European Journal of Nuclear Medicine and Molecular Imaging最新文献

{"title":"A quantitative SPECT/CT metric for diagnosing transthyretin cardiac amyloidosis: multicenter study on biopsy-confirmed cases","authors":"Taku Takaishi, Masaya Kisohara, Ryosuke Horino, Hitomi Kaneko, Naohide Hotta, Kyosuke Mizuno, Takamine Ezaka, Yuto Kitagawa, Sachiko Okochi, Susumu Kobayashi, Masanori Kitase, Shuichi Kitada, Misugi Urano, Akio Hiwatashi","doi":"10.1007/s00259-025-07294-z","DOIUrl":"https://doi.org/10.1007/s00259-025-07294-z","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>99mTechnetium-pyrophosphate ([^99mTc]Tc-PYP) scintigraphy is the gold standard for diagnosing transthyretin amyloid cardiomyopathy (ATTR-CM). Conventional metrics, such as heart-to-contralateral-chest (H/CL) ratio and visual Perugini score, can be influenced by physiological blood pool uptake, leading to false positives and additional patient burdens. This study aimed to develop and validate a simple quantitative metric widely applicable for ATTR-CM diagnosis.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This multicenter retrospective study enrolled 253 patients who underwent [^99mTc]Tc-PYP SPECT/CT between April 2021 and September 2024. SPECT/CTs were acquired 3 h post-injection of 740 MBq [^99mTc]Tc-PYP. A lateral wall-to-aorta (LW/Ao) ratio was obtained by dividing the average radiotracer count in the lateral wall of the left ventricle by the average count in the ascending aorta. The diagnosis of ATTR-CM diagnosis was determined by endomyocardial biopsy. As statistical analyses, area under receiver operating characteristic (AUC) was used to compare diagnostic accuracy, and intraclass correlation coefficient (ICC) was used to assess inter-rater agreement.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Among 52 patients (31 men; mean age 77) whose biopsy results were available, 11 were diagnosed with ATTR-CM. LW/Ao ratio showed a sensitivity of 100% (11/11), specificity of 97.6% (40/41), and positive likelihood ratio of 41.0. LW/Ao ratio showed higher AUC (0.99; 95% CI: 0.99–1.00) compared to H/CL ratio (AUC = 0.90, <i>p</i> = 0.04) and visual score (AUC = 0.87, <i>p</i> &lt; 0.01). The ICC of LW/Ao ratio was excellent (0.91 ≥ 0.9).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The quantitative SPECT/CT metric demonstrated superior diagnostic accuracy for ATTR-CM compared to conventional methods.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"23 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866648","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":"Subcutaneous adipose tissue [18F]FDG uptake and CT-derived body composition variables for predicting survival outcomes in patients with locally advanced gastric cancer","authors":"Xiaoshan Chen, Xiaolin Chen, Xinming Zhao, Xiao Pang, Meng Dai, Yuhan Sun, Mengjiao Wang, Jingya Han, Yan Zhao","doi":"10.1007/s00259-025-07296-x","DOIUrl":"https://doi.org/10.1007/s00259-025-07296-x","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>This study aimed to investigate the impact of glucose metabolism in subcutaneous adipose tissue (SAT) and skeletal muscle (SM) variables on overall survival (OS) in patients with locally advanced gastric cancer.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A retrospective study was conducted on 110 patients with advanced gastric cancer who underwent baseline [¹⁸F]FDG PET/CT. Demographic, clinical, and survival data were collected. Mean standardized uptake value (SUVmean) of SAT as well as skeletal muscle, and body composition measurement, including SAT area, SAT radiodensity, SM area, and SM radiodensity, were assessed on PET/CT. SM area was normalized for patient stature, resulting in the skeletal muscle index (SMI). Patients were stratified into subgroups with high and low SAT uptake based on the optimum cut-off value of the SAT SUVmean. The univariate, multivariate regression analysis, Kaplan–Meier survival analysis, and Spearman’s correlation analysis were employed to evaluate the associations among metabolic activity and CT-derived body composition variables as well as OS.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Out of 110 patients with an average age of 62.65 ± 13.25 years, 58 (52.73%) patients died during follow-up. Cox regression analysis identified TNM stage, SAT SUVmean, and SMI as independent prognostic factors for OS (all <i>p</i> &lt; 0.05). Notably, patients with elevated SAT uptake exhibited significantly poorer long-term survival compared to those with low SAT uptake (<i>p</i> &lt; 0.001). Correlation analyses revealed a moderate positive association between SAT SUVmean and SAT radiodensity (<i>p</i> &lt; 0.001, <i>r</i> = 0.47), whereas a significant inverse correlation was observed between SAT SUVmean and SAT area (<i>p</i> &lt; 0.001, <i>r</i> = -0.465). Additionally, stratification by combined SAT SUVmean and SMI profiles showed that patients with low SAT uptake and high SMI exhibited a better prognosis than those with high SAT uptake and/or low SMI (<i>p</i> = 0.004 and <i>p</i> &lt; 0.001).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Increased [¹⁸F]FDG uptake in SAT was correlated with higher SAT radiodensity as well as lower SAT area, and shortened survival in patients with advanced gastric cancer, underscoring its potential as a biomarker for adverse outcomes.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"54 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866849","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":"Quantification of baseline amyloid PET in individuals with subjective cognitive decline can identify risk of amyloid accumulation and cognitive worsening: the FACEHBI study","authors":"Guilherme Domingues Kolinger, Oscar Sotolongo-Grau, Núria Roé-Vellvé, Juan Pablo Tartari, Ángela Sanabria, Esther Pérez-Martínez, Norman Koglin, Andrew W. Stephens, Montserrat Alegret, Lluís Tárraga, Miren Jone Gurruchaga, Agustín Ruiz, Mercè Boada, Santiago Bullich, Marta Marquié","doi":"10.1007/s00259-025-07270-7","DOIUrl":"https://doi.org/10.1007/s00259-025-07270-7","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Amyloid PET imaging is capable of measuring brain amyloid load in vivo. The aim of this study is to assess the relationship of the baseline amyloid with its accumulation over time and with cognition in individuals with subjective cognitive decline (SCD), giving a focus on those below Aβ positivity thresholds.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>118 of 197 individuals with SCD from the Fundació ACE Healthy Brain Initiative underwent three [¹⁸F]florbetaben scans and the remaining 79 underwent two scans in a 5-year span. Individuals were categorised based on baseline Centiloid values (CL) into amyloid positive (Aβ+; CL &gt; 35.7), Grey Zone (GZ; 20 &lt; CL ≤ 35.7), and amyloid negative (Aβ-; CL ≤ 20). Relationship between conversion to mild cognitive decline (MCI) and baseline amyloid levels was assessed. Then, to focus on sub-threshold individuals with amyloid accumulation, the Aβ- group was split into two groups (N1 (CL ≤ 13.5) and N2 (13.5 &lt; CL ≤ 20)), Aβ accumulation was determined, and a parametric image analysis of the Aβ accumulators in the N1 group was performed.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>At baseline, 20 individuals were Aβ+, 8 GZ, 160 N1, and 9 N2. Higher Aβ load, older and less educated individuals presented increased risk of MCI-conversion. Longitudinally, 19% of N1 individuals were accumulators despite very low Aβ burden at baseline. Meanwhile, 89% of the N2 group accumulated Aβ as well as all GZ individuals (which had the highest rate of amyloid accumulation, 5.1 CL/year). In the parametric image analysis of N1 accumulators, a region within the precuneus was linked to increased Aβ over time.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Baseline amyloid levels differentiate individuals who accumulate amyloid over time and that are at risk for cognitive decline, including those at sub-threshold levels of Aβ. This can be valuable to identify pre-clinical AD in a SCD population.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"4 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862955","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":"Synthesis and preclinical evaluation of small molecule-based radiotracers for PET imaging of PD-L1 expression and dynamics","authors":"Gaochao Lv, Nan Zhang, Junyi Zhu, Xin Hu, Qianhui Wang, Bingqing Qiu, Qingzhu Liu, Ling Qiu, Jianguo Lin","doi":"10.1007/s00259-025-07290-3","DOIUrl":"https://doi.org/10.1007/s00259-025-07290-3","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Small molecule-based radiotracers offer several potential advantages in positron emission tomography (PET) imaging, and are therefore a promising approach for non-invasively and accurately monitoring of programmed death ligand 1 (PD-L1) expression in vivo. In this study, two small-molecule radiotracers were developed to assess PD-L1 expression and dynamics during treatments.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>[¹⁸F]LG-2 and [¹⁸F]LG-3 were designed based on a phenoxymethyl-biphenyl scaffold with a tris-(hydroxymethyl)-aminomethane terminal group. The radiolabeling was achieved by a two-step method through the “click” chemistry. Cellular uptake assays in different tumor cells were performed to determine the specificity of the two tracers to PD-L1. The ability of [¹⁸F]LG-2 and [¹⁸F]LG-3 to detect PD-L1 expression in vivo as well as to monitor PD-L1 dynamics during chemotherapy and immunotherapy was investigated <i>via</i> PET imaging.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The radiolabeling of [¹⁸F]LG-2 and [¹⁸F]LG-3 was achieved with overall radiochemical yield of 15 ± 3% for [¹⁸F]LG-2 and 18 ± 5% for [¹⁸F]LG-3. In vitro cell uptake studies in tumor cells with varying PD-L1 levels demonstrated the specific binding of these tracers to PD-L1. PET imaging in mice bearing B16-F10 tumors displayed comparable tumor uptake of 6.45 ± 0.38%ID/mL for [¹⁸F]LG-2 and 5.64 ± 0.02%ID/mL for [¹⁸F]LG-3, while [¹⁸F]LG-3 showed nearly a 50% reduction in uptake in the liver and intestines compared to [¹⁸F]LG-2. PET signals of [¹⁸F]LG-3 in A375-hPD-L1, A375-hPD-L1/A375 and A375 tumor-bearing mice demonstrated a strong and linear correlation with PD-L1 expression levels. The dynamic of PD-L1 status in tumors after cisplatin and PD-L1 inhibitor treatments were accurately evaluated with [¹⁸F]LG-3 PET imaging.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The small-molecule radiotracer [¹⁸F]LG-3 is a promising candidate for evaluating PD-L1 expression and monitoring the dynamic of PD-L1 status during the treatment process.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"71 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862958","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":"Systemic effects of 177Lu-DOTATATE therapy to patients with metastatic neuroendocrine tumors: mechanistic insights and role of exosome","authors":"Swati, Preetam Basak, B. R. Mittal, Jaya Shukla, Vijayta Dani Chadha","doi":"10.1007/s00259-025-07291-2","DOIUrl":"https://doi.org/10.1007/s00259-025-07291-2","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>The present study aimed to evaluate the systemic redox status in metastatic neuroendocrine tumor (NET) patients following ¹⁷⁷Lu-DOTATATE therapy and to explore the role of exosomes in communicating the redox signals in-vitro.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Levels of reactive oxygen species (ROS), enzymes associated with oxidative stress and lipid peroxidation, gene expression of oxidative stress markers (COX2, iNOS, NF-κB and SOD) were determined in peripheral blood mononuclear cells (PBMCs) and serum isolated from a total of 30 NET subjects at three time points viz.: before, 4 weeks after first and fourth cycle of ¹⁷⁷Lu-DOTATATE therapy. Serum cytokine levels (IL-2, IL-6, IFN-γ, TNF-α, IL-4, IL-10 and TGF-β) were measured by ELISA. DNA damage was assessed by checking the expression of γH2AX and DNA repair genes (ATM: Ataxia-Telangiectasia Mutated and ATR: Ataxia-Telangiectasia and Rad3-related). Plasma-derived exosomes were characterized, their uptake by PBMCs was visualized and consequent ROS generation was assessed in in-vitro co-culture.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The study exhibits a significant increase in ROS level and relatively higher expression of COX2 and iNOS in PBMCs of NET patients post therapy. Serum inflammatory cytokines including IL-2, IL-6 and TNF-α were found elevated. The study did not find any change in the expression of genes associated with DNA damage. In-vitro co-culture of PBMCs (isolated before therapy) with exosomes derived after therapy exhibited significant increase in ROS as compared to control cells.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The study concludes that ¹⁷⁷Lu-DOTATATE therapy alters redox status, however it does not cause DNA damage, suggestive of its safety. Further, the study demonstrates the role of exosomes in spreading of oxidative stress systemically.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"17 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862956","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":"Harmonizing Aβ deposition threshold for 18F-florbetaben PET imaging: Addressing discrepancies and calibration between PET/CT and PET/MRI","authors":"Huamei Lin, Quanling Jiang, Yunhao Yang, Qi Huang, Ying Zhang, Zhengwei Zhang, Yuhua Zhu, Jiaying Lu, Jing Wang, Min Wang, Jianwei Men, Yufeng Yang, Huiwei Zhang, Yihui Guan, Jingjie Ge, Jie Lu, Jiehui Jiang, Chuantao Zuo","doi":"10.1007/s00259-025-07279-y","DOIUrl":"https://doi.org/10.1007/s00259-025-07279-y","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Discrepancies between PET/CT and PET/MRI scanners can affect the determination of amyloid beta (Aβ) deposition thresholds in patients with cognitive impairment. This study aimed to identify these differences and propose a calibration method to standardize Aβ quantification across imaging modalities.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A total of 133 patients with cognitive impairment underwent Aβ PET imaging and were divided into four groups: a head-to-head PET/CT and PET/MRI cohort (group A, <i>n</i> = 6), an independent PET/CT cohort (group B, <i>n</i> = 48), an independent PET/MRI cohort (group C, <i>n</i> = 79), and another independent PET/MRI cohort (group D, <i>n</i> = 10). Standardized uptake value ratios (SUVR) of global cortical target (CTXsuvr) and centiloid (CL) values were compared within group A and between groups B and C. A whole cerebellum (WC)-referenced SUVR method was used to calibrate CL values in group C, with verification in group D.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>CTXsuvr values were significantly higher in PET/MRI than in PET/CT in both group A (<i>P</i> &lt; 0.05) and group C versus group B (<i>P</i> &lt; 0.001). Aβ-negative/positive cases showed mean ± variance of CTXsuvr as 1.023 ± 0.104/1.479 ± 0.203 in group B and 1.146 ± 0.100/1.743 ± 0.254 in group C, with cutoffs of 1.140 (CL = 20) and 1.401 (CL = 60), respectively. WC-referenced calibration adjusted PET/MRI cutoff to 1.132 (CL = 19) in group C, aligning it with PET/CT thresholds and validated in group D.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>WC-referenced SUVR calibration effectively mitigates differences in Aβ thresholds between PET/CT and PET/MRI, enhancing Aβ quantification standardization in multi-modal imaging.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"7 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862957","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":"Genomic instability is associated with response to [¹⁷⁷Lu]Lu-PSMA-I&T radioligand therapy: an exploratory, preliminary liquid biopsy analysis","authors":"Kilian Kluge, David Haberl, Alexander Haug, Lukas Kenner, Gero Kramer, Shahrokh Shariat, Katarina Kumpf, Marcus Hacker","doi":"10.1007/s00259-025-07280-5","DOIUrl":"https://doi.org/10.1007/s00259-025-07280-5","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>PSMA-targeted radioligand therapies (PSMA RLT) are an effective and safe option for metastatic castration-resistant prostate cancer, but responsive subtypes and their biomarkers are not fully defined.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Plasma samples for cell-free DNA (cfDNA) analysis were collected from 17 patients undergoing [¹⁷⁷Lu]Lu-PSMA-I&amp;T. CfDNA underwent whole-genome sequencing to establish copy number variation (CNV) profiles and circulating-tumor DNA (ctDNA) levels and compared between prostate-specific antigen (PSA) response- and 1-year overall survival (1YOS) groups.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Non-responders exhibited higher degrees of cfDNA CNV burden (<i>P</i> = 0.048) and higher ctDNA levels (<i>P =</i> 0.036) than responders. Both markers allowed for the differentiation of responses (AUC: 0.792, 0.806) and 1YOS (AUC: 0.778, 0.847).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Unresponsive patients exhibited higher levels of cfDNA genomic instability and ctDNA levels, warranting genome-wide CNV profiling studies next to targeted approaches for mechanistic radiobiological insights and their value as response biomarkers for PSMA RLTs.</p><h3 data-test=\"abstract-sub-heading\">Graphical Abstract</h3>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"17 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857552","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":"Comparison of PET/CT using 68Ga-NOTA-Exendin-4 with 68Ga-DOTATATE, 18F-FDG, and conventional imaging in the localization of insulinomas","authors":"Haonan Yu, Xiangyuan Bao, Yian Gu, Meijie Pan, Qing He, Dong Li, Qiusong Chen, Shaobo Yao","doi":"10.1007/s00259-025-07288-x","DOIUrl":"https://doi.org/10.1007/s00259-025-07288-x","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Accurate preoperative localization is particularly important for surgical treatment of insulinomas. Current imaging methods, including ¹⁸F-FDG (FDG) PET/CT, ⁶⁸Ga-DOTATATE (TATE) PET/CT, CE-CT, and CE-MRI, have limitations. This prospective study provides a direct comparison of ⁶⁸Ga-NOTA-Exendin-4 (Ex4) PET/CT with other imaging techniques.</p><h3 data-test=\"abstract-sub-heading\">Method</h3><p>47 patients with biochemically proven endogenous hyperinsulinemic hypoglycemia underwent Ex4 PET/CT and other imaging methods. Sensitivity and accuracy of all imaging procedures for localizing insulinoma were calculated at the patient level and lesion level. Both clinical (&gt;10 years experience) and junior (&lt; 2 years experience) nuclear medicine physician readings were used to assess the diagnostic efficacy. We compared the SUV_max and tumor-to-background ratio (TBR) of three tracers and analyzed the values with Ki-67, maximum tumor diameter, and glucose metabolism indicators.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>In patient level, the sensitivity and accuracy of Ex4 PET/CT (94.11% and 95.74%) were higher than TATE PET/CT (70.59%, <i>p</i> = 0.026; 78.72%, <i>p</i> = 0.030), FDG PET/CT (50.00%, <i>p</i> &lt; 0.001; 63.83%, <i>p</i> &lt; 0.001), CE-CT (77.77%, <i>p</i> = 0.135; 72.22%, <i>p</i> = 0.007), and CE-MRI (63.64%, <i>p</i> = 0.135; 43.75%, <i>p</i> &lt; 0.001), respectively. Interobserver agreement was higher for Ex4 PET/CT than TATE PET/CT and FDG PET/CT (Cohen κ, 0.839 vs. 0.707 and 0.784, respectively). SUV_max and TBR of Ex4 and TATE PET/CT were significantly higher than FDG PET/CT (<i>p</i> &lt; 0.01). Negative correlations of tumor Ki-67 with TATE PET/CT were observed with SUV_max (<i>r</i> = -0.637, <i>p</i> &lt; 0.001). SUV_max and TBR of three molecular imaging methods had positive correlations with the maximum tumor diameter (<i>p</i> &lt; 0.05), except TBR of FDG PET/CT. Semi-quantitative values of the three tracers showed no correlation with the lowest blood glucose level, corresponding insulin, and C-peptide level. TBR of TATE PET/CT showed a positive correlation with C-peptide (<i>r</i> = 0.393, <i>p</i> = 0.043).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Ex4 PET/CT showed superior characteristics in localization compared to routine imaging modalities in benign insulinomas. Ex4 PET/CT demonstrates better imaging quality and interpretability than FDG PET/CT and TATE PET/CT. Combined Ex4 and TATE PET/CT could provide a comprehensive evaluation/localization of insulinoma.</p><h3 data-test=\"abstract-sub-heading\">Trial registration</h3><p>The trial was retrospectively registered at ClinitalTrial.gov (NCT06690957 and NCT06725693) on November 14, 2024 and December 5, 2024.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"16 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857545","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 eye-black sign of lower eyelids related to R-CHOP therapy: a rare imaging pitfall","authors":"Ivana Dewi Mulyanto, Elizabeth Celine, Ryan Yudistiro, Febby Hutomo, Hapsari Indrawati, Marcel P.M. Stokkel","doi":"10.1007/s00259-025-07284-1","DOIUrl":"https://doi.org/10.1007/s00259-025-07284-1","url":null,"abstract":"","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"14 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143853454","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":"A pilot study of [18F]F-fluciclovine positron emission tomography/computed tomography for staging muscle invasive bladder cancer preceding radical cystectomy","authors":"Thomas S. C. Ng, Mofei Liu, Matthew Robertson, Arda Könik, Su Chun Cheng, Martin K. Bakht, Kristen Harrington, Andrew Wolanski, Lauren Gilbert, Mark Preston, Matthew Mossanen, Himisha Beltran, Michelle S. Hirsch, Guru Sonpavde, Heather A. Jacene","doi":"10.1007/s00259-025-07287-y","DOIUrl":"https://doi.org/10.1007/s00259-025-07287-y","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Aim</h3><p>To assess the ability of [¹⁸F]F-fluciclovine-PET/CT to stage muscle invasive bladder cancer (MIBC) before radical cystectomy.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This single-site prospective pilot study enrolled patients with MIBC and T2-T4, N0 disease on CT/MRI slated to undergo radical cystectomy (RC). Dynamic and static [¹⁸F]F-fluciclovine-PET/CT images were acquired. Clinical readers assessed for confirmation of the primary bladder lesion on imaging and the presence of pelvic nodal metastases. Findings were compared to pathology at RC. Kinetic parameters from dynamic PET/CT were compared across bladder lesions of different clinical stages.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The study enrolled sixteen patients (median age: 73 years, range: 57–88 years, 11 males, 5 females), twelve receiving neoadjuvant chemotherapy before RC. There was high specificity amongst all three readers for detecting lymph node metastases (overall specificity: 0.91, 95%CI: 0.81–1.00) with good overall agreement rate with pathology (0.67, 95%CI: 0.44–0.83). The overall PPV for all readers for identifying node-positive disease was 0.4 (95%CI: 0–1.00), and the overall sensitivity was 0.13 (95%CI: 0–0.44). The overall PPV for detecting the primary tumor was 0.69 (95%CI: 0.47–0.88), and the sensitivity was 0.89 (95%CI: 0.78–1.00), with NPV and specificity being 0.70 (95%CI: 0.33, 1.00) and 0.39 (95%CI: 0.33, 0.50), respectively. Compartmental analysis of the primary bladder tumor revealed that k₁ and v_b parameters significantly differentiated between low (pT0-pT1) and high (pT2-pT4) risk disease (<i>p</i> &lt; 0.05). Immunohistochemical assessment showed no significant correlation of tumor [¹⁸F]F-fluciclovine uptake nor kinetic parameter with amino acid transporter expression.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>[¹⁸F]F-fluciclovine demonstrates good specificity and agreement rate for MIBC staging, with sensitivity like CT/MRI. Kinetic parameters such as k₁ was able to delineate higher-stage ( ≥ = pT2) primary lesions. Heterogeneous amino acid transporter expression can be seen across lesions. Further studies are warranted to understand [¹⁸F]F-fluciclovine PET/CT use in the context of other imaging modalities in this disease.</p><h3 data-test=\"abstract-sub-heading\">Clinical trial registration</h3><p>NCT04018053 Registered 2/26/2020.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"108 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143853451","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}