European Journal of Nuclear Medicine and Molecular Imaging最新文献

{"title":"Image fraud in nuclear medicine research.","authors":"Robert M Kwee,Andreea M Pavel,Thomas C Kwee","doi":"10.1007/s00259-025-07515-5","DOIUrl":"https://doi.org/10.1007/s00259-025-07515-5","url":null,"abstract":"PURPOSETo assess nuclear medicine researchers' experiences and attitudes toward image fraud, as well as their perspectives on preventive measures.METHODSThis survey targeted corresponding authors who published in three nuclear medicine journals between 2021 and 2024. Participants were asked about their experiences related to medical image fraud, as well as their views on its prevalence, causes, and potential preventive measures.RESULTSOf the 2,837 corresponding authors invited, 284 (10.0%) completed the survey. Most of the 284 respondents were mid-career European male MDs with over 10 years of research experience. While 91% reported never feeling pressured to falsify medical images, 13.7% admitted doing so in the past five years, and 38.7% had witnessed colleagues engaging in such practices. Common forms included cherry-picking, unauthorized image reuse, and misleading enhancements. In the past five years, 1.1% admitted using AI to falsify medical images, while 2.8% reported witnessing colleagues do so. No demographic factors were significantly associated with misconduct. Key drivers cited were publication pressure, competition, and aesthetic expectations. Respondents emphasized the need for greater transparency, oversight, and cultural change. Current safeguards were generally considered ineffective. Stricter policies, increased awareness, and AI tools were suggested as potential solutions.CONCLUSIONSImage fraud in nuclear medicine research appears to be relatively prevalent. It is more frequently witnessed among other colleagues than self-reported by individual researchers. The findings highlight the need to fostering a culture of research integrity and for stronger preventive measures, including greater awareness, stricter journal policies, and improved control.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"20 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857798","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":"Comprehensive analysis of [18F]MFBG biodistribution normal patterns and variability in pediatric patients with neuroblastoma.","authors":"Peipei Wang,Xiaorui Chen,Xiaofang Yan,Jing Yan,Shuye Yang,Junqing Mao,Fang Li,Xinhui Su","doi":"10.1007/s00259-025-07490-x","DOIUrl":"https://doi.org/10.1007/s00259-025-07490-x","url":null,"abstract":"PURPOSE[18F]-meta-fluorobenzylguanidine ([18F]MFBG) PET/CT is a promising imaging modality for neural crest-derived tumors, particularly neuroblastoma. Accurate interpretation necessitates an understanding of normal biodistribution and variations in physiological uptake. This study aimed to systematically characterize the physiological distribution and variability of [18F]MFBG uptake in pediatric patients to enhance clinical interpretation and differentiate normal from pathological uptake.METHODSWe retrospectively analyzed [18F]MFBG PET/CT scans from 169 pediatric neuroblastoma patients, including 20 in confirmed remission, for detailed biodistribution analysis. Organ uptake was quantified using both manual segmentation and deep learning(DL)-based automatic segmentation methods. Patterns of physiological uptake variants were categorized and illustrated using representative cases.RESULTS[18F]MFBG demonstrated consistent physiological uptake in the salivary glands (SUVmax 9.8 ± 3.3), myocardium (7.1 ± 1.7), and adrenal glands (4.6 ± 0.9), with low activity in bone (0.6 ± 0.2) and muscle (0.8 ± 0.2). DL-based analysis confirmed uniform, mild uptake across vertebral and peripheral skeletal structures (SUVmean 0.47 ± 0.08). Three physiological liver uptake patterns were identified: uniform (43%), left-lobe predominant (31%), and marginal (26%). Asymmetric uptake in the pancreatic head, transient brown adipose tissue activity, gallbladder excretion, and symmetric epiphyseal uptake were also recorded. These variants were not associated with structural abnormalities or clinical recurrence and showed distinct patterns from pathological lesions.CONCLUSIONThis study establishes a reference for normal [18F]MFBG biodistribution and physiological variants in children. Understanding these patterns is essential for accurate image interpretation and the avoidance of diagnostic pitfalls in pediatric neuroblastoma patients.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"42 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144851253","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":"The utility of 68Ga-pentixafor PET/CT in superselective adrenal artery embolization(SAAE) for treating aldosterone adenomas.","authors":"Fang Zhoufei,Zhang Qixiang,Zhou Wei,Lin Jinxiu,Peng Feng,Cai Han","doi":"10.1007/s00259-025-07465-y","DOIUrl":"https://doi.org/10.1007/s00259-025-07465-y","url":null,"abstract":"PURPOSEExpression of CXC chemokine receptor 4 (CXCR4) has proved to be a valuable tool for guiding the diagnosis and treatment of aldosterone-producing adenoma (APA). In this study, we evaluated whether CXCR4 imaging with 68Ga-pentixafor PET/CT shows significant changes after superselective adrenal artery embolization (SAAE).METHODSWe prospectively recruited 25 patients with clinically diagnosed APA. All patients were examined with 68Ga-pentixafor PET/CT and adrenal venous blood sampling (AVS) before and after SAAE. PET/CT showed that the tracer uptake of unilateral nodular adrenal gland was higher than that of normal adrenal tissue. AVS showed that the dominant secretory side was consistent with that on PET/CT. All patients were successfully treated with SAAE. Clinical follow-up was carried out according to primary aldosteronism surgical outcome (PASO) criteria, and included monitoring of drug type, blood pressure, serum potassium, and aldosterone/renin ratio to evaluate surgical effect. Post operation 68Ga-pentixafor PET/CT and the maximum standardized uptake value (SUVmax) were used to observe the uptake of adrenal lesions after SAAE.RESULTSAmong the 25 APA patients who successfully underwent SAAE, 14 were men and the average age was 51.88 ± 8.89 years. The consistency between AVS and 68Ga-pentixafor PET/CT reaches 100%. Before operation, the SUVmax of the diseased side (16.79 ± 2.51, n = 25) was significantly higher than that of the non-diseased side (4.56 ± 0.57, P < 0.01). According to PASO criteria, 13 of 25 patients achieved complete clinical remission, 9 achieved partial remission and the treatment was ineffective for three patients. 19 cases achieved biochemical complete remission and 3 cases achieved partial remission. Following the treatment, 22 patients showed complete or partial remission. The 68Ga-pentixafor SUVmax of the diseased side decreased significantly (16.75 ± 2.54 vs. 4.37 ± 1.52, n = 22, P < 0.001). For the patients who ineffective to the treatment, the SUVmax did not change (17.07 ± 2.72 vs. 16.17 ± 2.72, n = 3, P = 0.842). The 25 patients were divided into two groups according to the average value (≥ 65% and < 65%) of the decrease in SUVmax. The decrease in SUVmax correlated with a good patient prognosis under the PASO standard (P = 0.009).CONCLUSIONA decrease in SUVmax is related to the prognosis. CXCR4 imaging with 68Ga-pentixafor can be used for pre- and post-SAAE evaluation in patients with APA.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"6 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144851255","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":"Prognostic value of [18F]FAZA PET/MR imaging pre and post revascularization in chronic limb-threatening ischemia: a prospective pilot study on tissue microcirculation.","authors":"Seyed Ali Mirshahvalad,Adam Farag,Tetsuro Sekine,Andres Kohan,Sebastian Mafeld,Graham Roche-Nagle,John Byrne,Ur Metser,Kongteng Tan,Patrick Veit-Haibach","doi":"10.1007/s00259-025-07514-6","DOIUrl":"https://doi.org/10.1007/s00259-025-07514-6","url":null,"abstract":"PURPOSETo evaluate the prognostic value of [18F]FAZA PET in predicting long-term clinical outcomes of critical limb-threatening ischemia (CLTI) patients undergoing endovascular revascularization.METHODSThis prospective pilot study received IRB and ethics committee approval. Patients who were planned to undergo revascularization were recruited. All patients underwent both dynamic and static [18F]FAZA PET at two different time points, before and after revascularization. After modelling, dynamic [18F]FAZA PET-derived parameters (including K1, K2, K3, K4, Ki, and total volume distribution [VT]) were extracted from each scan, and delta parameters were calculated. Also, standardized uptake values were calculated from the static [18F]FAZA PET. Furthermore, ankle-brachial indices (ABIs) were measured before and after revascularization. Patients were followed up clinically. All major events were documented, and patients were classified into two groups accordingly: \"sustained response\" and \"therapy failure\".RESULTSFrom the 12 prospectively recruited patients (mean age = 69 years), five patients were diagnosed with therapy failure during follow-up. K1 (p = 0.012) and ABI (p = 0.006) were significantly different in the post-angioplasty setting versus pre-angioplasty evaluations, being significantly lower and higher, respectively. In patients who experienced sustained clinical response, K1 (p = 0.028; significantly lower after treatment), VT (p = 0.018; significantly higher after treatment), and ABI (p = 0.028; significantly higher after treatment) were significantly different after angioplasty versus before angioplasty. In patients with therapy failure, only VT (p = 0.043; significantly lower after treatment) was significantly different. Considering between-group differences, ΔVT was significantly different between those who experienced sustained response versus those with therapy failure (p = 0.003).CONCLUSIONOur findings could support the potential prognostic value of changes in dynamic [18F]FAZA's initial volume distribution in the pre- versus post-revascularization setting. Unlike traditional measures, such as ABI, which show tissue's macrovasculature patency, dynamic [18F]FAZA PET could capture tissue-level microcirculation by VT mapping.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"181 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144851254","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 and safety of [18F]NaF PET/CT guided intraarticular block for lumbar facet joint and sacroiliac joint arthropathy: a single-arm phase 2 trial.","authors":"Rajender Kumar,Venkata Subramanian Krishnaraju,Vishal Kumar,Bhagwant Rai Mittal,Avanthiga Subrhamanian,Babita Ghai,Harmandeep Singh,Sarvdeep Singh Dhatt,Anish Bhattacharya","doi":"10.1007/s00259-025-07516-4","DOIUrl":"https://doi.org/10.1007/s00259-025-07516-4","url":null,"abstract":"PURPOSETo evaluate the efficacy and safety of robotic-arm-assisted [18F]NaF-PET/CT-guided intra-articular block for lumbar facet joint (LFJ) or sacroiliac joint (SIJ) arthropathy.MATERIALS AND METHODSIn this single-centre, non-randomized, prospective phase 2 clinical-trial, participants with chronic low back pain (CLBP) were recruited from August 2022 to June 2024. Participants having NaF-avid LFJ or SIJ on [18F]NaF-PET/CT underwent robotic-arm-assisted intra-articular block with steroids and local anaesthesia. Baseline, immediate post-procedural, and 3-month follow-up visual analog score (VAS), Low-Back Outcome Scale (LBOS), Oswestry Disability Index (ODI), and change in SUV values of target joints were documented. The primary end-point of the trial was ≥ 50% improvement in VAS at 3 months, and secondary end-points were improvements in ODI, LBOS by at least one grade and change in SUV. Descriptive statistics were applied. Qualitative variables were reported in percentages.RESULTSOut of 85 enrolled participants, 79 (92.9%) underwent [18F]NaF-PET/CT. Among them, 61 (77.2%) had NaF-avid joints, and 55(69.6%) underwent PET/CT-guided robotic-arm-assisted intra-articular blocks. The primary end-point was met in 84% (46/55) participants, and secondary end-points in 96% (53/55) and 89% (49/55), respectively. The procedure was technically successful in all the target joints. A significant change in pre- and post-procedural median SUVmax and SUVpeak of the treated joints was noticed. No major adverse effects were noticed in the participants.CONCLUSIONRobotic-arm-assisted [18F]NaF-PET/CT guided intra-articular blocks of LFJ and SIJ in CLBP appear to be safe and feasible in NaF-avid arthropathy. However, lack of comparison with the standard of care, small sample size, selection bias and radiation exposure limit its generalizability.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"19 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144851252","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":"Deep learning-based non-invasive prediction of PD-L1 status and immunotherapy survival stratification in esophageal cancer using [18F]FDG PET/CT.","authors":"Fei Xie,Mobei Zhang,Chunhong Zheng,Zhenwei Zhao,Jiarou Wang,Yufan Li,Kai Wang,Wenzhuo Wang,JunJie Lin,Tingting Wu,Yifan Wang,Xi Chen,Yongchao Li,Zhaohui Zhu,Hubing Wu,Yinfeng Li,Qingxing Liu","doi":"10.1007/s00259-025-07463-0","DOIUrl":"https://doi.org/10.1007/s00259-025-07463-0","url":null,"abstract":"PURPOSEThis study aimed to develop and validate deep learning models using [18F]FDG PET/CT to predict PD-L1 status in esophageal cancer (EC) patients. Additionally, we assessed the potential of derived deep learning model scores (DLS) for survival stratification in immunotherapy.METHODSIn this retrospective study, we included 331 EC patients from two centers, dividing them into training, internal validation, and external validation cohorts. Fifty patients who received immunotherapy were followed up. We developed four 3D ResNet10-based models-PET + CT + clinical factors (CPC), PET + CT (PC), PET (P), and CT (C)-using pre-treatment [18F]FDG PET/CT scans. For comparison, we also constructed a logistic model incorporating clinical factors (clinical model). The DLS were evaluated as radiological markers for survival stratification, and nomograms for predicting survival were constructed.RESULTSThe models demonstrated accurate prediction of PD-L1 status. The areas under the curve (AUCs) for predicting PD-L1 status were as follows: CPC (0.927), PC (0.904), P (0.886), C (0.934), and the clinical model (0.603) in the training cohort; CPC (0.882), PC (0.848), P (0.770), C (0.745), and the clinical model (0.524) in the internal validation cohort; and CPC (0.843), PC (0.806), P (0.759), C (0.667), and the clinical model (0.671) in the external validation cohort. The CPC and PC models exhibited superior predictive performance. Survival analysis revealed that the DLS from most models effectively stratified overall survival and progression-free survival at appropriate cut-off points (P < 0.05), outperforming stratification based on PD-L1 status (combined positive score ≥ 10). Furthermore, incorporating model scores with clinical factors in nomograms enhanced the predictive probability of survival after immunotherapy.CONCLUSIONDeep learning models based on [18F]FDG PET/CT can accurately predict PD-L1 status in esophageal cancer patients. The derived DLS can effectively stratify survival outcomes following immunotherapy, particularly when combined with clinical factors.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"8 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850863","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":"[18F]FDG PET/CT for treatment monitoring and prediction of progression in retroperitoneal fibrosis.","authors":"Christian Bayerl,Jonas Kaufmann,Giulia Metzger,Julian M M Rogasch,Holger Amthauer,Imke Schatka,Winfried Brenner,Markus van der Giet,Christian Furth","doi":"10.1007/s00259-025-07479-6","DOIUrl":"https://doi.org/10.1007/s00259-025-07479-6","url":null,"abstract":"PURPOSERetroperitoneal fibrosis (RPF) is a rare inflammatory disease, that, if left untreated, can lead to ureteral obstruction and subsequent renal impairment. First-line treatment is prednisolone, with rituximab, often used for refractory cases. This study evaluates treatment response in both [18F]FDG PET and CT, and potential baseline parameters for early prediction of progression.METHODS50 patients with RPF underwent at least two [18F]FDG PET/CT scans (baseline, BL, and first follow-up, FU1), 36 patients a second (FU2), 18 patients a third follow-up (FU3). PET parameters SUVmax, SUVmean, SUVpeak, metabolic active volume (MAV), thickness (CTrim) and cranio-caudal extension (CTcc) of the retroperitoneal mass were measured. Therapy groups were divided into prednisolone, rituximab and the combination of both.RESULTSAll PET parameters showed significant correlations with CTrim at all four timepoints. After therapy all PET parameters and CTrim decreased significantly (p ≤ 0.021). Highly significant metabolic and morphologic response was seen in the prednisolone (p ≤ 0.003) and the combination therapy group (p ≤ 0.001). At FU2, eight patients showed progression, with MAV as a good predictor of progression in BL (p = 0.041; 217.33 versus 100.86 ml). At FU2, SUVmax, SUVpeak and MAV differed significantly between progression and non-progression group (p ≤ 0.009), while CT showed no significant differences.CONCLUSIONOur findings underscore the superiority of PET against CT in therapy monitoring of RPF, especially in the detection of progression at FU2. Higher BL MAV correlated with progression at FU2, indicating its potential as a predictive marker. Still, especially when PET is not available, CT can be considered for initial therapy monitoring.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"39 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850872","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":"Predicting visceral pleural invasion in invasive adenocarcinoma with a maximum diameter ≤ 3 cm based on ¹⁸F-FDG PET/CT radiomics.","authors":"Qiujie Dong, Jinju Sun, Jianping You, He Long, Xin Li, Jun Cheng, Daoxi Hu, Yi Wang, Xiao Chen","doi":"10.1007/s00259-025-07511-9","DOIUrl":"https://doi.org/10.1007/s00259-025-07511-9","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the feasibility of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) radiomics in preoperative prediction of visceral pleural invasion (VPI) status in invasive adenocarcinoma (IAC) with a maximum diameter ≤ 3 cm.</p><p><strong>Materials and methods: </strong>A total of 590 IAC patients with a maximum diameter ≤ 3 cm were enrolled and divided into training set (n = 364), validations set 1 (n = 156) and validation set 2 (n = 70). A conventional model was built based on clinical and PET/CT imaging features by logistic regression. Radiomics features extracted from CT and PET images were screened using interclass correlation coefficients, Pearson correlation analysis and the least absolute shrinkage and selection operator. These selected features were used to calculate the CT and PET rad-scores. Finally, a combined model was constructed using multivariate logistic regression.</p><p><strong>Results: </strong>Tumor type [odds ratio (OR): 3.258, P = 0.012], distance between tumor and pleura (OR: 0.464, P = 0.001), and maximum standardized uptake value (SUVmax) (OR: 1.109, P = 0.002) were used to construct the conventional model. Ten CT radiomics features and six PET radiomics features were used to establish the CT and PET rad-score models. The area under the curve (AUC) value of the combined model (0.824) was higher than conventional model (0.734), CT rad-score model (0.790) and PET rad-score model (0.748) in the training set, and the differences were statistically significant as tested by Delong test (P < 0.05). In the validation set 1 and validation set 2, the combined model exhibited the highest AUC values (0.835 and 0.787), and the difference between the combined model and PET rad-score model (validation set 1: 0.835 vs. 0.747, P = 0.028; validation set 2: 0.787 vs. 0.657, P = 0.043) and CT rad-score model (validation set 2: 0.787 vs. 0.694, P = 0.025) was statistically significant.</p><p><strong>Conclusion: </strong>The combined model based on PET/CT radiomics is an effective and non-invasive tool for preoperative predicting VPI status in IAC patients.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844984","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":"Model-based cost-effectiveness studies in nuclear medicine: an unavoidable fact of life.","authors":"Sietse van Mossel,Dennis Vriens,Anna Barnes,Kristoff Muylle,Sopany Saing,Giorgio Treglia,Hendrik Koffijberg,Lioe-Fee de Geus-Oei","doi":"10.1007/s00259-025-07473-y","DOIUrl":"https://doi.org/10.1007/s00259-025-07473-y","url":null,"abstract":"","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"35 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850831","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":"Integrated [18F]FAPI-42 PET/MR improves diagnostic accuracy in breast cancer: comparison with simultaneously acquired breast MRI.","authors":"Peng Hou,Jie Lv,Weige Tan,Shaonan Zhong,Sihao Liang,Youcai Li,Miao Ke,Penghao Chen,Ruiyue Zhao,Huizhen Zhong,Qiao Zou,Xigang Ye,Xinlu Wang,Changhong Liang","doi":"10.1007/s00259-025-07460-3","DOIUrl":"https://doi.org/10.1007/s00259-025-07460-3","url":null,"abstract":"PURPOSEThis study assessed the diagnostic efficacy of fluorine-18-labeled fibroblast activation protein inhibitor 42 ([18F]FAPI-42) PET/MR versus simultaneously acquired breast MRI in identifying primary breast lesions and axillary lymph node metastases.METHODSA prospective study enrolled 64 women with BI-RADS 4 or 5 lesions identified through mammography or ultrasound. All participants underwent contrast-enhanced [18F]FAPI PET/MRI scans of the breast. Histology and imaging follow-up (median 11.5 months) were used as the gold standard. Primary lesions and lymph nodes were assessed using three imaging modalities: breast MRI, qualitative/quantitative [18F]FAPI PET, and integrated [18F]FAPI PET/MR. Quantitative PET parameters comprised the maximum standardized uptake value (SUVmax) and the tumor-to-background ratio (TBR). Receiver operating characteristic analysis assessed diagnostic performance, while net reclassification improvement (NRI) evaluated the diagnostic enhancement of PET/MR compared to breast MRI.RESULTSThe study included 114 breast lesions (89 malignant, 25 benign) and 114 lymph node groups (82 malignant, 32 benign). In detecting primary breast lesions, the quantitative PET/MR based on TBR (PET/MR-TBR) demonstrated superior specificity over breast MRI (96% vs. 68%, P = 0.016), corresponding to a marked reduction in false positive rate from 32% (8/25) to 4.0% (1/25; P = 0.027), while maintaining comparable sensitivity (94% vs. 97%, P = 1.00). For BI-RADS 3/4 lesions on breast MRI, PET/MR-TBR achieved an AUC of 0.90, with a significant NRI of 90.5% (P = 0.018) for BI-RADS 4 lesions. For breast lesions smaller than 10 mm, PET/MR-TBR increased specificity to 94% versus 75% for breast MRI (P > 0.05). For axillary lymph node evaluation, the quantitative PET/MR based on SUVmax (PET/MR-SUVmax) showed improved sensitivity (95% vs. 62%, P < 0.001) and a nonsignificant decrease in specificity (94% vs. 97%, P = 1.00) compared with breast MRI.CONCLUSION[18F]FAPI PET/MR significantly improves diagnostic accuracy over breast MRI, particularly in reducing false positives and improving the detection of axillary lymph node metastases. This modality holds potential for refining breast cancer diagnostics, especially in challenging BI-RADS 4 lesions and improving more accurate staging for smaller lesions.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"20 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144825708","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}