EJNMMI Research最新文献

{"title":"Evaluation of [18F]MFPBG: a novel automatically radiolabeled probe for NET PET imaging.","authors":"Zhenheng Wei, Guojian Zhang, Xinai Wu, Jie Li, Pengfei Xia, Xuemei Wang","doi":"10.1186/s13550-026-01482-0","DOIUrl":"10.1186/s13550-026-01482-0","url":null,"abstract":"<p><strong>Background: </strong>Cardiac sympathetic nerve imaging is critical for sudden death risk stratification in heart failure patients. Conventional SPECT probe [¹²³I]MIBG is limited by inadequate spatial resolution and restricted quantitative ability. While [¹⁸F]-labeled PET probes have shown promise, some suffer from high hepatic uptake that interferes with cardiac signals, and low radiolabeling efficiency hinders clinical translation. Thus, a novel norepinephrine transporter (NET) probe [¹⁸F]MFPBG was developed for cardiac sympathetic nerve imaging, synthesized via an automated radiolabeling module.</p><p><strong>Results: </strong>The decay-corrected radiochemical yield of [¹⁸F]MFPBG was 15.14±2.57% (n = 5), with a retention time of 11.87 minutes. The probe exhibited a radiochemical purity of >95% and remained stable (purity >95%) for 4 hours at ambient temperature. The biodistribution studies in ICR mice (n=28) showed a cardiac uptake of 9.34±0.73 %ID/g at 5 minutes post-injection, with the heart to liver ratio (3.99±0.15). At 120 minutes, cardiac uptake remained high (4.88±0.85 %ID/g), and the heart to liver ratio was 4.46±0.85. In Bama miniature pigs, imipramine pre-treatment significantly reduced cardiac uptake compared to controls at 10 minutes (SUV-bw: 2.08±0.16 vs. 3.73±0.29; P < 0.001) and 60 minutes (SUV-bw: 1.21±0.14 vs. 2.15±0.21; P < 0.001).</p><p><strong>Conclusions: </strong>[¹⁸F]MFPBG demonstrates NET-mediated uptake, stable cardiac retention, low background noise, and suitability for automated radiolabeling, establishing it as a promising agent for cardiac sympathetic nerve imaging with favorable characteristics that warrant further preclinical validation, including in vivo metabolic profiling, to fully assess its clinical translatability.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404045","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":"Radioluminescence microscopy of tumor organoids enabled by a reconfigurable high-resolution imaging setup.","authors":"Sofia Demianova, Martin Dierolf, Maximilian Reichert, Laura Schmidleitner, Franz Pfeiffer, Wolfgang A Weber","doi":"10.1186/s13550-026-01484-y","DOIUrl":"10.1186/s13550-026-01484-y","url":null,"abstract":"<p><strong>Background: </strong>This study aims to construct and implement an experimental radioluminescence microscopy (RLM) setup using a standard light microscope to visualize tumor organoids with high resolution. This approach seeks to address the challenges of imaging organoids, facilitating advancements in precision medicine for cancer research. Tumor organoids grown in collagen were incubated with 100 MBq to 120 MBq of 18F-fluorodeoxyglucose to visualize metabolic activity within their structures. Imaging was performed using a sensitive electron-multiplying charge-coupled device in conjunction with a scintillator crystal and an optical system with a high light collection efficiency and adapted magnification.</p><p><strong>Results: </strong>The constructed RLM setup demonstrated high-resolution imaging of organoid samples, significantly exceeding the resolution achievable with positron-emission tomography. The combination of RLM with brightfield and fluorescence microscopy provided comprehensive morphologic and metabolic characterization of the organoids at sub-organoid spatial resolution.</p><p><strong>Conclusion: </strong>The study successfully illustrates the feasibility of using a modified light microscope for RLM to achieve imaging of tumor cell metabolism in organoids with a spatial resolution on the order of tens of micrometers. This approach opens new avenues for studies of tumor cell metabolism during tumor progression and during therapeutic interventions.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":"16 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403996","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":"Development and validation of a pulmonary embolism quantification method using single photon emission computed tomography ventilation and perfusion scintigraphy.","authors":"Harini Fernando, Christopher Sibley-Allen, Charlotte Fowler, Livieratos Lefteris","doi":"10.1186/s13550-026-01379-y","DOIUrl":"10.1186/s13550-026-01379-y","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary embolism (PE) remains an important cause of cardiovascular death and morbidity worldwide. Conventionally, PE imaging is reported in a binary manner, with reports stating the presence or absence of a thrombus. No generally accepted graduated quantification systems are available to guide management or predict the development of acute or long-term complications. V/Q SPECT is a well-established method for diagnosing PE in acute and chronic settings. The use of volumetric perfusion and ventilation functional images could potentially calculate the volumetric PE burden. This project aimed to develop and optimise a volumetric V/Q SPECT PE quantification technique, utilising V/Q SPECT phantoms, 100 consecutive clinical V/Q SPECT studies, and advanced V/Q SPECT image analysis with semiautomated %PE quantification methods.</p><p><strong>Results: </strong>Lung phantoms with PE defects of known volume demonstrated that the choice of acquisition, reconstruction parameters, and the volumetric cutoff threshold influences %PE results. The V/Q quotient image utilised a semiautomated technique with phantom-derived optimisation parameters, which was found to be the most accurate quantification method.</p><p><strong>Conclusion: </strong>This study, combining phantom and clinical study analysis, developed a successful method for semiautomated V/Q SPECT %PE quantification, which has the potential utility of guiding patient management and outcome prediction.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396305","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":"Identifying genetics biomarkers in correlation with pathological and PSMA PET/CT characteristics in prostate cancer.","authors":"Lili Qu, Kaiyue Li, Muwen Wang, Yadi Xiao, Xin Jin, Hang Zhou, Lujie Yuan, Yuekai Li, Shiwei Wang, Rui Li, Marcus Hacker, Xin Li, Xiang Li","doi":"10.1186/s13550-026-01471-3","DOIUrl":"10.1186/s13550-026-01471-3","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer is a prevalent disease with diverse tumor characteristics that complicate treatment. The integration of spatial patterns from prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT), pathology and expanding genomic data represents a groundbreaking advancement in histo-imaging genomics. The aim of this study was to elucidate the internetwork mapping between genetic biomarkers and PSMA PET/CT imaging in prostate cancer patients.</p><p><strong>Results: </strong>mRNA sequencing and clinical data from 433 prostate cancer patients were retrieved from The Cancer Genome Atlas (TCGA) database. Differential gene expression between the Gleason score (GS) > 7 and GS ≤ 7 groups was analyzed. Feature selection was performed following the univariate and multivariate logistic regression analyses. A GS predictive model was developed using multivariate logistic regression. Additionally, local samples and images from 27 patients were collected. PSMA PET/CT imaging was performed before radical prostatectomy, and mRNA sequencing of prostate cancer lesions was conducted using next-generation sequencing. Differentially expressed genes identified from the TCGA dataset were subsequently analyzed for correlations with PET-related metrics in the local dataset by utilizing Pearson correlation analysis.Out of the TCGA dataset, 174 genes exhibited differential expression. After feature selection, 53 genes remained. In the local dataset, ten genes (EFNA2, CACNA1I, CA1, MYBPC3, CYP1A1, TLCD3B, LRTM2, GBX2, SPSB4, and GDF3) demonstrated significant associations with PET-related metrics. When comparing the differential expression of genes between the GS>7 and GS≤7 groups, six genes (STMN2, CYP1A1, THRSP, LIPC, GBX2, and SPSB4) in the GS>7 group and eight genes (FBXL16, KLK14, DIRAS2, TERB2, PRAME, UTS2B, UGT2B15, and LINC02798) in the GS≤7 group were significantly correlated with PET-related parameters.</p><p><strong>Conclusions: </strong>This study identified genetic markers significantly correlated with PSMA PET/CT imaging features in prostate cancer patients. These findings may provide a valuable foundation for optimizing prostate cancer diagnostic procedures and tailoring therapeutic approaches based on genetic and imaging biomarkers.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387194","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":"[¹⁸F]MNI-1054, a novel PET ligand for lysine-specific histone demethylase 1 A (LSD1): first-in human validation and enzyme occupancy of the LSD1 inhibitor TAK-418.","authors":"Adam J Schwarz, Christine M Sandiego, Cristian Constantinescu, Akihiro Takano, Paul McQuade, Johannes Tauscher, Nichole Daegele, Ken Marek, Roger N Gunn, Jennifer Madonia, David S Russell","doi":"10.1186/s13550-026-01477-x","DOIUrl":"10.1186/s13550-026-01477-x","url":null,"abstract":"<p><strong>Background: </strong>The enzyme lysine-specific histone demethylase 1 (LSD1) epigenetically regulates gene expression and is a pharmacological target of interest in neurology. The aims of this study were to characterize the novel LSD1 brain PET tracer [¹⁸F]MNI-1054 in humans for the first time, including whole body radiation dosimetry and test-retest repeatability, and then utilize it to determine the enzyme occupancy of the brain-penetrant LSD1 inhibitor TAK-418. PET scans were acquired ~6 h and ~ 26 h following single oral doses (1.5 mg, 10 mg or 30 mg) of TAK-418. Due to the irreversible binding of both compounds to the same LSD1 binding site and the presence of residual circulating TAK-418 at the later scan time, a binding model was developed and applied to account for ongoing irreversible binding and enzyme turnover, and to simultaneously estimate the Day 1 and Day 2 enzyme occupancies and the apparent LSD1 enzyme turnover rate using data from all three dose cohorts.</p><p><strong>Results: </strong>Kinetic brain PET data were most accurately modeled by an irreversible two-tissue compartment model. The highest and most reproducible signal was observed in the cerebellum, for which an acquisition time of 120 min was sufficient to maintain accurate and reliable estimates of K_i. Within the limits of the three TAK-418 dose levels assessed, the binding model estimated a maximum occupancy of 85-86% and an LSD1 enzyme turnover half-life of approximately 30 h. The estimated whole body effective dose was 0.049 mSv/MBq, with the liver being the limiting organ (0.073 mSv/MBq).</p><p><strong>Conclusions: </strong>[¹⁸F]MNI-1054 was evaluated in humans for the first time and demonstrated acceptable radiation dosimetry, brain tissue kinetics and test-retest reliability. It was successfully applied to assess enzyme occupancy of TAK-418, a novel LSD1 small molecule inhibitor, and the LSD1 enzyme turnover rate in humans.</p><p><strong>Trial registration: </strong>https://clinicaltrials.gov/study/NCT04202497 , registered 12 December 2019.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374841","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":"Automatic lesion segmentation in ⁶⁸Ga-PSMA PET/CT and ¹⁷⁷Lu-PSMA SPECT/CT: added value of PET-guided SPECT in a bicentric study.","authors":"Solène Perret, Léa Albe, Agathe Edet-Sanson, David Tonnelet, Thomas Carlier, Camilla Kohi, Matthieu Barbaud, Romain Modzelewski, Pierre Vera, Laetitia Augusto, Frédéric Di Fiore, Sébastien Hapdey, Clément Bailly, Arnaud Dieudonné, Pierre Decazes","doi":"10.1186/s13550-026-01468-y","DOIUrl":"10.1186/s13550-026-01468-y","url":null,"abstract":"<p><strong>Background: </strong>Manual segmentation of prostate cancer metastases on PSMA PET/CT and SPECT/CT is time-consuming and poorly scalable, particularly in highly metastatic patients. This study evaluated nnU-Net-based automatic segmentation models trained on PET and SPECT either separately or jointly and assessed whether PET-derived information can improve SPECT lesion segmentation. Seventy-three patients with metastatic castration-resistant prostate cancer treated with ¹⁷⁷Lu-PSMA were retrospectively included: 48 from the Henri Becquerel Cancer Center (HBCC) and 25 from Nantes University Hospital (NUH). For each patient, ⁶⁸Ga-PSMA PET/CT and ¹⁷⁷Lu-PSMA SPECT/CT were acquired before and during the first treatment cycle respectively. All images were manually segmented by four nuclear medicine physicians in consensus. Four nnU-Net models were trained: M1 (PET/CT only), M2 (SPECT/CT only), M3 (joint PET/CT+SPECT/CT, unimodal input at inference), and M4 (SPECT/CT with PET/CT segmentation as a priori input). Models were first trained and internally validated on HBCC data, then retrained on the full HBCC cohort and externally validated on NUH data.</p><p><strong>Results: </strong>For PET/CT segmentation, M1 and M3 achieved comparable performance. M1 reached DSCs of 0.83 ± 0.19 (internal) and 0.76 ± 0.22 (external), while M3 achieved 0.83 ± 0.16 (internal) and 0.77 ± 0.21 (external). For SPECT/CT, the PET-guided model M4 (DSC: 0.63 ± 0.24 internal; 0.78 ± 0.14 external; PPV: 0.65 ± 0.26 internal; 0.75 ± 0.23 external) provided the best results. Compared with the SPECT-only model M2 (DSC: 0.61 ± 0.26 internal; 0.70 ± 0.25 external; PPV: 0.63 ± 0.25 internal; 0.71 ± 0.24 external), M4 showed no statistically significant difference in internal validation (DSC p = 0.35), while being statistically significant in external validation (DSC p = 0.014).</p><p><strong>Conclusion: </strong>The nnU-Net framework enables accurate lesion segmentation on both ⁶⁸Ga-PSMA PET/CT and ¹⁷⁷Lu-PSMA SPECT/CT. While PET-only and joint PET+SPECT models perform similarly on PET images, incorporating PET-derived segmentations as prior information tends to improve SPECT/CT lesion segmentation. This PET-guided SPECT segmentation strategy leverages the higher spatial resolution of PET and represents a key step towards fully automated extraction of volumetric and dosimetric biomarkers for personalized prostate cancer treatment.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367295","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":"The impact of PSMA-PET/CT on clinical decision-making in primary staging of prostate cancer.","authors":"Jacob Ingvar, Rasmus Green, Elin Trägårdh, Anders Bjartell","doi":"10.1186/s13550-026-01480-2","DOIUrl":"10.1186/s13550-026-01480-2","url":null,"abstract":"<p><strong>Background: </strong>Accurate staging is essential for optimal management of prostate cancer. Conventional imaging with computed tomography and bone scintigraphy has limited sensitivity and specificity, particularly for small-volume disease. Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA-PET/CT) has emerged as a more sensitive modality, but its impact on clinical decision-making in primary staging remains to be fully defined. In this retrospective single-center study, we evaluated the impact of PSMA-PET/CT on treatment strategies compared with conventional imaging in patients with intermediate- and high-risk prostate cancer at Skåne University Hospital, Sweden, between October 2020 and December 2022. All patients underwent [¹⁸F]PSMA-1007 PET/CT, computed tomography and bone scintigraphy within 90 days. Management decisions were assessed by comparing treatment decisions based on conventional imaging alone with those incorporating PSMA-PET/CT findings, and were classified as major (shift between curative and non-curative treatment intent), medium (modification of surgical or radiotherapy plans without altering overall treatment intent), and minor (additional investigations or minor adjustments resulting in treatment delay without change of intent or modality).</p><p><strong>Results: </strong>A total of 287 consecutive patients were included, of whom 59 (21%) had intermediate-risk and 228 (79%) high-risk disease. Overall, 187 patients (65%) had negative findings on all imaging modalities, while 100 (35%) had positive findings. PSMA-PET/CT identified lesions in 94 patients, whereas only 6 patients had positive findings exclusively on conventional imaging. PSMA-PET/CT led to a change in clinical management in 65 patients (22.6%), including major changes in 31 (10.8%), medium changes in 28 (9.9%), and minor changes in 6 (2.1%). Among patients with positive PSMA-PET/CT findings (n = 94), 32.0% experienced major, 29.8% medium and 5.2% minor treatment modifications. Management changes were more frequent in high-risk patients (24.6%) compared to intermediate-risk patients (15.3%).</p><p><strong>Conclusion: </strong>PSMA-PET/CT provides actionable information that leads to changes in clinical management in approximately one in four patients undergoing primary staging of prostate cancer, with the greatest impact observed in high-risk disease. These findings support the integration of PSMA-PET/CT into routine staging to enable more precise and individualized treatment planning.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":"16 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359901","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":"Can chatGPT-4o reliably standardize PSMA PET/CT and PET/MRI reports using PROMISE V2 criteria? - An exploratory study.","authors":"Anna Hinterberger, Maurin H Mangold, Caroline Weigel, Henri Hartmann, Dominik Nörenberg, Matthias F Froelich, Ricarda Ebner, Caelán Max Haney-Aubert, Karl-Friedrich Kowalewski, Stefan O Schönberg, Freba Grawe","doi":"10.1186/s13550-026-01475-z","DOIUrl":"10.1186/s13550-026-01475-z","url":null,"abstract":"<p><strong>Background: </strong>Structured reporting standardizes and facilitates reporting, improves accurate communication, and ultimately clinical decision-making. Although standardized frameworks such as PROMISE criteria are available for prostate-specific membrane antigen positron emission tomography (PSMA PET) for prostate cancer patients, free-text reporting remains predominant in both clinical routine and trials. Large language models (LLMs) may enable low-effort, time-efficient extraction of structured classifications from narrative reports. This study evaluated the performance of ChatGPT-4o for extracting PROMISE V2-based classifications from unstructured PSMA-PET/CT and PET/MRI reports.</p><p><strong>Results: </strong>For PSMA-PET/CT, overall miTNM accuracy was 79.8%, whereas PSMA-PET/MRI achieved a significantly higher accuracy of 91.0% (OR = 2.80, 95% CI: 1.32-6.51, p = 0.003). Component-wise, PET/MRI outperformed PET/CT in T-stage classification (83.8% vs. 57.7%; OR = 3.83, 95% CI: 1.34-12.69, p = 0.006) and demonstrated numerically higher N-stage classification accuracy (100% vs. 85.9%, p = 0.014), while M-stage classification was comparable between modalities (89.1% vs. 95.7%; OR = 0.84, 95% CI: 0.20-4.19, p = 0.748). PRIMARY score accuracy was also comparable for PET/CT and PET/MRI (70.4% vs. 88.1%; OR = 0.43, 95% CI: 0.05-2.14, p = 0.315). ChatGPT-4o's rationale for classifications was rated highly plausible across modalities, with a minimum Likert score of ≥ 4.8 for miTNM and 4.1 for PRIMARY.</p><p><strong>Conclusion: </strong>ChatGPT-4o enables reliable extraction of PROMISE V2-based N- and M-stage classifications from free-text PSMA-PET reports, with limited accuracy for T-stage. This work provides a first step toward leveraging LLMs to support structured and efficient reporting in PSMA PET imaging and points out present limitations.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":"16 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338315","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":"Long-term outcomes in medullary thyroid cancer patients treated with [¹⁷⁷Lu]Lu-DOTAGA.FAPi dimer therapy.","authors":"Sanjana Ballal, G B Priyanka, Madhav Prasad Yadav, Kunal Ramesh Chandekar, Frank Roesch, Mohammad Sakir, Shipra Agarwal, Chandrasekhar Bal","doi":"10.1186/s13550-026-01474-0","DOIUrl":"10.1186/s13550-026-01474-0","url":null,"abstract":"<p><strong>Background: </strong>Fibroblast activation protein (FAP)-targeted radionuclide therapy is a promising approach for patients with advanced or metastatic medullary thyroid carcinoma (MTC). This study evaluates efficacy, safety, and survival outcomes of [¹⁷⁷Lu]/[²²⁵Ac]-DOTAGA.Glu.(FAPi)₂ therapy in this population.</p><p><strong>Results: </strong>Nineteen patients with progressive MTC were treated with either [¹⁷⁷Lu]Lu-DOTAGA.Glu.(FAPi)₂ or [²²⁵Ac]Ac-DOTAGA.Glu.(FAPi)₂, receiving a median of 5 cycles. The median cumulative activity administered was 20.3 GBq (Lu) and 6.66 MBq (Ac) and the median follow-up was 21 months. Of the 17 evaluable patients, radiological response was assessed in 15 patients using the Response Evaluation Criteria in Solid Tumors (RECIST 1.1). The analysis demonstrated a partial response (PR) in 33% of patients, stable disease (SD) in 47%, and progressive disease (PD) in 20%, resulting in a disease control rate (DCR) of 80%. Positron emission tomography response criteria in solid tumors (PERCIST) evaluation (n = 15) showed 47% PR, 40% SD, and 13% PD. Biochemical response was evaluable in 14 patients: 64.2% showed stable or decreasing tumor markers. Median calcitonin doubling time was 6.7 months. Clinical progression occurred in 2 patients. Median PFS was 26 months; median OS was 42 months. No statistically significant difference in OS was observed between progression and non-progression groups (log-rank p-0.758). No Grade 4 or life-threatening toxicities were observed. Only two patients experienced Grade 3 adverse events-one with elevated alkaline phosphatase and one with worsening anemia. All other hematologic and biochemical toxicities were limited to Grade 1-2.</p><p><strong>Conclusion: </strong>[¹⁷⁷Lu]/[²²⁵Ac]-DOTAGA.Glu.(FAPi)₂ therapy shows encouraging disease control, acceptable safety, and preliminary efficacy signals such as increased survival in the treated patients of advanced MTC.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316337","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":"Outcome after primary directed radiotherapy in predominantly PSMA-PET/CT-staged patients with metastatic prostate cancer.","authors":"Christian Trapp, Sarah Frederike Brose, Michael Keilholz, Minglun Li, Nina-Sophie Schmidt-Hegemann, Claus Belka, Elena Berg, Philipp Weinhold, Jozefina Casuscelli, Christian Stief, Gabriel Sheikh, Paul Rogowski","doi":"10.1186/s13550-026-01473-1","DOIUrl":"10.1186/s13550-026-01473-1","url":null,"abstract":"<p><strong>Background: </strong>Oligometastatic prostate cancer (OMPC) is typically treated with systemic therapy, which may be complemented by radiotherapy (RT) of the prostate as part of primary directed therapy (PDT). This study retrospectively evaluated clinical outcomes following PDT in OMPC.</p><p><strong>Results: </strong>Twenty-four consecutive patients who underwent PDT for OMPC between 2011 and 2023 were analyzed retrospectively. The primary endpoint was progression-free survival (PFS); secondary endpoints included biochemical PFS (bPFS), overall survival (OS), and treatment-related toxicity. Survival was estimated using Kaplan-Meier analysis, and prognostic factors for PFS were assessed using univariate log-rank tests and multivariate Cox regression. The median follow-up was 40 months. Median age was 75 years (range: 58-83), with a median of two metastases (range: 1-5). Nineteen patients (79%) were staged with PSMA-PET/CT; 20 had synchronous and 20 low-burden disease (CHAARTED criteria). The most common RT regimen was 60 Gy in 20 fractions. Twenty-three patients received androgen deprivation therapy (ADT), including six with an androgen receptor signaling inhibitor (median duration: 23 months). Additionally, 22 underwent metastasis-directed therapy (MDT), and five elective nodal RT. Median PFS and bPFS were 80 and 73 months, respectively; median OS was not reached. Three-year PFS, bPFS, and OS were 78%, 81%, and 84%. Low metastatic burden (p = 0.007) and synchronous metastases (p = 0.027) predicted longer PFS. No acute grade 3 toxicity occurred; late grade 3 gastrointestinal and genitourinary toxicity occurred in 8% each.</p><p><strong>Conclusions: </strong>In this predominantly PSMA-PET/CT-staged cohort, PDT combined with MDT and ADT achieved promising long-term outcomes with acceptable toxicity, warranting confirmation in larger prospective studies.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":"16 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301459","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}