EJNMMI Research最新文献

{"title":"Construction and clinical application of a predictive model for the efficacy of ¹³¹I therapy in refractory Graves' disease in children and adolescents.","authors":"Qianyu Chen, Zhiyuan Deng, Qianyu Deng, Yan Wang, Jian Wang, Chuanliu Wan, Liling Tan","doi":"10.1186/s13550-026-01465-1","DOIUrl":"https://doi.org/10.1186/s13550-026-01465-1","url":null,"abstract":"<p><strong>Background: </strong>Radioactive iodine (RAI) is a crucial treatment for refractory pediatric and adolescent Graves' disease (GD) cases characterized by poor response to antithyroid drug (ATD), recurrence, adverse effects, or excessive thyroid enlargement. Compared to adults, pediatric and adolescent patients currently lack effective efficacy prediction models tailored to this specific population. Furthermore, the applicability of existing adult dose calculation standards to children remains controversial. This study aims to develop a predictive model and explore the cutoff values of key variables influencing treatment efficacy, thereby providing a new adjunctive tool for the clinical management of pediatric and adolescent GD patients.</p><p><strong>Methods: </strong>A total of 95 children and adolescents with GD who received RAI therapy at the Department of Nuclear Medicine, the Second Affiliated Hospital of Nanchang University, between January 2020 and May 2025 were initially screened. Following the exclusion of 13 patients who had undergone prior thyroid surgery, received non-initial RAI treatment, or lacked regular follow-up, 83 patients (aged 9-19 years; 58 females) were finally enrolled. Based on thyroid function status 6 months post-treatment, patients were categorized into the cured group (Clinical Cure and Hypothyroidism) and the uncured group (Ineffective and Partial Improvement). Univariate analysis and LASSO regression were employed for preliminary variable screening to identify predictive indicators. A multivariate logistic regression model was subsequently constructed based on these selected variables. Model performance was evaluated using the area under the curve (AUC), calibration curves, and decision curve analysis (DCA), with internal validation performed via Bootstrap (2000 resamplings). The optimal cutoff values were determined using the Youden index.</p><p><strong>Results: </strong>The proposed dose per gram of thyroid tissue was a protective factor (OR = 1.048, 95% CI (1.01-1.09), P = 0.018); Thyroid weight (OR = 0.956, 95% CI (0.924-0.983), P = 0.004) and TRAb (OR = 0.914, 95% CI (0.861-0.963), P = 0.001) were risk factors. The model achieved an AUC of 0.833 on the original dataset, and an adjusted AUC of 0.810, After model establishment, further analysis of key variables revealed significantly reduced cure rates in patients with thyroid weight > 55.52 g, TRAb > 13.8 IU/L, and the proposed dose per gram of thyroid tissue < 97.5 µCi/g (3.61 MBq/g).</p><p><strong>Conclusion: </strong>A model incorporating the proposed dose per gram of thyroid tissue, TRAb, and thyroid weight effectively predicts treatment efficacy. For high-risk patients (thyroid weight > 55.52 g, TRAb > 13.8 IU/L), increasing the proposed dose (≥ 97.5 µCi/g or 3.61 MBq/g) is recommended to enhance treatment outcomes.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307097","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":"Cardiopulmonary transit time measured on dynamic rubidium cardiac PET/CT is a predictor for pulmonary hypertension.","authors":"Lena C Seige, Jakob Heimer, Karsten Murray, Eva Seiler, Niklas Stauffer, Cristina Popescu, Christian la Fougère, Eric Moulton, Nidaa Mikail, Sabin G Pop, Irene A Burger, Alexander W Sauter","doi":"10.1186/s13550-026-01387-y","DOIUrl":"10.1186/s13550-026-01387-y","url":null,"abstract":"<p><strong>Background: </strong>Cardiopulmonary transit time (CPTT), the time for blood to circulate from the right to the left ventricle, can be assessed on dynamic Rubidium-82 ([⁸²Rb]) cardiac PET/CT. Given its association with cardiac and pulmonary function, CPTT holds potential as a screening marker for pulmonary hypertension. This study investigated the relationship between CPTT and echocardiographic markers of cardiac function, as well as its association with pulmonary hypertension. In this retrospective single-center study, 111 patients (72 male, 39 female) referred for [⁸²Rb]RbCl-PET/CT and echocardiography within 31 days were included. CPTT, normalized to heart rate (NCPTT), was calculated from peak right and left ventricular [⁸²Rb] activity and examined in relation to patient characteristics and echocardiographic parameters, which were further used to categorize left and right ventricular systolic dysfunction, left ventricular diastolic dysfunction, and signs of elevated pulmonary arterial pressure.</p><p><strong>Results: </strong>Prolonged NCPTT was significantly associated with lower left ventricular ejection fraction and increased body weight (p < 0.05). NCPTT was significantly associated with left and right ventricular systolic dysfunction (OR = 1.21, 95%CI:1.04-1.42, p < 0.05; OR = 1.18, 95%CI:1.04-1.34, p < 0.01), elevated pulmonary arterial pressure (OR = 1.21, 95%CI:1.02-1.44, p < 0.05), and possible pulmonary hypertension (p < 0.05), but not with left ventricular diastolic dysfunction.</p><p><strong>Conclusion: </strong>Our findings suggest that NCPTT may serve as a useful additional marker for assessing cardiac function, particularly ejection fraction, and could help in the evaluation of patients with suspected cardiac systolic dysfunction, as well as the detection of pulmonary hypertension.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293678","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":"Dual-time-point [¹⁸F]FDG-PET/CT as a prognostic biomarker in patients with pleural mesothelioma undergoing immunotherapy.","authors":"Solfrid Thunold, Eivor Hernes, Lars Tore Gyland Mikalsen, Saima Farooqi, Åsa Kristina Öjlert, Roslyn J Francis, Anna K Nowak, Weronika Maria Szejniuk, Søren Steen Nielsen, Susana Cedres, Marc Simo Perdigo, Jens Benn Sørensen, Carin Meltzer, Åslaug Helland, Eirik Malinen, Vilde Drageset Haakensen","doi":"10.1186/s13550-026-01469-x","DOIUrl":"10.1186/s13550-026-01469-x","url":null,"abstract":"<p><strong>Background: </strong>[¹⁸F]FDG PET/CT provides a non-invasive assessment of tumour glucose metabolism. While conventional PET/CT captures a single time point, dual-time-point PET/CT (DTP-PET) evaluates metabolic dynamics by acquiring images at two defined times after injection. This study investigated whether the change in [¹⁸F]FDG uptake between 60 and 120 min-retention index (RI)-predicts clinical outcomes in patients with pleural mesothelioma (PM) receiving immunotherapy. Patients from the NIPU trial (NCT04300244) underwent DTP-PET at baseline (n = 50) and/or week-5 (n = 45), with 42 completing both. Peak SUV was measured in a 2-cm spherical volume of interest centred on the most avid lesion at 60 and 120 min, and RI was calculated as the percentage change between the two. Survival (OS, PFS) was analysed using Kaplan-Meier curves and Cox proportional hazards models based on tertiles of RI and SUV_60min. Objective response and disease control were defined by mRECIST and iRECIST. Group comparisons used the Wilcoxon rank-sum test.</p><p><strong>Results: </strong>At week-5, RI tertiles showed stepwise separation for both OS (p = 0.038) and PFS (p = 0.031), with the lowest tertile associated with the most favourable outcomes. SUV_60min tertiles were also significantly associated with OS (p = 0.042) and PFS (p = 0.043), though OS exhibited a non-monotonic pattern in which the middle tertile had the poorest survival. Objective responders displayed significantly lower RI and SUV_60min at week-5. Baseline RI tertiles were not associated with OS or PFS.</p><p><strong>Conclusions: </strong>Week-5 [¹⁸F]FDG DTP-PET suggests prognostic value in PM patients receiving immunotherapy. Both RI and SUV_60min were associated with objective response. RI showed a consistent stepwise association with survival, whereas SUV_60min showed a non-monotonic relationship for OS. These findings are exploratory and require validation in larger cohorts. Further studies are warranted to explore underlying biological mechanisms.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT04300244. Registered 2020-03-09. https://clinicaltrials.gov/study/NCT04300244.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13538317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293682","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":"Impact of different PSMA PET-based eligibility criteria on outcome of [¹⁷⁷Lu]Lu-PSMA radioligand therapy using [¹⁸F]rhPSMA-7/[¹⁸F]rhPSMA-7.3 (Flotufolastat).","authors":"Sonia Grigorascu, Thomas Langbein, Isabel Rauscher, Kimberley Hansen, Theo Lorenzini, Wolfgang A Weber, Türkay Hekimsoy, Lena Unterrainer, Matthias Eiber","doi":"10.1186/s13550-026-01459-z","DOIUrl":"10.1186/s13550-026-01459-z","url":null,"abstract":"<p><strong>Background: </strong>[¹⁷⁷Lu]Lu-PSMA radioligand therapy (RLT) is key in treating metastatic castration-resistant prostate cancer (mCRPC). Various PSMA agents and eligibility criteria for [¹⁷⁷Lu]Lu-PSMA RLT have been described. We retrospectively assessed applicability and outcomes using Blue Earth Therapeutics' (BET) phase I study criteria with [¹⁸F]rhPSMA-7 and Flotufolastat ([¹⁸F]rhPSMA-7.3), comparing them to VISION trial-based PSMA PET/CT criteria. Patients eligible for [¹⁷⁷Lu]Lu-PSMA RLT, as assessed by an interdisciplinary board, were retrospectively stratified into four groups based on whether their PSMA PET scans with Flotufolastat met BET (B + /B-) and/or VISION (V + /V-) criteria. Outcome parameters like PSA response, PSA progression-free survival (PSA-PFS), and overall survival (OS) were compared, and reasons for (in-)eligibility by BET or VISION were analyzed.</p><p><strong>Results: </strong>In total, 191 mCRPC patients from our institutional database were included, of which 138 underwent [¹⁸F]rhPSMA-7.3 and 53 [¹⁸F]rhPSMA-7. 161 (84.3%) met both criteria (V + /B +), 13 (6.8%) were ineligible (V-/B-), and 17 (8.9%) met VISION but not BET criteria (V + /B-). No patient was BET-eligible without also fulfilling VISION criteria. Of the 30 patients excluded by BET criteria, 17 (56.7%) lacked the \"majority\" tumor volume criterion; 10/13 (76.9%) excluded by VISION had visceral metastases with lower PSMA expression than the liver. In the subgroups V + /B + , V + /B-, and V-/B-, a PSA response > 50% was present in 62/157 (39.5%), 2/17 (11.8%), and 0/13 (0%) patients, respectively. V + /B + patients had the significantly longest PSA-PFS compared to V + /B- and V-/B- (PSA-PFS: 4.3 months (95% CI 3.4 - 5.2) vs. 1.5 months (95% CI 1.4 - 1.6) vs. 2.8 months (95% CI 0.0 - 6.5), p = 0.002) and a trend towards longer OS (14.9 vs. 13.1 vs. 7.7 months, p = 0.065).</p><p><strong>Conclusion: </strong>Multiple similarities between BET and VISION eligibility criteria (V + /B +) prior to [¹⁷⁷Lu]Lu-PSMA RLT were observed, with the majority of patients fulfilling both. Positivity in both criteria was associated with the best outcome. Data from our pilot cohort suggest that the criteria for BET's phase I trial select patients more strictly for [¹⁷⁷Lu]Lu-PSMA RLT than VISION criteria, while OS did not significantly differ between the three different groups.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270718","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":"First-in-human radiation dosimetry of the GRPR antagonist [⁶⁸Ga]Ga-NOTA-PEG₂-RM26 in patients with prostate and breast cancer.","authors":"Annie Bjäreback, Ulrika Estenberg, Antonios Tzortzakakis, Rimma Axelsson, Chunde Li, Renske Altena, Thuy A Tran, Cecilia Hindorf","doi":"10.1186/s13550-026-01472-2","DOIUrl":"10.1186/s13550-026-01472-2","url":null,"abstract":"<p><strong>Background: </strong>Gastrin-releasing peptide receptor (GRPR) is overexpressed in several malignant tumours, while its physiological expression in major organs, except for pancreas, is low. GRPR is therefore an interesting target in nuclear medicine. The GRPR-binding ligand, [⁶⁸Ga]Ga-NOTA-PEG₂-RM26 has previously been proven safe in humans. This study evaluates human dosimetry of the radioligand using 12 cancer patients (6 women with breast cancer and 6 men with prostate cancer) based on PET-CT imaging at six timepoints post injection. The voided urine was also collected to serve as an input to a urinary bladder model.</p><p><strong>Results: </strong>The pancreas, liver, spleen, kidney parenchyma, gall bladder, urinary bladder contents and cortical bone were identified as source organs/regions. Results using OLINDA/EXM 2.3.0 dosimetry software showed that pancreas was the organ that received the highest absorbed dose, 110 ± 43 µGy/MBq, followed by the urinary bladder wall, 100 ± 36 µGy/MBq, and the kidneys, 31 ± 11 µGy/MBq. The osteogenic cells received 15 ± 7 µGy/MBq. The median (range) of the total excreted activity through urine was 56% (43-75%) of the injected activity in 4h. The effective dose (ICRP 103) from an injection of [⁶⁸Ga]Ga -NOTA-PEG₂-RM26 was calculated to 11 µSv/MBq, using a 1h voiding interval in the urinary bladder model.</p><p><strong>Conclusion: </strong>A standard person of 70kg receiving 140MBq of [⁶⁸Ga]Ga-NOTA-PEG₂-RM26 will receive an effective dose of 1.5 mSv, which is lower or in accordance with other ⁶⁸Ga-labelled GRPR targeted radioligands.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov, NCT06147362, Registered 17 November 2023 - Retrospectively registered, https://www.</p><p><strong>Clinicaltrials: </strong>gov/study/NCT06147362.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":"16 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270712","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":"Early timepoint ^99mTc-DPD whole body scintigraphy and quantitative SPECT/CT imaging for diagnosis of cardiac ATTR amyloidosis.","authors":"Stephan Settelmeier, Lukas Kessler, Noah Hammersen, Maria Papathanasiou, Christoph Rischpler, Alexander Carpinteiro, Sara Oubari, Lars Michel, Julia Vogel, Tim Wollenweber, Jing Ning, Marcus Hacker, Clemens P Spielvogel, Zohreh Varasteh, Wolfgang P Fendler, Francesco Barbato, Pedro Fragoso Costa, Stephan Leyser, Tienush Rassaf, Ken Herrmann, Tugce Telli, David Kersting","doi":"10.1186/s13550-026-01466-0","DOIUrl":"10.1186/s13550-026-01466-0","url":null,"abstract":"<p><strong>Background: </strong>Cardiac transthyretin amyloidosis (ATTR-CM) is a progressive myocardial disease ultimately leading to heart failure. Standard diagnostic workup includes ^99mTc-DPD scintigraphy performed after 2.5-3 h. The purpose of this study is to compare early (1 h after injection) to late imaging of ^99mTc-DPD scintigraphy and SPECT for the detection of ATTR-CM. Early imaging could improve patient comfort and examination efficiency.</p><p><strong>Results: </strong>50 patients undergoing ^99mTc-DPD scintigraphy and SPECT for suspected ATTR-CM were included. Imaging was performed at both 1 h and 2.5-3 h post-injection. Tracer uptake was assessed visually (Perugini score), semi-quantitatively (e.g., heart-to-mediastinum ratio, HMR), and quantitatively (e.g., maximum standardized uptake value, SUV_max). ATTR-CM was diagnosed in 28% of patients. Median visual Perugini score was significantly higher for early imaging (0.5 vs. 0, p < 0.001). Findings were validated using an external validation cohort. Intraclass correlation coefficients between early and late imaging were very good. Visual evaluation of early imaging demonstrated comparable sensitivity, specificity, and overall diagnostic accuracy to late imaging. HMR and SUV_max from early imaging showed higher diagnostic accuracy. No false-negative results were observed. Visual evaluation using the Perugini score was slightly less consistent between readers in early compared to late imaging, with lower inter-observer agreement at 1 h.</p><p><strong>Conclusions: </strong>Early ^99mTc-DPD imaging provides diagnostic performance equivalent to conventional late imaging while substantially enhancing patient comfort and workflow efficiency. Adoption of early imaging protocols, complemented by quantitative and semi-quantitative analysis, may streamline ATTR-CM diagnostics, enabling timely diagnosis and treatment.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":"16 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13263361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239135","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":"Incidental [⁶⁸Ga]Ga-DOTATATE uptake in bone metastases of breast carcinoma in a patient with a secondary carcinoid tumor.","authors":"Jan Kemle, Sabin G Pop, Alexander Sauter, Rafael Pereira, Tilly Nothhelfer, Gad Singer, Cornelia Leo, Irene A Burger","doi":"10.1186/s13550-026-01462-4","DOIUrl":"10.1186/s13550-026-01462-4","url":null,"abstract":"<p><strong>Background: </strong>Lobular breast cancer often shows only low [¹⁸F]FDG uptake, limiting the sensitivity to detect metastases. Alternative tracers, targeting tumor activated fibroblasts or estrogen receptors, can offer higher accuracy. Also, Somatostatin Receptor 2 (SSTR2) is significantly expressed in some breast cancers, particularly in estrogen receptor rich tumors. Typical pulmonary carcinoids also have low [¹⁸F]FDG accumulation, but approximately 63% of well-differentiated lesions express SSTR2.</p><p><strong>Case presentation: </strong>We report the case of a 66-year-old female patient with lobular breast cancer and a coincidentally discovered typical carcinoid of the lung. On subsequent [⁶⁸Ga]Ga-DOTATATE PET/CT to stage the carcinoid tumor, two SSTR2 positive focal lesions in the bones were present, without [¹⁸F]FDG uptake but with mild sclerosis, atypical for metastasis of carcinoids. Biopsy confirmed osseous breast cancer metastases.</p><p><strong>Conclusion: </strong>SSTR2 expression in normal breast tissue and breast carcinoma has been described previously. However, the case underscores the importance of awareness of atypical presentations of cancer within a multi-tracer approach, whereby receptor profile and morphology must be carefully integrated.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216975","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":"Complementary roles of 68Ga-FAPI and 18 F-FDG PET/CT in evaluating IgG4-related disease: a systematic review and pooled analysis.","authors":"Xue Cai, Qin Wang, Qingfan Hao, Jian Zhang","doi":"10.1186/s13550-026-01452-6","DOIUrl":"10.1186/s13550-026-01452-6","url":null,"abstract":"<p><strong>Background: </strong>IgG4-related disease (IgG4-RD) lacks standardized imaging criteria. This study systematically reviewed head-to-head comparisons of ⁶⁸Ga-FAPI and ¹⁸F-FDG PET/CT to clarify their complementary roles in diagnosing and staging IgG4-RD.</p><p><strong>Main body: </strong>Three high-quality studies (n = 90) were pooled. ⁶⁸Ga-FAPI showed significantly higher SUVmax and target-to-background ratios (TBR) in parenchymal organs (pancreas, salivary glands) vs. ¹⁸F-FDG (P < 0.001), offering superior lesion contrast. While ¹⁸F-FDG detected more lymph node activity, ⁶⁸Ga-FAPI identified 136 vs. 78 total lesions, improving systemic burden assessment. Pathology correlated FAPI with fibrosis and FDG with inflammation, defining a \"flip-flop\" pattern. A FAPI/FDG ratio ≥ 1.5 predicted relapse risk.</p><p><strong>Conclusion: </strong>⁶⁸Ga-FAPI excels in parenchymal organ involvement, while FDG highlights inflammatory lymphadenopathy. Combining both tracers enables multimodal evaluation of fibroinflammatory activity, guiding personalized management and prognostication in IgG4-RD.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13478051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216933","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":"Experimental study of [⁶⁸Ga]Ga-HER2-RGD, a dual-target molecular probe, for breast cancer PET/CT imaging.","authors":"Xiujuan Zhao, Meng Dai, Tianyue Li, Nuo Li, Xiaolin Chen, Bo Dong, Yingxiao Guo, Mengyue Wei, Xinming Zhao, Jingmian Zhang","doi":"10.1186/s13550-026-01467-z","DOIUrl":"10.1186/s13550-026-01467-z","url":null,"abstract":"<p><strong>Background: </strong>Radiolabeled heterodimeric peptides have emerged as a highly promising targeting strategy for PET imaging due to their superior binding properties. The Human epidermal growth factor receptor 2 (HER2)- and Arg-Gly-Asp (RGD)-targeting moieties bind to HER2 and integrin αvβ3, respectively, receptors that are both overexpressed in many different types of tumors. This study focuses on the synthesis and evaluation of the heterodimeric radioligand [⁶⁸Ga]Ga-DOTA-HER2-RGD for PET imaging of the breast cancers-bearing mouse models that overexpress HER2 and/or integrin αvβ3.</p><p><strong>Results: </strong>The heterodimeric radiopeptide was successfully synthesized and radiolabeled with ⁶⁸Ga, achieving a radiochemical purity of > 95%. The receptor-binding properties and tumor-targeting efficacy were evaluated in vitro and in vivo using three breast cancer cell lines-MDA-MB-435 S (high HER2, high αvβ3), MDA-MB-231 (high HER2, low αvβ3), and MCF-7 (low HER2, low αvβ3)-and their respective xenograft models. Flow cytometry verified the cell-surface expression profiles of HER2 and integrin αvβ3 in all three cell types. In vitro cell studies showed that the MDA-MB-435 S cell line exhibited the highest uptake of [⁶⁸Ga]Ga-HER2-RGD, followed by MDA-MB-231 and MCF-7. High specificity was demonstrated in blocking studies using excess unlabeled HER2-RGD. Competitive binding assays revealed that [⁶⁸Ga]Ga-HER2-RGD exhibited high binding affinity, with an IC50 value of 12.9 nM. Micro-PET/CT imaging revealed a significant accumulation of [⁶⁸Ga]Ga-HER2-RGD in MDA-MB-435 S xenografts, with no or very low uptake in nontarget organs and tissues. Consistent with the in vitro findings, the tumor-to-nontumor ratios across the three xenograft models followed the order: MDA-MB-435 S > MDA-MB-231 > MCF-7. A significant decrease in [⁶⁸Ga]Ga-HER2-RGD uptake in the MDA-MB-435 S xenografts was observed after the administration of blocking amount of HER2-RGD.</p><p><strong>Conclusion: </strong>[⁶⁸Ga]Ga-HER2-RGD demonstrates specific dual-receptor-targeting properties towards HER2 and integrin αvβ3, as evidenced by in vitro and in vivo studies. This radiopeptide shows promise as a novel PET agent for the noninvasive visualization of HER2 and/or integrin αvβ3 expression in breast cancer, and is capable of semi-quantitatively evaluating the expression levels of HER2 and/or integrin αvβ3 to a certain extent.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203680","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":"Quantitative mid-treatment imaging biomarkers for response prediction after radiotherapy in head and neck cancer: a systematic review and meta-analysis.","authors":"Yuvnik Trada, Mark T Lee, Michael G Jameson, Paul Keall, Daniel Moses, Allan Fowler","doi":"10.1186/s13550-026-01446-4","DOIUrl":"10.1186/s13550-026-01446-4","url":null,"abstract":"<p><strong>Background: </strong>To systematically review and meta-analyse the prognostic value of quantitative mid-treatment imaging biomarkers for predicting locoregional tumour control in patients undergoing definitive radiotherapy for mucosal head and neck squamous cell carcinoma.</p><p><strong>Main body: </strong>A systematic literature search (2005-2023) was conducted in PubMed, EMBASE, Scopus, and Cochrane databases according to a pre-registered PROSPERO protocol. Studies evaluating quantitative imaging features derived from CT, MRI, or PET during radiotherapy were included. Imaging features were grouped as baseline, absolute mid-treatment, or relative mid-treatment (delta) parameters. A random-effects meta-analysis was performed on studies reporting receiver operating characteristic (ROC)-based area under the curve (AUC) values. Forty-one studies encompassing 1654 patients were included. Seventeen studies (n = 612 patients) reported sufficient data for meta-analysis. The pooled AUC for relative mid-treatment parameters was 0.796 (95% CI: 0.762-0.831), demonstrating higher predictive performance than absolute mid-treatment parameters (AUC 0.686; 95% CI: 0.628-0.745). Baseline parameters showed moderate predictive ability (AUC 0.736; 95% CI: 0.688-0.785), and while numerically lower than relative mid-treatment parameters, this difference did not reach statistical significance. Diffusion-weighted MRI (ΔADCmean) and FDG-PET (ΔMTV, ΔTLG) emerged as the most consistently predictive modalities. Relative measures offer practical advantages, including internal self-normalisation and improved reproducibility across imaging platforms.</p><p><strong>Conclusions: </strong>Relative mid-treatment imaging biomarkers demonstrate superior predictive performance compared to baseline and absolute measures, supporting their potential role in adaptive radiotherapy strategies. Further prospective multi-centre studies with standardised imaging protocols and external validation are essential for clinical translation.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175679","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}