EJNMMI Research最新文献

{"title":"Glypican-3 targeted radiopharmaceuticals for hepatocellular carcinoma: a review of molecular platforms.","authors":"Yue Sun, Lin Qiu","doi":"10.1186/s13550-026-01454-4","DOIUrl":"10.1186/s13550-026-01454-4","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is characterized by high heterogeneity, making early diagnosis and systemic therapy challenging. Glypican-3 (GPC-3) targeted radiopharmaceuticals are promising tools for HCC. This review summarizes the development of this field from a platform-centric perspective, comparing various molecular targeting vectors designed against GPC-3.</p><p><strong>Main body: </strong>The development of GPC-3 radiopharmaceuticals has evolved from slow-clearing monoclonal antibodies (mAbs) to rapidly excreted antibody fragments, peptides and other promising platforms. Early platform selection faced a compromise between molecular size and tumor retention. Current strategies tend to optimize pharmacokinetic profiles through chemical modifications, including the application of albumin-binding groups, PEGylation (polyethylene glycol modification), cyclization and integrating these strategies. These engineering approaches aim to provide an optimal signal-to-noise ratio in same-day imaging for diagnosis, while ensuring sustained tumor retention required for targeted radionuclide therapy.</p><p><strong>Conclusion: </strong>Future clinical translation will require further exploration of optimal pharmacokinetic properties to achieve a better balance between diagnostic and therapeutic capabilities, which is essential to promote GPC-3 theranostics into routine clinical practice. Furthermore, emerging strategies such as shifting towards more potent alpha-radionuclides; moving from single-targeting to multi-targeting strategies, such as GPC-3 and prostate-specific membrane antigen (PSMA); and synergizing radionuclide therapy with immunotherapy (e.g., immune checkpoint inhibitors) are expected to become key to overcoming tumor heterogeneity and prolonging patient survival.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148028422","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":"Simultaneous partial volume correction and denoising of brain PET images, using transformers and transfer learning.","authors":"Sanaz Kaviani, Amirhossein Sanaat, Mersede Mokri, Habib Zaidi, Jean-François Carrier","doi":"10.1186/s13550-026-01448-2","DOIUrl":"10.1186/s13550-026-01448-2","url":null,"abstract":"<p><strong>Background: </strong>Positron emission tomography (PET) is a key tool for quantitative brain imaging, but its image quality and quantitative reliability are strongly dependent on injected radiotracer activity and acquisition time. Reducing injected dose or acquisition time lowers radiation exposure but increases image noise, while partial volume effects (PVE) further degrade signal accuracy, especially in cortical regions critical for neurodegenerative disease assessment. Conventional partial volume correction (PVC) methods such as Iterative Yang can improve quantification but are highly sensitive to noise and perform poorly in low count settings, while also relying on accurate anatomical information, typically derived from MRI, which may be unavailable, misregistered, or impractical in routine clinical workflows; in parallel, most deep learning (DL) approaches reported to date focus mainly on denoising and do not jointly address PVE. A method capable of simultaneously mitigating low count noise and PVE is needed. This study aimed to evaluate whether a DL approach can generate full count, PVC brain PET images from fast or low count non PVC scans, using both clinical and phantom datasets.</p><p><strong>Results: </strong>Using clinical and phantom brain PET datasets with ¹⁸F-FDG and ¹⁸F-Florbetapir, we compared low count PET images at 10% of full counts with images processed by Iterative Yang PVC and a Swin Unetr based DL-PVC model. The DL-PVC method consistently outperformed low count non-PVC PET across all evaluations. It achieved higher structural similarity index (SSIM) by about 2%, higher peak signal to noise ratio (PSNR) by about 11%, and lower relative root mean square error (rRMSE) by about 4%, indicating improved image quality and quantitative accuracy. In the clinical test sets, DL-PVC further showed clear gains for both tracers, with SSIM improvements of 2.1% for ¹⁸F-FDG and 2% for ¹⁸F-Florbetapir, PSNR increases of 21.6% and 22.3% respectively, and substantial rRMSE reductions of 50% for ¹⁸F-FDG and 44% for ¹⁸F-Florbetapir.</p><p><strong>Conclusions: </strong>Our study introduced a DL based PVC method based on Transformer and Unet architectures. By combining phantom and clinical data through a transfer learning strategy, the network benefits from the phantom ground truth activity maps while also learning the complexities present in real clinical PET. With this approach, it improves PET image quality and quantitative agreement with a high count reference, and at inference it requires only PET input, so it can be deployed without MR images for PVC.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987066","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":"From imaging heterogeneity to clinical decision: a novel imaging biomarker based on bone marrow kinetics for advanced NSCLC patients in partial response.","authors":"Yubo Wang, Zhiheng Yao, Jingjing Wan, Yuan Cai, Xinyu Yang, Rongliang Wu, Kebir Sied, Tao Sun, Ying Liang","doi":"10.1186/s13550-026-01440-w","DOIUrl":"10.1186/s13550-026-01440-w","url":null,"abstract":"<p><strong>Background: </strong>Risk of disease progression varies substantially among advanced non-small cell lung cancer (NSCLC) patients who achieve a partial response to initial therapy, and this subgroup currently lacks practical prognostic tools. This study aimed to develop a novel imaging biomarker by assessing bone marrow kinetic heterogeneity via pretreatment dynamic ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT). We retrospectively analyzed 51 patients with advanced NSCLC, focusing on the 32 who attained a partial response following first-line treatment. Time-activity curves (TACs) from the tumor and bone marrow were metabolically decomposed. Through integrated analysis of clinical characteristics, conventional PET parameters, and 28 TAC-derived features, coupled with a rigorous bootstrap-LASSO-Cox procedure (1000 resamples) for robust feature selection, we developed a multivariate Cox model and a simplified risk-stratification model.</p><p><strong>Results: </strong>The bootstrap-LASSO-Cox analysis identified the slope of the bone marrow free FDG TAC between 10 and 30 min post-injection (BM_C_f_Slope_10-30) as the most significant independent predictor. In the multivariate Cox model, this feature was strongly associated with a reduced risk of progression (Hazard Ratio = 0.10, 95% CI: 0.03-0.35, P < 0.001) and demonstrated good discriminative ability (C-index = 0.77, 95% CI: 0.68-0.86). Using an optimal cutoff value of -0.01119, this single parameter significantly stratified patients into high- and low-risk groups with distinct progression-free survival (Log-rank P < 0.001). The simplified model showed robust predictive performance, with average time-dependent AUCs of 0.792, 0.774, and 0.731 at 12, 18, and 24 months, respectively, and provided clinical net benefit. Neither conventional metabolic parameters nor clinical characteristics showed significant predictive value.</p><p><strong>Conclusion: </strong>For advanced NSCLC patients achieving an initial partial response, pretreatment assessment of bone marrow kinetics via dynamic ¹⁸F-FDG PET/CT emerges as a potential prognostic biomarker. The TAC slope feature, which reflects early interstitial clearance, can identify patients at high risk of early progression, offering potential for personalizing surveillance strategies and guiding timely therapeutic interventions.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":"16 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147986771","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":"Preoperative assessment of IDH status in adult glioma by integrated ¹⁸F-FET PET/MR fusion: a comparative analysis of fusion algorithms.","authors":"Kun Zheng, Qingqing Han, Tuo Li, Zihang Liu, Enhui Li, Jiahui Liu, Wenbin Ma, Hui You, Yu Wang, Li Huo","doi":"10.1186/s13550-026-01457-1","DOIUrl":"10.1186/s13550-026-01457-1","url":null,"abstract":"<p><strong>Background: </strong>To investigate the diagnostic value of PET/MR fusion images for the noninvasive prediction of IDH status using various fusion strategies.</p><p><strong>Methods: </strong>This retrospective study involved 45 patients with histopathologically confirmed gliomas who underwent preoperative integrated 18F-FET PET/MR from May 2023 to August 2024. Image fusion was performed by combining PET and the IVIM-derived α map using three commonly used fusion algorithms: discrete wavelet transform (DWT), Laplacian pyramid (LP), and ratio-of-low-pass pyramid (RP). PET parameters and first-order histogram features were extracted from 18F-FET PET, IVIM α map, and fused images. A support vector machine (SVM) classifier with a radial basis function (RBF) kernel was used for classification. Model performance was evaluated through stratified cross-validation, with the area under the receiver operating characteristic curve (AUC) as the main metric.</p><p><strong>Results: </strong>All three fusion-based models outperformed single-modality models and the combined model baseline. Specifically, the LP-based fusion model showed an improved AUC of 0.790 (95% CI: 0.783-0.798); the RP-based fusion model achieved the highest AUC of 0.820 (95% CI: 0.813-0.828); and the DWT-based fusion model reached an AUC of 0.814 (95% CI: 0.806-0.821), with the highest sensitivity at 0.747. Additionally, the parameter analyses demonstrated that the fusion performance was highly sensitive to the weighting strategy across frequency bands. Optimized fusion weights are critical to realize the full benefit of PET/MR image fusion.</p><p><strong>Conclusion: </strong>Integrated ¹⁸F-FET PET/MR image fusion offers a promising alternative to traditional multimodal analysis. Its application in individualized treatment and precision medicine is highly promising.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971311","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":"Distinguishing lymphoma from benign lymphadenopathy in fever of unknown origin using a diagnostic model based on PET/CT and clinical-laboratory parameters.","authors":"Xinchao Zhang, Yujing Hu, Yalong Di, Congna Tian, Qiang Wei, Ruming Zhou, Jingjie Zhang, Fenglian Jing, Yanzhu Bian","doi":"10.1186/s13550-026-01450-8","DOIUrl":"10.1186/s13550-026-01450-8","url":null,"abstract":"<p><strong>Background: </strong>Fever of unknown origin (FUO) remains a complex diagnostic challenge, with infection, malignancy, and inflammatory diseases as the leading causes. A substantial proportion of FUO patients present with lymphadenopathy, among which lymphoma and benign lymph node disorders are the most critical differential diagnoses due to their markedly different management and prognosis. Although ¹⁸F-FDG PET/CT plays an indispensable role in lymphoma detection, significant metabolic overlap between malignant and benign lymphadenopathy limits its standalone diagnostic accuracy in FUO. Therefore, integrating PET/CT metabolic parameters with clinical features and laboratory markers may improve the differentiation between lymphoma and benign lymphadenopathy, facilitating timely and accurate diagnosis in FUO patients.</p><p><strong>Results: </strong>This study retrospectively analyzed patients with FUO who underwent PET/CT. Lymph nodes were included if their short-axis diameter was ≥ 1 cm on axial CT or if metabolic activity exceeded that of the mediastinal blood pool. Volumes of interest were manually delineated in LIFEx using a 40% SUVmax threshold. Among 203 patients (114 with lymphoma and 89 with benign lymphadenopathy), logistic regression analyses identified independent predictors across three domains: hyperpyrexia, joint pain, and rash among clinical factors; albumin (ALB), procalcitonin (PCT), and serum amyloid A (SAA) among laboratory indicators; and SUVmean, total metabolic tumor volume (TMTV), and total lesion glycolysis (TLG) among PET parameters. A combined model incorporating rash, PCT, SAA, SUVmean, and TMTV achieved superior diagnostic performance, with an area under the ROC curve (AUC) of 0.965, significantly outperforming models based solely on clinical (AUC = 0.790), laboratory (AUC = 0.866), or PET (AUC = 0.845) variables (all P < 0.001). A nomogram was subsequently developed for individualized risk prediction.</p><p><strong>Conclusions: </strong>Rash, PCT, SAA, SUVmean, and TMTV were independent predictors distinguishing lymphoma from benign lymphadenopathy in FUO. Integrating clinical, laboratory, and PET parameters markedly improved diagnostic accuracy.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971392","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":"[⁶⁸Ga]Ga-FAPI-04 PET/CT for subtyping and prognostication of IgG4-related disease.","authors":"Silu Liu, Qingqing Pan, Hongzhe Zhang, Linyi Peng, Wen Zhang, YunLu Feng, Yaping Luo","doi":"10.1186/s13550-026-01451-7","DOIUrl":"10.1186/s13550-026-01451-7","url":null,"abstract":"<p><strong>Background: </strong>Recently, two subtypes of immunoglobulin G4-related disease (IgG4-RD), proliferative type and fibrotic type, were defined according to patients' clinicopathological characteristics. The objective of this study is to determine the difference of fibrotic activity shown in [⁶⁸Ga]Ga-FAPI-04 PET/CT in these two subtypes of IgG4-RD.</p><p><strong>Results: </strong>Sixty-eight IgG4-RD patients (50 proliferative subtype, 18 fibrotic subtype; 47 newly diagnosed treatment-naïve, 21 with relapsed or persistent disease after treatment) who underwent [⁶⁸Ga]Ga-FAPI-04 PET/CT were enrolled. The SUVmax and target-to-background ratio (TBR) were measured in IgG4-RD lesions. Metabolic lesion volume (MLV) and total lesion uptake (TLU) were obtained from the MIM workstation, and SUVmean of the global lesions was calculated as the quotient of TLU and MLV (SUVmean = TLU/MLV). Proliferative subtype of IgG4-RD showed significantly higher uptake of [⁶⁸Ga]Ga-FAPI-04 than the fibrotic subtype (SUVmax, 16.59 ± 7.06 vs. 12.08 ± 4.65, P = 0.007; TBR, 14.50 ± 7.98 vs. 10.32 ± 5.08, P = 0.036). The TLU and MLV were also significantly higher in the proliferative subtype (median [IQR], TLU, 861.40 [340.40, 2465.48] vs. 419.15 [244.98, 657.90], P = 0.020; MLV, 177.11 [79.99, 503.94] vs. 107.98 [54.10, 163.24], P = 0.029). The pancreato-hepato-biliary disease demonstrated the highest SUVmax and TBR, followed by fibrosis/periaortitis, head-and-neck disease, and others involvements (P < 0.05). Lymph nodes demonstrated the lowest SUVmax and TBR among all disease. The relapse-free survival curve did not show significant difference between proliferative and fibrotic patients (P = 0.56). Patients with TBR ≥ 16.3 or SUVmean ≥ 5 had significantly shorter relapse-free survival than those below these thresholds (TBR, 39.7 months vs. not reached, P = 0.0078, hazard ratio = 5.74 [95%CI, 1.58-20.80]; SUVmean, 39.0 months vs. not reached, P = 0.019, hazard ratio = 4.36 [95%CI, 1.27-14.94]).</p><p><strong>Conclusion: </strong>The proliferative subtype of IgG4-RD exhibited more dominant uptake of [⁶⁸Ga]Ga-FAPI-04 than the fibrotic subtype, suggesting greater fibrotic disease burden. [⁶⁸Ga]Ga-FAPI-04 PET/CT derived parameters is predictive of relapse-free survival in patients with IgG4-RD.</p><p><strong>Trial registration: </strong>ClinicalTrials. NCT04125511 (Characterizing IgG4RD With 68GaFAPI PET/CT). Registered 14 October 2019, https//clinicaltrials.gov/study/NCT04125511?cond=NCT04125511&rank=1.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927575","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":"Subcutaneous injection of semaglutide causes increased muscle uptake of ¹⁸F-FDG and reduces the imaging quality of PET/CT: a case report.","authors":"Dong-Chun Hong, Liyuan Le, Weipeng Chen, Wen Long, Wei Fan","doi":"10.1186/s13550-026-01373-4","DOIUrl":"10.1186/s13550-026-01373-4","url":null,"abstract":"<p><strong>Background: </strong>Semaglutide, a glucagon-like peptide-1 receptor agonist widely used in diabetes management, has not been previously reported to interfere with PET/CT imaging. This case highlights a novel observation regarding same-day subcutaneous semaglutide injection leading to increased muscular ¹⁸F-FDG uptake, which compromises lesion detectability.</p><p><strong>Case presentation: </strong>A 48-year-old male with diabetes presented with \"right ear fluid outflow\" and underwent a baseline PET/CT scan without recent semaglutide, showing focal uptake in the nasopharynx and lymph nodes without muscular interference. Thirteen months later, he returned with lower back pain. A repeat PET/CT performed on the same day as semaglutide injection showed diffusely elevated muscle uptake, obscuring potential lesions. After discontinuing semaglutide for 6 days, a third scan revealed normalized muscular activity and clear visualization of multiple hypermetabolic lesions.</p><p><strong>Conclusions: </strong>This is the first report indicating that same-day semaglutide administration can significantly reduce PET/CT image quality by increasing muscle FDG uptake. Clinicians should consider discontinuing semaglutide at least 24 h prior to PET/CT in diabetic patients to ensure diagnostic accuracy.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873771","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":"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":"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":2.7,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323478/pdf/","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":"OA","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":"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":2.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13315395/pdf/","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":"OA","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":"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":2.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13287276/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}