European Journal of Nuclear Medicine and Molecular Imaging最新文献

{"title":"PET imaging of TREM2 in amyloid-beta induced neuroinflammation.","authors":"Amelia D Dahlén, Sahar Roshanbin, Ximena Aguilar, Nadja M Bucher, Sara Lopes van den Broek, Dag Sehlin, Stina Syvänen","doi":"10.1007/s00259-025-07358-0","DOIUrl":"https://doi.org/10.1007/s00259-025-07358-0","url":null,"abstract":"<p><strong>Purpose: </strong>The triggering receptor expressed on myeloid cells 2 (TREM2) has become a promising target for biologics in both monitoring and treating neuroinflammation in Alzheimer's disease (AD). This study aimed to develop and compare bispecific anti-TREM2 antibodies featuring different transferrin receptor (TfR) binders to enhance brain delivery, identifying the most suitable format for in vivo PET imaging of TREM2 in transgenic AD mice.</p><p><strong>Methods: </strong>Three bispecific TREM2-antibody formats were produced and evaluated for their ability to cross the blood-brain barrier (BBB) via TfR-mediated transcytosis and bind TREM2. Blood concentration profiles up to 72 h post-injection (p.i.), and ex vivo brain uptake of iodine-125-labeled antibody constructs were quantified in App^NL-G-F and age-matched wild type (WT) mice using a γ-counter. The best-performing bispecific TREM2-antibody was radiolabeled with iodine-124 and used for in vivo PET imaging of brain TREM2 levels in App^NL-G-F mice at 72 h p.i. Brain TREM2 concentrations were subsequently quantified using ELISA.</p><p><strong>Results: </strong>The antibody format carrying two scFv8D3 TfR-binders (IgG-scFv₂), demonstrated the highest brain concentrations of all tested bispecific constructs. This antibody also exhibited significantly higher brain concentrations in App^NL-G-F mice compared to WT mice at both 48 and 72 h p.i. This difference was further visualized and quantified through in vivo PET imaging. Moreover, brain concentrations of the antibody ligand correlated with elevated TREM2 levels in brain homogenates.</p><p><strong>Conclusion: </strong>These findings highlight IgG-scFv₂ as a promising radioligand for in vivo PET imaging of TREM2, advancing non-invasive neuroinflammation studies and supporting drug development for AD and other neurodegenerative diseases.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157564","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":"Correction to: Safety and dosimetry of [¹⁷⁷Lu]Lu-DOTA-TATE in adolescent patients with somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumours, or pheochromocytomas and paragangliomas: Primary analysis of the Phase II NETTER-P study.","authors":"Mark N Gaze, Daria Handkiewicz-Junak, Raquel Hladun, Theodore W Laetsch, Caryn Sorge, Richard Sparks, Simon Wan, Antony Ceraulo, Aneta Kluczewska-Galka, Cristina Gámez-Cenzano, Lisa J States, Riham El Khouli, Paola Aimone, Kevin Perraud, Gabor Kollar, Fariba Khanshan, Lars Blumenstein, Fazia Brouri, Anne-Laure Giraudet","doi":"10.1007/s00259-025-07344-6","DOIUrl":"https://doi.org/10.1007/s00259-025-07344-6","url":null,"abstract":"","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149466","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":"Combined perfusion and metabolic imaging of small cell lung cancer with dual-isotope LAFOV-PET.","authors":"Nasir Gözlügöl,Hasan Sari,Tereza Losmanová,Ali Afshar-Oromieh,Axel Rominger,Federico Caobelli","doi":"10.1007/s00259-025-07355-3","DOIUrl":"https://doi.org/10.1007/s00259-025-07355-3","url":null,"abstract":"","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"10 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144146159","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":"Pharmacokinetics study of FT-FAPI, a novel multi-nuclide label-able FAP targeting tracer, in mice and healthy volunteers.","authors":"Jiajun Ye,Shu Yang,Yu Liu,Zhiyong Quan,Mingru Zhang,Guiyu Li,Zifan Zhu,Jia Wang,Taoqi Ma,Junlin Wang,Zhibo Liu,Jing Wang,Fei Kang","doi":"10.1007/s00259-025-07362-4","DOIUrl":"https://doi.org/10.1007/s00259-025-07362-4","url":null,"abstract":"PURPOSEFibroblast activation protein (FAP) has emerged as one of the most promising theranostic targets. FT-FAPI, a potential FAP-targeted probe with enhanced tumor-targeting ability using an organotrifluoroborate linker, was verified for the biological effect in cell and animal experiments in previous work. However, the differences in pharmacokinetic profiles, biodistribution and dosimetry of FT-FAPI under multiple nuclides labeling in animals and humans is unclear. In this study, we sought to explore the discrepancies in the performance of FT-FAPI after labeling with different radioisotopes and to compare 68Ga-FT-FAPI with 68Ga-FAPI-04 in healthy volunteers.METHODSPreparation and quality control of 18F-/68Ga-/177Lu-FT-FAPI injections were conducted. Biodistribution studies were performed in mice and pharmacokinetic analysis were performed using blood samples. 18F-FT-FAPI and 68Ga-FT-FAPI were initially tested in normal volunteers, respectively. Further, 68Ga-FT-FAPI was scanned at multiple time points for 1 h dynamic, 2 h and 3 h static imaging, and compared with 68Ga-FAPI-04 to clarify the distribution patterns and excretion parameters. Radiation dosimetry was estimated based on the uptake of the probes in organs of mice or humans, respectively.RESULTS18F-/68Ga-/177Lu-FT-FAPI showed high safety and tolerability in mice or humans. The pharmacokinetic characteristics of FT-FAPI in mice and humans best fit a two-compartment model. In mice, the results of biodistribution showed that the clearance half-life (T1/2β) of FT-FAPI varied with different labeled radionuclides, with 68Ga-FT-FAPI having the shortest T1/2β of 26.1 min. In HT-1080-FAP tumor-bearing mice, 177Lu-FT-FAPI showed higher tumor uptake and longer retention time than 177Lu-FAPI-04, which implies a higher radiation dose in the tumor. In healthy volunteers, both 18F-FAPI-04 and 68Ga-FT-FAPI were metabolized by the kidneys and excreted through the urinary system. The uptake of 68Ga-FT-FAPI in most normal tissues was similar to that of 68Ga-FAPI-04, being higher only in the sublingual gland, thyroid gland and pancreas. 68Ga-FT-FAPI had similar T1/2β (75.0 min vs. 77.2 min) and a slightly higher effective dose (ED) (12.4 ± 1.51 µSv·MBq-1 vs. 9.99 ± 1.85 µSv·MBq-1) compared to 68Ga-FAPI-04. Compared to 68Ga-FT-FAPI, 18F-FT-FAPI has slightly higher liver and bone uptake, especially in the delayed time points.CONCLUSIONThe pharmacokinetics of FT-FPAI varies depending on the labeled nuclide. Compared to 177Lu-FAPI-04, 177Lu-FT-FAPI showed higher tumor uptake and longer retention time. In healthy volunteers, 68Ga-FT-FAPI had lower renal uptake and higher sublingual gland, thyroid gland and pancreas uptake at 1 h p.i. than that of 68Ga-FAPI-04, with no significant differences in other organs. Further optimization will be conducted for the radiolabeling process of 18F-FT-FAPI to evaluate its diagnostic efficacy.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"18 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144146164","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":"Multitracer comparison of gold standard PSMA-PET/CT with 68Ga-FAPI and 18F-FDG in high-risk prostate cancer: a proof-of-concept study.","authors":"Osama Mahmoud,Lukas Püllen,Lale Umutlu,Tibor Szarvas,Wolfgang P Fendler,Saskia Ting,Henning Reis,Henning Bayer,Ken Herrmann,Boris A Hadaschik,Mulham Al-Nader,Christoph Berliner","doi":"10.1007/s00259-025-07352-6","DOIUrl":"https://doi.org/10.1007/s00259-025-07352-6","url":null,"abstract":"PURPOSEThe aim of this study was to, evaluate the diagnostic accuracy of [⁶⁸Ga]Ga-FAPI-46 positron emission tomography (PET)/computed tomography (CT) in high-risk prostate cancer (PC) compared to [¹⁸F]PSMA / [⁶⁸Ga]Ga- PSMA- and [¹⁸F]FDG- PET/CT as well as multiparametric magnetic resonance imaging (MRI).MATERIALS AND METHODSTen patients with high-risk PC (PSA > 20 ng/mL, Gleason score > 7, or > T2c) underwent PET/CT imaging using [⁶⁸Ga]Ga-FAPI-46, [¹⁸F]F-/[⁶⁸Ga]Ga-PSMA and [¹⁸F]FDG before radical prostatectomy (RP). The maximum standardized uptake values (SUVmax) were measured for the entire prostate and individual prostate sextants. Diagnostic accuracy was assessed per patient and per segment by correlating imaging findings with final histopathologic results. Immunohistochemical analysis of PSMA and FAP expression was performed on the index tumor lesion.RESULTSHistopathologic analysis confirmed pT2c and pT3 prostate adenocarcinoma in 4 (40%) and 6 (60%) patients, respectively. One patient (10%) had regional lymph node metastasis (pN1). The International Society of Urological Pathology (ISUP) grade groups (GGs) were 2 (60%), 3 (20%), and 5 (20%). Overall, 46 of 60 prostate sextants were histologically positive for PC. While PSMA expression was detected in all patients, FAP expression was observed in 5 of 9 cases (55.5%). Per-patient and per-segment analyses demonstrated that [⁶⁸Ga]Ga-FAPI-46 and [¹⁸F]F-/[⁶⁸Ga]Ga-PSMA had comparable diagnostic accuracy and outperformed [¹⁸F]FDG. The mean (SD) SUVmax of the entire prostate was highest for PSMA PET/CT at 13.1 (7), followed by FAPI at 7.6 (5.5) and FDG at 5.4 (3.5) (p = 0.015). Among patients in the FAPI subgroup, those with ISUP GG 3-5 exhibited greater FAP expression and radiotracer uptake compared to ISUP GG 2 cases. In the two high-grade patients, [⁶⁸Ga]Ga-FAPI-46 demonstrated greater tumor uptake than [¹⁸F]PSMA / [⁶⁸Ga]Ga-PSMA PET/CT. Notably, MRI demonstrated higher diagnostic accuracy and superior local staging compared to all radiotracers evaluated.CONCLUSIONFAP expression was detected in a subset of high-risk PC patients, particularly in those with higher-grade disease. This proof-of-concept study may suggest a role for [⁶⁸Ga]Ga-FAPI-46 PET/CT in primary PC with low PSMA avidity, but further research is warranted to define its clinical application.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"14 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144146158","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":"Development and validation of a radiogenomics prognostic model integrating PET/CT radiomics and glucose metabolism-related gene signatures for non-small cell lung cancer.","authors":"Chunsheng Wang,Congjie Wang,Jianguo Zhang,Mingjun Ding,Yizhi Ge,Xia He","doi":"10.1007/s00259-025-07354-4","DOIUrl":"https://doi.org/10.1007/s00259-025-07354-4","url":null,"abstract":"BACKGROUNDNon-small cell lung cancer (NSCLC) is a highly heterogeneous malignancy characterized by altered glucose metabolism. Integration of PET/CT radiomics with glucose metabolism-related genomic signatures could provide a more comprehensive approach for prognosis and treatment guidance.METHODSRadiomics features were extracted from PET/CT images of 156 NSCLC patients from The Cancer Imaging Archive (TCIA) database, and glucose metabolism-related gene signatures were obtained from TCGA and GEO databases. We developed a multimodal radiogenomics prognostic model (RGC-score) using least absolute shrinkage and selection operator (LASSO) regression, combining PET/CT radiomics, glucose metabolism-related genes (GMR-genes). Functional enrichment analysis, immune infiltration assessment, and drug sensitivity analysis were performed to investigate the biological significance of glucose metabolism-related genes (GMR-genes).RESULTSThe RGC-score model effectively stratified NSCLC patients into distinct high- and low-risk groups with significant differences in survival outcomes (P < 0.001), demonstrating excellent predictive performance (1-year AUC = 0.907, 5-year AUC = 0.968).GMR-genes are mainly involved in the process of metabolic remodeling of tumors, which is closely related to the immune microenvironment (especially CD8+ T cell infiltration) and immune checkpoint molecule expression. Additionally, significant differences in drug sensitivity were identified between glucose metabolism subtypes.CONCLUSIONThe RGC-score robustly predicts NSCLC prognosis and informs metabolic-immune interactions for personalized therapy. Limitations include the retrospective design and modest validation cohort size, necessitating prospective multicenter trials.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"51 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144146146","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":"Texture analysis and metabolic parameters of 18F-FDG PET/CT to predict primary tumour response and prognosis of paediatric soft tissue sarcomas.","authors":"Ayşenur Sinem Kartal,Mehmet Oğuz Kartal,Nadide Başak Gülleroğlu,Neriman Sarı,İnci Ergürhan İlhan,Nedim C M Gülaldı","doi":"10.1007/s00259-025-07359-z","DOIUrl":"https://doi.org/10.1007/s00259-025-07359-z","url":null,"abstract":"INTRODUCTIONWe aimed to investigate the value of primary tumour F-18 fluorodeoxyglucose (18F-FDG) parameters and textural features in predicting tumour response to neoadjuvant chemoradiotherapy (neo-CRT) and prognosis in paediatric patients with soft tissue sarcoma (STS).MATERIALS AND METHODSTwenty-eight paediatric patients with STS who underwent 18F-FDG PET/CT studies before neo-CRT were included in this retrospective and single-center study. SUVmax, SUVpeak, SUVmean, metabolic tumour volume (MTV, 40% SUVmax), total lesion glycolysis (TLG), and textural features were extracted from the primary tumour volumes delineated semiautomatically on the baseline PET images. Patients were classified as responders or non-responders according to Response Evaluation Criteria in Solid Tumors 1.1. A receiver operating characteristic (ROC) analysis was performed. The highest AUC values within their respective quantitative groups were selected for further analysis, including logistic regression analysis for response prediction and Cox regression analysis for survival prediction.RESULTSIn univariate analysis SUVmax > 13.0 (p = 0.009), SUVpeak > 12.7 (p = 0.017), Histogram Entropy > 0.97 (p = 0.036), and NGTDM Busyness < 0.37 (p = 0.005) were associated with tumour response for the median follow-up of 25 months. NGTDM Busyness was an independent predictor for the treatment response (OR: 30.5; 95% CI: 1.50-618.5; p = 0.026). Age was associated with progression (Cut-off: 11 years, [AUC:0.73 (95% CI: 0,53 - 0,93)] 𝑝=0.022). Progression-free survival outcomes were assessed in aged > 11 years subpopulation. PFS was significantly shorter in patients with high GLSZM_GLNU (p = 0,024), GLSZM_ZSNU (p = 0,003), and TLG (p = 0,016). In multivariate analysis GLSZM_ZSNU > 13,04 (HR: 11.61; 95% CI: 1.35-54.02; p = 0.026) was an independent predictor of PFS in subpopulation aged > 11 years.CONCLUSIONHeterogeneity texture features Histogram Entropy and NGTDM Busyness and metabolic PET parameters (SUV max and SUVpeak) can predict tumour response. In aged > 11 years patients subgroup analyses, GLSZM ZSNU was an independent factor for PFS.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"3 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136838","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":"PSMA radioligand uptake correlates with PSMA expression in high-grade glioma and brain metastasis: insights from a prospective PET-MRI guided multiregional biopsy study.","authors":"Ilanah J Pruis,Vera van Dis,Sybren L N Maas,Rutger K Balvers,Thierry P P van den Bosch,Marcel Segbers,Sophie E M Veldhuijzen van Zanten","doi":"10.1007/s00259-025-07338-4","DOIUrl":"https://doi.org/10.1007/s00259-025-07338-4","url":null,"abstract":"PURPOSEProstate-specific membrane antigen (PSMA) is a potential target for radioligand therapy (RLT) in neuro-oncology. This study investigates the direct relation between [68Ga]Ga-PSMA-11 uptake on PET and PSMA expression in the tumour micro-environment of high-grade glioma (HGG) and brain metastasis (BM).METHODSTwelve patients with HGG (glioblastoma n = 6, oligodendroglioma n = 1), or BM (lung- n = 4, breast cancer n = 1), underwent PET-MRI after intravenous [68Ga]Ga-PSMA-11 injection (1.5 MBq/kg), followed by image-guided biopsy sampling during (re-)resection surgery. Multiple samples (median n = 3/patient, n = 23 HGG/n = 20 BM) from locations of low and high [68Ga]Ga-PSMA-11 uptake were analysed for PSMA expression in vasculature and non-vascular structures using morphology and immunohistochemistry.RESULTSAll patients showed [68Ga]Ga-PSMA-11 uptake in tumour ( SUVmax median, range: 10.5, 4.7-19.8). Strong PSMA expression was found in tumour microvasculature (14/23, 61% in HGG, 13/20, 65% in BM). Tumour cell PSMA expression was found in a subset of HGG (10/23; of which strong in 8/10) and BM (3/20; none of which showed strong expression). Strong PSMA expression was also found on non-malignant glial cells in tumour. PSMA expression in healthy brain control samples was negligible. In HGG, a significant correlation existed between [68Ga]Ga-PSMA-11 uptake and PSMA expression in tumour microvasculature (r = 0.487, P < 0.01), but not tumour cells.CONCLUSIONPSMA expression in brain tumours is predominately vascular, which likely explains why microvascular (rather than tumour cell) PSMA expression correlates with [68Ga]Ga-PSMA-11 uptake in HGG. This neovascular expression is crucial information for future PSMA-based RLT studies, as alpha-emitters may not sufficiently target tumour DNA. NCT05798273; date of registration: 1/9/2020.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"34 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136845","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":"Expanding the scope of PSMA-RLT: evaluating treatment in challenging mCRPC patients with poor performance status (ECOG 3).","authors":"Moritz B Bastian,Benedikt Wörl,Arne Blickle,Caroline Burgard,Tilman Speicher,Mark Bartholomä,Andrea Schaefer-Schuler,Stephan Maus,Samer Ezziddin,Florian Rosar","doi":"10.1007/s00259-025-07346-4","DOIUrl":"https://doi.org/10.1007/s00259-025-07346-4","url":null,"abstract":"PURPOSEGiven the increasing inclusion of ECOG 3 patients in oncology practice, data on this subgroup in the context of prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) remain limited. This study evaluates the safety and outcome of PSMA-RLT in metastatic castration-resistant prostate cancer (mCRPC) patients with ECOG performance status 3.METHODSIn this analysis, a cohort of 18 mCRPC patients with ECOG performance status 3 who received PSMA-RLT was examined. The median number of treatment cycles was 2 (range: 1-10), with a mean cumulative administered activity of 21.5 ± 15.0 GBq (range: 2.7-62.6 GBq) of [177Lu]Lu-PSMA-617. Outcome and adverse events including hematologic and renal toxicities, fatigue, and xerostomia were analyzed.RESULTS50% of patients achieved either stable disease or a partial biochemical response. Median progression-free survival and overall survival were 1.3 months and 2.8 months, respectively. Severe adverse events were uncommon, occurring in three patients: one developed grade 3 leukopenia, another experienced grade 3 thrombocytopenia, and one patient had pancytopenia of grade 3/4. No higher RLT-induced grade of renal toxicity and xerostomia were observed, whilst symptoms of fatigue improved in the cohort.CONCLUSIONThis study indicates that PSMA-RLT is a feasible and overall well-tolerated treatment for mCRPC ECOG 3 patients with manageable toxicity profile. Despite limited survival outcomes, ECOG 3 status may be considered not to be a categorical exclusion criterion for RLT. Future prospective studies should further investigate the role of PSMA-RLT in this challenging subgroup.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"139 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136840","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":"Less is more: once vs. multiple radioactive iodine (RAI) therapy in patients with RAI-avid pulmonary micrometastatic differentiated thyroid cancer.","authors":"Cong Shi,Di Sun,Yu-Qing Sun,Xin Zhang,Sheng-Yan Liu,Qi-Jun Li,Yi-Jin Pan,Wen-Ting Guo,Ying-Qiang Zhang,Xiao-Na Jin,Yu Liu,Yan-Song Lin","doi":"10.1007/s00259-025-07339-3","DOIUrl":"https://doi.org/10.1007/s00259-025-07339-3","url":null,"abstract":"PURPOSETo date, the survival benefits of multiple radioactive iodine therapies (RAIT) in RAI-avid pulmonary micrometastatic differentiated thyroid cancer (DTC) remain debatable. This study aimed to compare the progression-free survival (PFS) benefits between those received only once RAIT (o-RAIT) and multiple RAITs (m-RAIT) in such patients.METHODSPatients with RAI-avid pulmonary micrometastatic DTC were included and divided into either o-RAIT or m-RAIT group according to the number of RAIT cycles. The response to first RAIT in all patients and last RAIT in m-RAIT were evaluated and classified as partial response (PR), stable disease (SD), and progressive disease (PD). PFS was defined as the time from first RAIT to PD. Logistic regression analysis and Kaplan-Meier survival curves were employed to identify risk factors and estimate PFS, with propensity score matching (PSM) to reduce confounders.RESULTSA total of 117 patients with RAI-avid pulmonary micrometastatic DTC were retrospectively included, with 38 (32.5%) from o-RAIT and 79 (67.5%) from m-RAIT. Patients from m-RAIT exhibited younger age at diagnosis, more local persistent disease before RAIT, and more metachronous metastasis compared with o-RAIT group (all P < 0.05). In the comparison of RAIT response, there was no difference in the first RAIT response between the o-RAIT and m-RAIT, while the last RAIT response of m-RAIT is worse not only than o-RAIT (P = 0.005), but also than their own first RAIT response (P = 0.0003). Multivariate analysis revealed age at diagnosis (over 45 years old) (P = 0.006) and local persistent disease before RAIT (P = 0.001) were independent risk factors for PD after RAIT, while number of RAIT cycles was not. To minimize potential confounders, the risk factors for PD and follow-up time were matched by PSM, after which, no significant difference in PFS was observed between the matched o-RAIT and m-RAIT (5-year PFS rate: 83.6% vs. 81.6%, P = 0.808).CONCLUSIONSIn patients with RAI-avid pulmonary micrometastatic DTC, o-RAIT exhibited non-inferior PFS benefits compared with m-RAIT, suggesting the \"less is more\" management strategy of RAIT towards such patients.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"18 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136843","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}