003; 40 min: 1.26 [1.03, 3.53] vs. 3.00 [1.80, 4.07], P = 0.012). The LCR-10 min achieved the optimal diagnostic performance for differentiating PA-SCS from isolated PA (AUC = 0.737, cutoff = 1.935, sensitivity = 80.00%, specificity = 66.67%).</p><p><strong>Conclusions: </strong>⁶⁸Ga‑pentixafor PET/CT is an effective imaging modality for differentiating PA‑SCS from isolated PA, which complements conventional diagnostic. Methods and optimizes early diagnosis and clinical management of PA‑SCS patients.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834478","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":"Prospective comparison of [⁶⁸Ga]Ga-FAPI-04 PET/CT and salivary gland scintigraphy for the diagnosis of primary Sjögren's syndrome.","authors":"Ke Cheng, Tingting Xu, Zhuoyuan Li, Guangfu Liu, Rui Sun, Qingxue Shu, Yue Chen","doi":"10.1186/s13550-026-01438-4","DOIUrl":"https://doi.org/10.1186/s13550-026-01438-4","url":null,"abstract":"<p><strong>Background: </strong>Primary Sjögren's syndrome (pSS) is characterized by progressive fibro-inflammatory glandular injury. While conventional salivary gland scintigraphy (SGS) provides macroscopic functional assessment, it cannot visualize underlying active fibrotic remodeling. This prospective study aimed to evaluate the diagnostic performance of dual-time-point (10 and 40 min post-injection) [⁶⁸Ga]Ga-FAPI-04 PET/CT-a novel radiotracer targeting activated fibroblasts-compared to SGS in patients with suspected pSS.</p><p><strong>Results: </strong>Among 21 participants (15 with confirmed pSS, 6 non-SS controls with other autoimmune diseases), early-phase (10-minute) PET/CT achieved optimal diagnostic efficacy. Visually, early-phase PET/CT demonstrated substantially higher specificity (66.7% vs. 16.7%), positive predictive value (87.5% vs. 73.7%), and overall accuracy (85.7% vs. 71.4%) compared to SGS, while maintaining comparable high sensitivity (93.3%). Semiquantitatively, the SUVmax of the submandibular and sublingual glands exhibited significant diagnostic utility (AUC > 0.5, P < 0.05), achieving 100% specificity and significantly outperforming volumetric parameters, which were compromised by a \"background dilution effect.\" Clinically, early-phase global FAPI burden (TLF) correlated negatively with the systemic erythrocyte sedimentation rate (ESR). Regionally, early submandibular FTV correlated positively with the SGS excretion fraction (r = 0.594, P = 0.019), whereas the parotid glands exhibited no such correlation, corroborating the asynchronous structural progression of pSS. Furthermore, whole-body PET/CT successfully detected incidental extra-salivary fibro-inflammatory comorbidities (e.g., Hashimoto's thyroiditis, osteoarthritis).</p><p><strong>Conclusions: </strong>[⁶⁸Ga]Ga-FAPI-04 PET/CT demonstrates promising diagnostic utility and high specificity for pSS by selectively visualizing active fibroblast activation. It elegantly complements the macroscopic functional evaluation of SGS while providing profound in vivo insights into asynchronous disease progression. Crucially, its whole-body imaging capability delivers unparalleled clinical value for mapping systemic, multi-organ comorbidities. These findings underscore its potential as an advanced adjunctive diagnostic tool, warranting rigorous validation in large-scale, multicenter prospective cohorts.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834867","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":"Translational development of an SGLT2-targeted near-infrared contrast agent for intraoperative imaging of early-stage lung cancer.","authors":"Katherine A Ortmeyer, Kelly A McGovern, Jerica Tidwell, Xinyi Shi, Lydia Chen, Ryan Krouse, Kevin Guo, Jeffrey Huang, Michael Brown, Jake Mlakar, Paul Zhang, Venu Bandi, Sunil Singhal","doi":"10.1186/s13550-026-01425-9","DOIUrl":"https://doi.org/10.1186/s13550-026-01425-9","url":null,"abstract":"<p><strong>Background: </strong>Non-small cell lung cancer (NSCLC) is increasingly diagnosed at early stages, yet intraoperative localization of small and subsolid lesions remains challenging. Intraoperative molecular imaging (IMI) using tumor-targeted tracers is effective in many cancers; however, no available optical agents are specific for precursor or early-stage NSCLC. Sodium-glucose cotransporter 2 (SGLT2) is upregulated in in situ and minimally invasive lung cancers. This study aimed to develop and validate GlucoGlo, a novel SGLT2-targeted near-infrared (NIR) contrast agent, for IMI in early-stage NSCLC.</p><p><strong>Results: </strong>GlucoGlo, an SGLT2-targeted fluorescent tracer, was developed and assessed for specificity and efficacy in targeting and detecting NSCLC. Its SGLT2-specific binding was assessed by fluorescence imaging in in vitro and in vivo murine NSCLC models. Mice pretreated with an SGLT2 inhibitor were used to confirm on target binding. GlucoGlo's performance in detecting residual tumor after resection was compared to conventional visualization and palpation. GlucoGlo selectively bound SGLT2-expressing NSCLC cell lines in vitro with minimal fluorescent signal seen in negative controls. In vivo, it accumulated in flank xenografts at clinically relevant doses (peak signal to background ratio (SBR) of 6.85 at 48 h) without toxicity. Fluorescent signal was eliminated with pretreatment with a non-fluorescent SGLT2 inhibitor, confirming target specificity. Histopathologic analysis further confirmed the selective tumor accumulation. In a murine partial-resection model, GlucoGlo exhibited significantly greater sensitivity for detecting residual tumor compared to conventional visualization and palpation in resection models (100% vs. 62.5%; p < 0.01). In ex-vivo human lung tissue, GlucoGlo accurately identified pulmonary malignancy and had significantly greater mean fluorescence in tumor areas compared to normal lung (25,218 vs. 3,371 a.u., respectively, SBR: 7.57; p = 0.009).</p><p><strong>Conclusion: </strong>GlucoGlo demonstrated high sensitivity and specificity for SGLT2 in preclinical models of NSCLC, supporting its potential for clinical translation in intraoperative detection of ground glass opacities and early-stage lung cancer.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812425","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":"Giant bilateral ovarian metastases from small primary pulmonary adenocarcinoma: from dilemma to diagnosis.","authors":"Rakesh Ramprakash Pandey, Chaitali Bongulwar, Anand Pathak, Radhika Pagey, Ankita Tamhane","doi":"10.1186/s13550-026-01416-w","DOIUrl":"https://doi.org/10.1186/s13550-026-01416-w","url":null,"abstract":"<p><strong>Background: </strong>Ovarian metastasis has been reported mostly in gynaecological and gastro-intestinal malignancies followed by breast. Lung cancers rarely metastasize to ovaries and vice versa. Only ovarian metastasis from lung is rarely reported. In our case a mid-age patient presented as a case of carcinoma ovary. 18-F FDG PET/CT led to change in management of the patient by detecting solitary lung lesion. Histopathology and IHC played a pivotal role in making an accurate diagnosis and thus deciding the long term management of patient.</p><p><strong>Case presentation: </strong>In our case a 52-year-old woman presented with a three-month history of abdominal lump. On examination a large non-mobile abdominal mass was felt. 18-F FDG PET/CT revealed bilateral adnexal lesions, suspicious lymphadenopathy, and a small metabolically active right lung nodule. Definitive diagnosis of metastatic pulmonary adenocarcinoma involving both ovaries was established after histopathology evaluation of specimens obtained from laparoscopic excision of bilateral adnexal lesions and thoracoscopic excision of lung lesion.</p><p><strong>Conclusion: </strong>18-F FDG PET/CT and vigilant clinicopathological correlation enabled the identification and management of this rare instance of bilateral ovarian metastases from primary lung adenocarcinoma. This case highlights the essential role of metabolic imaging in complex oncological presentations. It further underscores the pivotal role of immunohistochemistry in characterizing these lesions and guiding subsequent patient management.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765805","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 emerging role of ¹⁸F-NaF PET/CT in osteoporosis: an emphasis on its application for the evaluation and management of lumbar spine osteoporosis.","authors":"Jaskeerat Gujral, Om H Gandhi, Amir A Amanullah, Mert Marcel Dagli, Shashi B Singh, Cyrus Ayubcha, Thomas J Werner, Mona-Elisabeth Revheim, William C Welch, Abass Alavi","doi":"10.1186/s13550-026-01411-1","DOIUrl":"https://doi.org/10.1186/s13550-026-01411-1","url":null,"abstract":"<p><strong>Background: </strong>Osteoporosis is a chronic skeletal disorder characterized by reduced bone mineral density and disrupted bone microarchitecture, affecting over 200 million individuals worldwide. The lumbar spine, containing the largest volume of metabolically active trabecular bone, is particularly vulnerable to osteoporotic degeneration and compression fractures. This narrative review examines recent advances in imaging modalities for lumbar spine osteoporosis assessment, emphasizing the diagnostic utility and emerging clinical applications of ¹⁸F-sodium fluoride (NaF) positron emission tomography/computed tomography (PET/CT). A comprehensive narrative review was conducted, synthesizing findings from pivotal studies investigating conventional imaging methods and newer PET-based technologies for osteoporosis evaluation. Particular focus was given to studies utilizing quantitative and kinetic PET biomarkers for assessing bone metabolic activity with ¹⁸F-NaF.</p><p><strong>Main body: </strong>While dual-energy X-ray absorptiometry (DXA) remains the clinical standard for bone mineral density assessment, it has significant limitations including poor spatial resolution, lack of three-dimensional capability, and inability to differentiate cortical from trabecular bone. In contrast, ¹⁸F-NaF PET/CT demonstrates superior image quality, rapid tracer kinetics, and quantitative assessment of regional osteoblastic activity. Studies show strong correlations between ¹⁸F-NaF uptake and bone turnover markers, mineral density measurements, and therapeutic response. Kinetic modeling approaches provide detailed insights into bone remodeling dynamics, supporting personalized treatment planning and prognostic assessment. Diagnostic performance studies report area under the receiver operating characteristic curves as high as 0.96 for osteoporosis detection when evaluated against DXA-derived BMD, though no study has yet compared both modalities against an independent gold standard such as fracture outcomes.</p><p><strong>Conclusion: </strong>¹⁸F-NaF PET/CT offers optimal clinical applications for early treatment response monitoring, evaluation of patients with discordant clinical risk and DXA findings, pre-surgical assessment in patients with borderline bone density, and investigation of complex metabolic bone disorders. Ideally, ¹⁸F-NaF PET/CT should be utilized in a complementary fashion to DXA. Primary barriers to clinical adoption include cost, limited accessibility, and absence of standardized kinetic modeling protocols. Future research should focus on establishing reference ranges across age and sex demographics, validating fracture prediction models, and determining cost-effectiveness thresholds for specific clinical scenarios such as high-risk patients with discordant DXA and fracture history.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765868","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":"Correction: Combined antitumor activity of [177Lu]Lu-FAPI-2286 and pazopanib in a sarcoma model: a preclinical theranostic study targeting fibroblast activation protein.","authors":"Jing-Ren Tseng, Cheng-Lung Hsu, Hsin-Hua Hsieh, Kung-Chu Ho, Chun-Yi Wu, Ko-Han Lin, Yi-Hsiu Chung, Chi-Chang Weng","doi":"10.1186/s13550-026-01443-7","DOIUrl":"10.1186/s13550-026-01443-7","url":null,"abstract":"","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":"16 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765913","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":"Beyond bisphosphonates: radiolabeled phosphopeptides for bone targeting.","authors":"Mazen Jamous, Barbara Roether, Eric Mühlberg, Christian Kleist, Armin Kübelbeck, Uwe Haberkorn, Walter Mier","doi":"10.1186/s13550-026-01437-5","DOIUrl":"https://doi.org/10.1186/s13550-026-01437-5","url":null,"abstract":"","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":"16 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765854","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":"[⁶⁷Ga]Ga-citrate SPECT/CT and [¹⁸F]FDG-PET/CT for evaluating therapeutic response in necrotizing otitis externa.","authors":"Eleonora G M Vosbeek, Louise V Straatman, Bart de Keizer, Hans G X M Thomeer, Adriana L Smit, Arthur J A T Braat","doi":"10.1186/s13550-026-01439-3","DOIUrl":"https://doi.org/10.1186/s13550-026-01439-3","url":null,"abstract":"","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765759","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":"Reliable localization of insulinomas with [⁶⁸Ga]Ga-NODAGA-Lys40-Exendin-4: a preliminary evaluation and clinical illustration.","authors":"Sreeja Raj Menon, Priyanka Verma, Arpit Mitra, Avik Chakraborty, Sudeep Sahu, Rucha Barapatre, Mukti Kanta Ray, Sharmila Banerjee, Sandip Basu, Tapas Das","doi":"10.1186/s13550-025-01365-w","DOIUrl":"https://doi.org/10.1186/s13550-025-01365-w","url":null,"abstract":"","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765856","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}