EJNMMI Research最新文献

{"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}

{"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":"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":2.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283949/pdf/","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":"OA","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":"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":2.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272747/pdf/","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":"OA","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":"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":2.7,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269627/pdf/","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":"OA","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":2.7,"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":"10.1186/s13550-026-01437-5","url":null,"abstract":"<p><p>BACKGROUND: The efficacy of current bone-targeting agents, notably bisphosphonates, in the treatment of bone metastases remains limited by their systemic toxicity and excessively long half-life. This study aims to develop bone-targeting agents inspired by osteotropic peptides involved in the bone mineralization process. These agents are intended to provide an innovative alternative to bisphosphonates for precision bone targeting. RESULTS: Osteotropic peptides and phosphopeptides were obtained by solid-phase synthesis and conjugated to DOTA. The peptides were radiolabeled with gallium-68 or lutetium-177, and their binding affinity to bone was tested in vivo. Osteopontin and matrix extracellular phosphoglycoprotein (MEPE) derived peptides did not show strong binding to bone. Systematic variations in oligoglutamic acid chain length, as well as the positioning and clustering of phosphorylated serine residues, enabled the identification of an optimized phosphopeptide. Clustering phosphorylated sites within the peptide sequence provided significant advantages over phosphorylated moieties scattered throughout the peptide sequence. DOTA-pS4E8 showed the strongest affinity for bone, comparable to the clinically used bone targeting agent methylene bisphosphonate (MBP). CONCLUSIONS: The novel phosphopeptides match the outstanding bone-targeting capabilities of bisphosphonates and show comparable pharmacokinetics. Owing to their peptidic nature and the consequently anticipated favorable toxicological profile, these agents warrant further investigation as versatile bone-targeting vectors. </p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":"16 1","pages":""},"PeriodicalIF":2.7,"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":"10.1186/s13550-026-01439-3","url":null,"abstract":"<p><p>BACKGROUND: Necrotizing otitis externa (NOE) is a rare but severe infection of the external ear canal that can progress to osteomyelitis of the temporal bone, often caused by Pseudomonas aeruginosa. Effective management requires prolonged systemic antibiotic therapy, as premature termination increases the risk of relapse. There is ongoing debate regarding the optimal duration of antibiotic treatment and the criteria for discontinuation. Functional imaging techniques, such as [67Ga]Gallium citrate SPECT/CT and [18F]FDG-PET/CT, have shown promise in assessing disease activity, but their roles in therapy evaluation remain underexplored. In this study, we describe the radiological disease activity during treatment and we relate activity at cessation of treatment to disease control in patients scanned with [67 Ga]Ga-citrate SPECT/CT and/or [18F]FDG-PET/CT. Secondly, inter-rater variability is assessed. RESULTS: Twenty patients with NOE, with a median duration of intravenous treatment of six months (range 1–24 months) were included. Relapse occurred in 3 patients. Qualitative assessment of 95 scans showed slight inter-rater agreement for [67Ga]Ga-citrate SPECT/CT (kappa = 0.167) and fair agreement for [18F]FDG-PET/CT (kappa = 0.400). Relapse was seen in patients both with and without complete resolution on imaging. In the semi-quantitative assessment, [67Ga]Ga-citrate SPECT/CT showed a decrease in countsmax ratio (1.93 to 1.35), but an increase in countsmean ratio (1.56 to 1.73) between baseline and end of treatment. [18F]FDG-PET/CT showed a 50% reduction in both maximal standardized uptake value, corrected for lean body mass (SULmax) and peak standardized uptake value, corrected for lean body mass (SULpeak) ratios and also a decrease in metabolic tumor volume (MTV) in most cases. CONCLUSIONS: Semi-quantitative measurements on [67Ga]Ga-citrate SPECT/CTs and [18F]FDG-PET/CTs demonstrated notable variation in NOE. However, our findings suggest that MTV might be a useful parameter in quantifying the [18F]FDG-PET/CT result during the course of disease. Although [18F]FDG-PET/CT with visual evaluation, potentially alongside MTV, appears to be the most effective, the inter-observer variability emphasizes the necessity for standardized protocols to improve consistency and reliability in clinical practice and to guide clinical decision-making. </p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260529/pdf/","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":"OA","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":"10.1186/s13550-025-01365-w","url":null,"abstract":"","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269569/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosimetry of [¹⁷⁷Lu]Lu-PSMA therapy in a hemodialysis patient: a case study.","authors":"Arjan D Hendriks, Alferso C Abrahams, Rob van Rooij, Fleur G M Verkaar, Martijn Dingemans, John L M Bemelmans, Kwok Wai Mui, Hugo W A M de Jong, Marnix G E H Lam","doi":"10.1186/s13550-026-01433-9","DOIUrl":"10.1186/s13550-026-01433-9","url":null,"abstract":"<p><p>BACKGROUND: In this case study, we share our experience on the treatment of a patient with [177Lu]Lu-PSMA for metastatic castration-resistant prostate cancer and comorbid kidney failure. Since a poor kidney function impacts [177Lu]Lu-PSMA clearance, the aim of this study was to carefully monitor the radiation dose to the organs-at-risk, and measure the activity distribution during hemodialysis sessions, by imaging, blood sampling and dialysate sampling. CASE PRESENTATION: A 72-year-old patient received a total of five cycles of approximately 7.4 GBq [177Lu]Lu-PSMA-I&T, with an interval of 5–7 weeks per cycle. The radiation dose per cycle (mean ± SD) was measured for different regions: total body 0.51 ± 0.06 Gy, liver (incl. tumours) 5.6 ± 0.5 Gy, kidney (single, poor function) 3.3 ± 0.4 Gy, salivary glands 5.5 ± 0.7 Gy, and bone marrow 0.41 ± 0.07 Gy. Hemodialysis was continued three times a week. Precautions for radiation protection were taken for the first hemodialysis session 20 h after [177Lu]Lu-PSMA administration, which took place at the radioligand therapy nursery unit. Blood and dialysate samples, collected during hemodialysis, showed a drop of the activity concentration in the blood of the patient (32% in 3 h), and a partial return of activity to the blood (rebound effect) after the end of the hemodialysis treatment. The radiation dose to the bone marrow of the hemodialysis patient was elevated (by a factor of two as compared to literature), but stayed below dose thresholds for severe deterministic side effects. CONCLUSIONS: Despite the preexisting kidney failure of a hemodialysis patient, the carefully monitored radiation dose of [177Lu]Lu-PSMA therapy remained below safe dose thresholds and no signs of severe hematotoxicity were observed. </p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13149701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765766","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}