European Journal of Nuclear Medicine and Molecular Imaging最新文献

{"title":"Clinical Significance of incidental findings of thyroid nodules with increased PSMA-uptake on PET.","authors":"Esref Alperen Bayraktar, Livia F Kruger, Trond Velde Bogsrud, Sean J Huls, Jun Zhang, Brian J Burkett, Cem Bilgin, Gokce Belge Bilgin, Yalda Nikanpour, Aysel Kaplan Bayraktar, Julie E Hallanger Johnson, Mukesh K Pandey, Ayse Tuba Kendi, Ann T Packard, Ahmad Parvinian, Geoff B Johnson, Jolanta M Durski","doi":"10.1007/s00259-026-08120-w","DOIUrl":"https://doi.org/10.1007/s00259-026-08120-w","url":null,"abstract":"<p><strong>Purpose: </strong>High uptake on PSMA PET has been reported for several solid non-prostate cancers, including thyroid carcinoma. PSMA uptake in benign thyroid nodules has been reported as well. In this retrospective single institution study, we investigated the incidence and etiology of incidentally detected thyroid nodules with uptake on PSMA PET in a cohort of prostate cancer patients.</p><p><strong>Methods: </strong>We performed a search of our imaging database and identified PSMA PET demonstrating focal thyroid uptake. When multiple PSMA PET, only the first that demonstrated a thyroid nodule with PSMA-uptake was included. PET images were reviewed visually and by measuring the maximum standardized uptake value (SUVmax) of the focal thyroid uptake. Ultrasound images, TI-RADS scores, cytology (Bethesda grade) and surgical pathology reports were reviewed.</p><p><strong>Results: </strong>110 patients with focal thyroid PSMA-uptake who subsequently underwent ultrasound were included. Five had normal thyroid ultrasound. Five demonstrated two foci. FNAC was performed for 71 nodules in 68 patients. Cytology was nondiagnostic in 3 (4.2%; Bethesda I), benign in 37 (52.1%; Bethesda II), atypia of undetermined significance in 11 (15.5%; Bethesda III), suspicious for follicular or oxyphilic neoplasm in 8 (11.3%; Bethesda IV), suspicious for malignancy in 2 (2.8%; Bethesda V), and malignant in 10 (14.1%; Bethesda VI). A total of 15 malignancies were identified.</p><p><strong>Conclusions: </strong>In our cohort of prostate cancer patients, thyroid nodules with PSMA-uptake incidentally found on PET were primary thyroid carcinoma in 13.6%. An incidental finding of a thyroid nodule with PSMA-uptake should be considered for further follow up with ultrasound and FNAC.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing hematological toxicity in [¹⁷⁷Lu]Lu-DOTATATE for NET patients: a national survey from the French group of endocrine tumors (GTE) on the clinical need for harmonized monitoring strategies.","authors":"S Oziel-Taieb, C Ansquer, G Tlili, E Deshayes, M Haissaguerre","doi":"10.1007/s00259-026-08118-4","DOIUrl":"https://doi.org/10.1007/s00259-026-08118-4","url":null,"abstract":"<p><p>Peptide receptor radionuclide therapy (PRRT) with [¹⁷⁷Lu]Lu-DOTATATE is a standard treatment for metastatic neuroendocrine tumors (NET), but management of hematological toxicity beyond the thresholds defined in the Summary of Product Characteristics (SmPC) relies heavily on individualized clinical judgment. To characterize real-world practices, we conducted a national anonymous survey among French nuclear medicine physicians and medical oncologists involved in PRRT, under the auspices of the SFMN, GTE, and ENDOCAN-RENATEN network. Forty expert physicians completed the 45-item LutaViRe questionnaire. Results show that clinicians frequently apply higher platelet thresholds than the SmPC minimum, adjust first-cycle activity, and rely on individualized, often multidisciplinary strategies when facing acute or persistent thrombocytopenia. Nutritional deficiency screening and structured long-term hematological monitoring, including for therapy-related myeloid neoplasms, remain insufficiently implemented. These findings reveal substantial heterogeneity in the real-world hematological management of [¹⁷⁷Lu]Lu-DOTATATE and support the development of harmonized, individualized monitoring guidelines integrating patient risk profiles and systematic pharmacovigilance reporting.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual‑targeted radioligand therapy with [¹⁷⁷Lu]Lu‑DOTATATE plus [¹⁷⁷Lu]Lu‑DOTA‑IBA for bone metastases from neuroendocrine neoplasms: a prospective pilot study.","authors":"Shumao Zhang, Jia Deng, Na Zhang, Xuecheng Bai, Bo Li, Chi Qi, Jian Yang, Yu Zhang, Yue Chen","doi":"10.1007/s00259-026-08125-5","DOIUrl":"https://doi.org/10.1007/s00259-026-08125-5","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the feasibility, safety and preliminary efficacy of dual-targeted radioligand therapy combining [¹⁷⁷Lu]Lu-DOTATATE and [¹⁷⁷Lu]Lu-DOTA-IBA in patients with bone metastases from neuroendocrine neoplasms (NENs).</p><p><strong>Methods: </strong>This prospective, single-center, single-arm study enrolled 30 patients with bone metastases from NENs to receive combined [¹⁷⁷Lu]Lu-DOTATATE and [¹⁷⁷Lu]Lu-DOTA-IBA therapy. Treatment response was assessed using RECIST 1.1 and SSTR-PERCIST for all lesions, and modified M.D. Anderson criteria (MDAC) for bone metastases. Pain palliation assessed by the Visual Analogue Scale (VAS). Treatment-related adverse events (TRAEs) were graded by Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Progression-free survival (PFS) was performed using the Kaplan-Meier method.</p><p><strong>Results: </strong>A total of 95 treatment cycles were administered. The overall bone pain relief rate was 95.9%, with complete pain resolution in 41.7% of patients. Among 24 evaluable patients, the objective response rates (ORR) were 16.7% by RECIST 1.1, 50% by SSTR-PERCIST, and 29.2% by MDAC. The corresponding disease control rates (DCR) were 79.2%, 79.2%, and 87.5%, respectively. Subgroup analyses revealed comparable ORRs and DCRs between GEP-NENs (n = 14) and non-GEP-NENs (n = 10) across all three criteria. Semi-Quantitative PET/CT parameters, including STV, SUVmax, SUVmean, TLS, TBR, SULpeak, SLD and TBV decreased significantly after treatment (all P < 0.05). Absorbed doses to critical organs remained within safe thresholds. No grade ≥ 4 AEs occurred. No significant difference in PFS was observed between the two subgroups (log-rank P = 0.828).</p><p><strong>Conclusion: </strong>Our findings suggest that dual-targeted radioligand therapy with [¹⁷⁷Lu]Lu-DOTATATE plus [¹⁷⁷Lu]Lu-DOTA-IBA is feasible and well-tolerated, and may provide preliminary antitumor efficacy and pain palliation. However, due to the single-arm design and limited sample size, its definitive anti-tumor efficacy requires confirmation in larger controlled trials.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of preoperative parathyroid imaging in primary hyperparathyroidism: A synthesis of eight health-economic analyses.","authors":"Petra Petranović Ovčariček, Matija Romić, Vedrana Gladić Nenadić, Martin W Huellner","doi":"10.1007/s00259-026-08123-7","DOIUrl":"https://doi.org/10.1007/s00259-026-08123-7","url":null,"abstract":"<p><strong>Purpose: </strong>Preoperative localisation of hyperfunctioning parathyroid tissue underpins minimally invasive parathyroidectomy (MIP) in primary hyperparathyroidism (pHPT). Cervical ultrasound (cUS), [⁹⁹ᵐTc]Tc-sestamibi ([⁹⁹ᵐTc]Tc-MIBI) single-photon emission computed tomography/computed tomography (SPECT/CT), and choline positron emission tomography/computed tomography (PET/CT) differ in diagnostic accuracy and cost. Whether choline PET/CT should be reserved for second-line use or implemented first-line remains debated. We synthesised cost-effectiveness evidence from recent health-economic analyses across different healthcare systems.</p><p><strong>Methods: </strong>In this narrative review, MEDLINE (via PubMed) was searched for original health-economic analyses evaluating preoperative parathyroid imaging in pHPT published 2022-2026, supplemented by reference-list screening. Eight studies were included. The modelling framework, analytical perspective, imaging comparators, base-case costs, incremental cost-effectiveness ratios (ICERs), incremental cost-utility ratios (ICURs) and willingness-to-pay (WTP) thresholds were extracted.</p><p><strong>Results: </strong>The included studies comprised two retrospective cohorts, three decision trees, one Markov model, one cohort-level state-transition model, and one randomised controlled trial (APACH2). Across most healthcare settings, first-line choline PET/CT was more cost-effective than [⁹⁹ᵐTc]Tc-MIBI-based pathways. Reported ICERs included €471 per additional surgical cure (APACH2), US$470 per quality-adjusted life-year (QALY) (USA), €12,650 per QALY (France), and Colombian pesos (COP) 101,727-277,037 per additional cure. At one Dutch centre, [¹¹C]choline PET/CT was a dominant strategy (ICUR -€18,846/QALY), while a Spanish cohort demonstrated approximately 19% lower per-patient costs with PET-only imaging. PET tariff and local [⁹⁹ᵐTc]Tc-MIBI performance were the principal determinants of cost-effectiveness.</p><p><strong>Conclusions: </strong>First-line choline PET/CT is cost-effective compared with [⁹⁹ᵐTc]Tc-MIBI-based imaging pathways across most WTP thresholds. Implementation should be guided by local PET reimbursement and [⁹⁹ᵐTc]Tc-MIBI performance.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of genetic factors on [¹⁸F]FDG PET metabolic phenotypes in dementia with Lewy bodies.","authors":"Sofie Lövdal, Sanne K Meles, Giulia Carli, Anna Dortmond, Rosalie V Kogan, Orly Goldstein, Mali Gana-Weisz, Rotem I Orad, Roy N Alcalay, Noa Bregman, Klaus L Leenders, Tamara Shiner","doi":"10.1007/s00259-026-08124-6","DOIUrl":"https://doi.org/10.1007/s00259-026-08124-6","url":null,"abstract":"<p><strong>Background: </strong>Neuroimaging with [¹⁸F]FDG PET can support the diagnosis of Dementia with Lewy Bodies (DLB), but it remains unclear how genetic factors influence metabolic phenotypes.</p><p><strong>Objectives: </strong>To determine whether GBA1 and APOE ε4 status are associated with diverging [¹⁸F]FDG PET metabolic patterns in DLB.</p><p><strong>Methods: </strong>We analyzed [¹⁸F]FDG PET scans from 43 patients with DLB stratified by GBA1 and APOE ε4 status, and 35 from healthy subjects. Analyses included the cingulate island sign (CIS), regions of interest, SSM/PCA disease patterns, and a machine learning multi-class model. We evaluated the similarity of the DLB patient scans in our cohort with respect to typical DLB, Alzheimer's disease (AD) and Parkinson's disease (PD)-like patterns.</p><p><strong>Results: </strong>APOE ε4 status mainly influenced the CIS, with APOE ε4-negative patients showing greater preservation of the DLB-typical CIS pattern (p = 0.03) compared to APOE ε4 carriers. In contrast, GBA1 status influenced global metabolic phenotype. GBA1 carriers showed a more homogeneous PD/DLB-like metabolic pattern in the machine learning model (p = 0.003) compared to GBA1 non-carriers, whereas the latter group demonstrated greater heterogeneity and higher expression of the AD-related metabolic pattern (p = 0.004). These effects were observed along a metabolic spectrum rather than as distinct clusters.</p><p><strong>Conclusions: </strong>APOE ε4 and GBA1 modulate distinct aspects of the metabolic phenotype in DLB. GBA1 non-carriers and APOE ε4 carriers showed a higher rate of atypical metabolic signatures, which may contribute to biological heterogeneity and increase the risk of diagnostic misclassification.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative dual-tracer ¹⁸F-FDG and ¹⁸F-DPA-714 PET/MR for characterizing pathological subtypes in refractory mesial temporal lobe epilepsy.","authors":"Siqi Zhang, Xiaocao Liu, Bixiao Cui, Wenqi Xu, Chenyang Yao, Bin Wang, Liankun Ren, Jie Lu","doi":"10.1007/s00259-026-08119-3","DOIUrl":"https://doi.org/10.1007/s00259-026-08119-3","url":null,"abstract":"<p><strong>Background: </strong>Pathological subtypes are key determinants of surgical strategy and prognosis in refractory mesial temporal lobe epilepsy (MTLE), with hippocampal sclerosis (HS) associated with better outcomes than gliosis only. Subtype-specific patterns of cerebral metabolism and neuroinflammation, which may inform lesion localization and subtype differentiation, remain poorly defined. This study aimed to delineate these patterns using ¹⁸F-FDG PET and translocator protein (TSPO) PET with ¹⁸F-DPA-714 for precise localization, with emphasis on the added value of quantitative analysis.</p><p><strong>Methods: </strong>Patients with unilateral refractory MTLE undergoing surgery were retrospectively included, and pathological subtypes were classified according to histological profiles (HS, n = 43; gliosis only, n = 41). Patients underwent sequential integrated dual-tracer PET/MR imaging within one week. Age- and sex-matched healthy controls (HC) were recruited. Whole-brain voxel-wise and temporal lobe subregional analyses were performed. Localization performance was assessed by visual inspection and quantitative analysis employing an asymmetry index (AI) derived from standardized uptake value ratios. Sensitivity and accuracy were calculated, with false discovery rate correction applied for multiple comparisons.</p><p><strong>Results: </strong>In total, 43 MTLE-HS and 41 MTLE-gliosis only were included. Compared with HC, both HS and gliosis exhibited significant ¹⁸F-FDG hypometabolism alongside increased ¹⁸F-DPA-714 uptake, more pronounced in HS. Whole-brain ¹⁸F-DPA-714 abnormalities were more confined to temporal regions, affording clearer lateralization and localization than ¹⁸F-FDG. In temporal-lobe subregional analysis, ¹⁸F-FDG outperformed ¹⁸F-DPA-714 for subtype discrimination, and hippocampal AI value achieved the best performance (35/43 [81.4%] vs. 22/41 [53.7%], p = 0.007). Quantitative analysis enhanced localization accuracy for both tracers, yielding the greatest improvement for TSPO in gliosis (from 10/41 [24.4%] to 19/41 [46.3%], p = 0.038).</p><p><strong>Conclusion: </strong>Dual-tracer PET/MR combined with quantitative analysis may improve subtype-specific presurgical localization in refractory MTLE. TSPO-PET precisely localized the epileptogenic lesion, whereas FDG-PET facilitated differentiation of pathological subtypes.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stage-dependent performance and molecular subtype-specific relapse patterns on same-session [18F]FDG PET/contrast-enhanced CT in breast cancer.","authors":"Agostino Chiaravalloti, Shyqyri Samarxhiu, Ilaria Portarena, Valeria Flaminio, Nicola D'Ascenzo, Orazio Schillaci, Gianluca Vanni","doi":"10.1007/s00259-026-08077-w","DOIUrl":"https://doi.org/10.1007/s00259-026-08077-w","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate stage-dependent performance of same-session [18F]FDG PET/contrast-enhanced CT (PET/ceCT) for initial breast cancer staging and PET/ceCT-detected relapse patterns during follow-up.</p><p><strong>Methods: </strong>This retrospective single-centre study included a primary staging cohort with one index PET/ceCT per patient and a longitudinal cohort of follow-up/restaging examinations. PET/ceCT-derived endpoints were assessed against clinically adjudicated reference standards established through multidisciplinary team review, pathology when available and follow-up imaging. SUVmax and ceCT lesion diameter were analysed as exploratory biomarkers.</p><p><strong>Results: </strong>The staging cohort included 116 patients. Baseline stage was evaluable in 106 patients: 65 had cN-positive disease, 9 had cT3-4 cN0 disease and 32 had cT1-2 cN0 disease. Overall nodal staging performance showed sensitivity 64.8%, specificity 88.9%, PPV 92.0%, NPV 56.1% and accuracy 72.9%. In cT3-4 and/or cN-positive disease, PET-positive nodal findings had a PPV of 100%. Baseline M-stage assessment was limited by the low number of clinically confirmed M1 cases. SUVmax correlated with Ki-67 (rho = 0.322, p = 0.003, q = 0.022). The longitudinal cohort included 176 patients and 429 examinations. In 311 adjudicated examinations, restaging performance for disease progression showed sensitivity 100%, specificity 93.5%, PPV 97.3%, NPV 100% and accuracy 98.1%. First confirmed relapse was multiorgan/multisystem in 48/82 patients and visceral-only in 15/82; visceral conversion occurred in 5/16 patients with initial bone-only or nodal/locoregional relapse.</p><p><strong>Conclusion: </strong>Same-session [18F]FDG PET/ceCT showed greatest baseline utility in higher-risk breast cancer and was useful for longitudinal characterization of relapse phenotype and metastatic evolution.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amygdalar metabolic activity associated with cerebrovascular events and carotid-vertebral artery stenosis in takayasu arteritis.","authors":"Lingying Ma, Bing Wu, Sifan Wu, Guobing Liu, Xiaomin Dai, Rongyi Chen, Hongcheng Shi, Pengcheng Hu, Lindi Jiang","doi":"10.1007/s00259-026-08090-z","DOIUrl":"https://doi.org/10.1007/s00259-026-08090-z","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association of amygdalar activity with disease activity, inflammatory markers, cerebrovascular events, and structural vascular injury in patients with Takayasu arteritis (TAK).</p><p><strong>Methods: </strong>A total of 303 TAK patients underwent 18F-fluorodexoyglucose positron emission tomography/computed tomography (¹⁸F-PET/CT). Amygdalar, bone marrow, and vessel wall SUV were quantified. Clinical, laboratory, and imaging data were collected. The median follow-up duration was 27 months, during which adverse events were recorded.</p><p><strong>Results: </strong>No significant association was found between amygdalar SUV and cerebrovascular events in the overall cohort. However, among treatment-naïve patients, those with cerebrovascular events had significantly lower amygdalar SUVmax (9.3±2.0 v.s. 10.3±2.0, p=0.011) and SUVmean (6.6±1.2 v.s. 7.4±1.5, p=0.003) than event-free patients. The low SUV group had a higher proportion of cerebrovascular events (24.3% vs. 15.9%, P=0.045), along with elevated IgG and IgA levels and decreased lymphocyte counts. Amygdalar SUVmax was an independent protective factor against combined carotid and vertebral artery stenosis (OR=0.876, P=0.032). During follow-up, the event group had significantly lower amygdalar SUVmax than the new-onset symptom group (8.2±2.6 v.s. 10.4±1.8, P=0.030).</p><p><strong>Conclusion: </strong>Low amygdalar metabolic activity in TAK is associated with adverse vascular outcomes and serves as an independent protective factor against combined carotid-vertebral artery stenosis, suggesting its potential as a novel imaging biomarker.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary clinical investigation of ¹⁸F-(2S,4R)-4-fluoroglutamine PET/CT in the evaluation of lung cancer.","authors":"Xiaoxia Xu, Futao Liu, Qing Xie, Song Liu, Nan Li, Zhi Yang","doi":"10.1007/s00259-026-08107-7","DOIUrl":"https://doi.org/10.1007/s00259-026-08107-7","url":null,"abstract":"<p><strong>Background: </strong>The clinical utility of ¹⁸F-fluoroglutamine (¹⁸F-FGln) PET/CT for characterizing metabolic heterogeneity and improving lung cancer staging remains underexplored.</p><p><strong>Methods: </strong>In this prospective study, 31 patients with 36 primary lung lesions underwent dual-tracer (¹⁸F-FDG/¹⁸F-FGln) PET/CT. A metastatic cohort (n = 28) was analyzed for distant staging. Diagnostic performance was assessed using ROC analysis, logistic regression, and radiomic texture parameters (volume, mass, CT histogram features).</p><p><strong>Results: </strong>For primary lesions, ¹⁸F-FDG showed marginally higher detection rates (86.1% vs. 80.6%) and significantly greater avidity (SUVmax: 9.15 ± 0.16 (FDG) vs. 3.94 ± 1.57 (FGln), P < 0.001). CT texture analysis revealed kurtosis as an independent predictor of ¹⁸F-FGln uptake (OR = 1.16, P = 0.025), correlating with metabolic-structural coupling (r = 0.445, P = 0.009). In nodal staging, ¹⁸F-FGln identified improved diagnostic performance than ¹⁸F-FDG (AUC: 0.92 vs. 0.62). Metastatic lymph nodes showed higher ¹⁸F-FGln uptake, with increased SUVmax (3.57 ± 1.23 vs. 2.03 ± 0.47, P < 0.001) and TBR (2.11 ± 0.92 vs. 0.93 ± 0.21, P < 0.001). Multivariate analysis identified ¹⁸F-FGln SUVmax (OR = 32.79, P < 0.001) and CT density (OR = 0.90, P < 0.001) were predictors of metastatic lymph nodes (LNs). For distant metastases, ¹⁸F-FGln detected more distant lesions (86 vs. 70), particularly in bone (SUVmax 7.48 ± 3.03 vs. 6.80 ± 4.48) and brain (TBR 7.04 ± 2.96 vs. 0.88 ± 0.30, P < 0.001), altering staging in 3 cases.</p><p><strong>Conclusion: </strong>¹⁸F-FGln PET/CT showed promising clinical potential in lung cancer, particularly in nodal staging, with higher diagnostic performance compared with ¹⁸F-FDG. It also demonstrated improved detection of bone and cerebral metastases in selected patients. Furthermore, ¹⁸F-FGln uptake correlated with CT-derived texture features, especially kurtosis, suggesting a possible association with tumor heterogeneity. Despite several false-negative cases, these results indicate that ¹⁸F-FGln may serve as a complementary metabolic imaging biomarker in lung cancer. Multicenter validation studies are needed to confirm these findings.</p><p><strong>Clinical trials registration: </strong>ChiCTR2000037834 Retrospectively Reg Date：2020-09-02.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of redifferentiation therapy in radioactive iodine refractory thyroid cancer: a systematic review and meta-analysis.","authors":"Emilia Zampella, Valeria Cantoni, Roberta Green, Valeria Gaudieri, Federica Volpicelli, Leandra Piscopo, Mariano Scaglione, Alberto Cuocolo, Michele Klain","doi":"10.1007/s00259-026-08115-7","DOIUrl":"https://doi.org/10.1007/s00259-026-08115-7","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically review and meta-analyze the efficacy of redifferentiation therapy in patients with radioactive iodine (RAI)-refractory thyroid cancer.</p><p><strong>Methods: </strong>PubMed and Scopus databases were comprehensively searched up to January 2026 to identify clinical studies evaluating patients with RAI-refractory thyroid cancer who received targeted therapies to restore radioiodine uptake. Eligible studies reported either the rate of successful iodine re-uptake or treatment response evaluated according to RECIST 1.1 criteria. The primary endpoint was the pooled rate of successful redifferentiation, while secondary endpoints were objective response rate (ORR) and disease control rate (DCR), each stratified by redifferentiation status.</p><p><strong>Results: </strong>Fifteen studies comprising 234 patients (cohort sizes: 3-33) were included. The pooled rate of successful redifferentiation was 51% (95% confidence interval, CI: 30%-71%), with no significant publication bias. Treatment response according to RECIST 1.1 was evaluated in 11 studies (93 patients). The pooled ORR was 28% (95% CI: 13%-44%) in redifferentiated patients compared to 8% (95% CI: 0%-44%) in non-redifferentiated individuals (P = 0.33). The pooled DCR was significantly higher, reaching 93% (95% CI: 79%-100%) in redifferentiated patients compared to 54% (95% CI: 15%-91%) in non-redifferentiated patients (P = 0.04).</p><p><strong>Conclusions: </strong>In patients with RAI-refractory thyroid tumors, redifferentiation therapy using mitogen-activated protein kinase inhibitors successfully restores radioiodine avidity in approximately half of the cases. Although short-term disease control rates are promising, statistically significant prognostic differences and long-term survival benefits remain to be demonstrated in larger, standardized trials with extended follow-up.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}