European Journal of Nuclear Medicine and Molecular Imaging最新文献

{"title":"Predictive value of [68Ga]Ga-FAPI-04 PET/CT on pathologic response to neoadjuvant chemoimmunotherapy for locally advanced resectable oral squamous cell carcinoma.","authors":"Yaqun Jiang,Zili Yu,Yanan Sun,Yueli Tian,Li Wang,Diankui Xing,Yiwei Huang,Yong He,Jun Jia","doi":"10.1007/s00259-025-07414-9","DOIUrl":"https://doi.org/10.1007/s00259-025-07414-9","url":null,"abstract":"PURPOSEThis prospective study aimed to investigate the performance of [68Ga]Ga-FAPI-04 PET/CT for prediction of pathologic response to neoadjuvant chemoimmunotherapy (NACI) in patients with resectable locally advanced oral squamous cell carcinoma (LAOSCC).METHODSThirty-one treatment-naïve OSCC patients (stage III-IVA) scheduled to receive two cycles of NACI followed by radical surgery were enrolled. [68Ga]Ga-FAPI-04 PET/CT was performed at baseline and after the second cycle of NACI. Semiquantitative PET parameters of the primary tumor were recorded or calculated, namely SUVmax, SUVmean, SUVpeak, and their change rates (∆SUVs, %). PET parameters were compared between the two groups, and their correlation with pathologic response, PD-L1, fibroblast activation protein (FAP), granzyme B (GZMB) expression, and infiltration of CD8+ T lymphocytes in the tumor tissues was also analyzed.RESULTSTwenty patients were included in the final analysis. Eight patients (40.0%) achieved major pathological response (MPR), including 6 with pathologic complete response (pCR), while 12 patients (60.0%) were categorized as non-MPR according to postoperative histopathological findings. The average preoperative SUVmax was significantly lower in the MPR group (9.38 ± 2.60) compared with that in the non-MPR group (16.20 ± 5.23; P = 0.003), while baseline SUVmax was not significantly different (P = 0.053). The ∆SUVmax (%) in the MPR group (- 59.10% ± 13.33) was notably lower than that in the non-MPR group (- 15.96%, [- 52.56%, 66.33%]; P = 0.002). Preoperative SUVs and ∆SUVs were significantly associated with pathologic response. FAP expression was positively correlated with preoperative SUVs, and the MPR group showed higher CD8 and GZMB expression versus the non-MPR group.CONCLUSION[68Ga]Ga-FAPI-04 PET/CT parameters are able to well predict the achievement of MPR following NACI in patients with LAOSCC. ΔSUVs are identified as significant predictors of MPR. These findings warrant validation in larger cohorts.CLINICAL TRIAL REGISTRATIONThis prospective study was reviewed and approved by the Medical Ethics Committee of Zhongnan Hospital, Wuhan University, and was registered online at NIH ClinicalTrials.gov (NCT05034146 & NCT05030597).","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"45 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370171","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":"Virtual cutaneous area severity index (vCASI): A comprehensive methodology for quantitative skin disease assessment on positron emission tomography images.","authors":"Aliasghar Mortazi, Jayaram K Udupa, Mahdie Hosseini, Yubing Tong, Drew A Torigian","doi":"10.1007/s00259-025-07423-8","DOIUrl":"10.1007/s00259-025-07423-8","url":null,"abstract":"<p><strong>Purpose: </strong>Quantification of skin diseases such as cutaneous lymphoma or psoriasis is important for pretreatment planning and response assessment. Currently, this quantification relies on clinical assessments, which are cumbersome, error-prone, and subject to inter-reader variability. FDG-PET/CT is a widely used molecular imaging technique for non-invasive detection and quantification of metabolically active disorders, providing biomarkers of disease extent, severity, and therapeutic response. However, skin disease quantification from PET/CT images remains challenging, error-prone, and labor-intensive.</p><p><strong>Methods: </strong>We proposed a novel comprehensive methodology called virtual Cutaneous Area Severity Index (vCASI) to quantitatively assess the extent and severity of metabolically active skin disease from FDG-PET/CT images. Firstly, we used an automated body region localization method, followed by a standardization technique for PET images to reduce interscan measurement variability. Then, we generated skin shell PET images and developed a standardized Maximum Intensity Projection (MIP) rendering technique to enable reproducible 3D visualization of the skin with the disease. Finally, we introduced and validated a new quantitative scoring system (vCASI score) to measure the extent and severity of skin disease via these renderings.</p><p><strong>Results: </strong>Correlations between vCASI scores and reference standard ground-truth assessments increased following the standardization of PET images, further improved with the use of adjusted mean of maximum percentile intensity values as the reference point for MIP rendering, and reached as high as 0.605. Additionally, correlations between repeated vCASI score assessments for the torso, thorax, abdomen, and pelvis exceeded 0.85, demonstrating high repeatability.</p><p><strong>Conclusions: </strong>The vCASI methodology allows for accurate and reproducible quantitative assessment of the extent and severity of metabolically active skin diseases, such as cutaneous lymphoma and psoriasis, from FDG-PET/CT images. It addresses the challenges related to body region localization, non-standardness of PET images, robust visualization, and standardized display of PET images to detect and quantify skin disease. Additionally, it overcomes the lack of a practical and validated scoring system for quantifying skin disease on PET images. We demonstrated that the vCASI scoring system has high repeatability and good accuracy, and is optimized by the proposed methodology.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368734","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":"Comparisons of treatment performance and therapy sequences in neuroendocrine neoplasms using progression-free survival ratios.","authors":"Philipp Melhorn,Elisabeth Kretschmer-Chott,Peter Mazal,Markus Raderer,Barbara Kiesewetter","doi":"10.1007/s00259-025-07411-y","DOIUrl":"https://doi.org/10.1007/s00259-025-07411-y","url":null,"abstract":"INTRODUCTIONOptimal sequencing of therapies is an important unresolved issue in metastatic neuroendocrine neoplasms (NEN). Progression-free survival (PFS) ratios constitute a potential method for intra-patient treatment comparisons and were used in this analysis to assess the relative treatment benefit of established therapies.METHODSThis retrospective study included NEN patients of the Medical University of Vienna (treated in 2010-2024) who had metastatic disease and had received ≥ 2 palliative systemic therapies. The primary objective was the calculation of PFS ratios for therapy sequences, with the PFS ratio defined as the proportion of PFS2 (subsequent treatment) and PFS1 (prior treatment).RESULTSOf the 177 patients included, 104 had neuroendocrine tumors (NET) G1/G2, 16 NET G3, 28 lung/thymic carcinoids, and 29 a neuroendocrine carcinoma (NEC). In terms of treatment sequence, SSA was the most common first-line treatment in NET G1/G2 and thoracic carcinoids (n = 84), frequently followed by PRRT (n = 60), everolimus (n = 13), and treatments grouped as 'other' (n = 9). After platinum/etoposide in NEC (n = 26), FOLFOX/FOLFIRI (n = 13), CAPTEM (n = 3), and 'other' therapies (n = 9) were second-line therapies. The median PFS ratio for PRRT after first-line SSA was 1.86, for everolimus 0.99, and for 'other' treatments 0.59 (p = 0.004). Following platinum/etoposide, FOLFOX/FOLFIRI had a median PFS ratio of 0.46. In subgroup analyses according to primary localization, everolimus led to disproportionately long PFS intervals following SSA/PRRT in lung/thymic carcinoids, whereas therapies after PRRT exhibited relatively low PFS ratios in enteropancreatic NET.CONCLUSIONSPFS ratios accommodate the heterogeneity of NEN and can provide insights regarding treatment performance and treatment sequencing.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"44 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335368","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":"[68Ga]FAPI PET/CT reveals increased pulmonary fibroblast activation protein expression in long COVID patients after ICU discharge.","authors":"B van Leer,M Londema,Ö Kasalak,J H van Snick,M L Duiverman,J C Kuijvenhoven,M D de Kruif,D E Oprea-Lager,K Pabst,M E Hellemons,H H Boersma,M Prokop,M W Nijsten,A W J M Glaudemans,J Pillay,R H J A Slart,","doi":"10.1007/s00259-025-07376-y","DOIUrl":"https://doi.org/10.1007/s00259-025-07376-y","url":null,"abstract":"PURPOSEPost-acute sequelae of COVID-19 (PASC) has emerged as a major healthcare problem. A comprehensive mechanism of disease remains to be elucidated. In this study we aimed to explore pulmonary and muscle fibroblast activation protein (FAP) activity in former critical COVID-19 patients with persistent dyspnea, using [68Ga]FAPI-46 PET/CT.METHODSIn this single center prospective observational study we included former critical COVID-19 patients reporting complaints of dyspnea > 3 months after hospital discharge. A [68Ga]FAPI PET/CT scan was performed including a high-resolution CT scan, lung function test, EQ-5D questionnaire, 6 min walking test and inflammatory markers. Age and sex-matched subjects, without pulmonary pathology, served as controls. The [68Ga]FAPI uptake was corrected for lean body mass and the target-to-background ratio (TBR) was calculated.RESULTSEighteen PASC patients and 15 controls (median age 59 and 63 years and BMI of 34.6 and 25.2 kg/m2) were included. The interval between hospital discharge and study visit was 30 months. Increased pulmonary FAP expression was observed in PASC, (TBR 0.79 ± 0.23) compared to controls (TBR 0.40 ± 0.13, P < 0.001). Increased FAP expression was also observed in the paravertebral muscles (PASC: TBR 1.17 and controls TBR 1.00, P = 0.03). Forced expiratory volume and forced vital capacity showed moderate negative correlation with the pulmonary TBR, while the percentage of ground glass opacities showed a moderate positive correlation.CONCLUSION[68Ga]FAPI PET/CT demonstrated elevated FAP expression in PASC. These findings provide insight into possible pathophysiological mechanisms of PASC and a potential new diagnostic modality.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"45 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337452","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":"Rapid and specific immunoPET imaging of Nectin-4 in gastric cancer and non-small cell lung cancer using [64Cu]Cu-NOTA-EV-F(ab')2.","authors":"Wenpeng Huang,Xinyao Sun,Xiaoyan Li,Jessica C Hsu,Yongkang Qiu,Molly C DeLuca,Jonathan W Engle,Liming Li,Jun Lu,Tianyao Wang,Lei Kang,Weibo Cai","doi":"10.1007/s00259-025-07402-z","DOIUrl":"https://doi.org/10.1007/s00259-025-07402-z","url":null,"abstract":"PURPOSEThis study aimed to develop and evaluate [64Cu]Cu-NOTA-EV-F(ab')2 as a rapid and specific immunoPET imaging probe targeting Nectin-4 in gastric cancer (GC) and non-small cell lung cancer (NSCLC).MATERIALS AND METHODSF(ab')2 fragments were generated from enfortumab vedotin (EV) using IdeS protease and conjugated with p-SCN-Bn-NOTA for radiolabeling with 64CuCl2. The radiochemical yield was 85.40 ± 2.43% (n = 5). In vitro binding affinity and specificity were assessed via flow cytometry and cell uptake assays using Nectin-4-positive (NCI-N87, H1975) and Nectin-4-low (HGC-27, H520) cell lines. In vivo PET imaging and biodistribution studies were conducted in murine models of GC and NSCLC to evaluate tumor targeting efficiency and tracer pharmacokinetics.RESULTS[64Cu]Cu-NOTA-EV-F(ab')2 demonstrated rapid tumor accumulation, with peak uptake observed at 4 h post-injection (10.23 ± 0.70%ID/g in NCI-N87 tumors, 3.03 ± 0.35%ID/g in HGC-27, 11.56 ± 1.12%ID/g in H1975, 2.77 ± 0.47%ID/g in H520). Compared to full-length EV, the tracer exhibited faster blood clearance and reduced off-target uptake. Blocking with excess EV-F(ab')2 significantly reduced subsequent tumor uptake (6.27 ± 0.49%ID/g in NCI-N87, P = 0.0029; 5.23 ± 0.31%ID/g in H1975, P = 0.00074), confirming Nectin-4 specificity. Ex vivo biodistribution analysis supported high tumor retention consistent with in vivo imaging findings.CONCLUSIONS[64Cu]Cu-NOTA-EV-F(ab')2 offers rapid, specific, and high-contrast immunoPET imaging of Nectin-4-expressing tumors in GC and NSCLC models, highlighting its potential as a non-invasive diagnostic tool for Nectin-4-targeted cancer imaging.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"5 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337470","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":"Reliability of [18F]FDG PET/CT for post-treatment surveillance of non-small cell lung cancer: agreement among multiple centers.","authors":"Kasper Foged Guldbrandsen,Markus Nowak Lonsdale,Hanne Marie Nellemann,Catharina Mølgaard Bylov,Joan Fledelius,Karin Hjorthaug,Barbara Jolanta Jørgensen,Martin Krakauer,Mette Schødt,Peter Michael Gørtz,Mie Kiszka Nielsen,Anne Lerberg Nielsen,Annemarie Gjelstrup Amtoft,Elisabeth Albrecht-Beste,Danijela Dejanovic,Marie Josée Zareh Lausten-Thomsen,Paw Christian Holdgaard,Magdalene Kubik,Søren Steen Nielsen,Oke Gerke,Torben Riis Rasmussen,Barbara Malene Fischer","doi":"10.1007/s00259-025-07420-x","DOIUrl":"https://doi.org/10.1007/s00259-025-07420-x","url":null,"abstract":"PURPOSEFluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ([18F]FDG PET/CT) has shown promise for post-treatment surveillance in patients with non-small cell lung cancer (NSCLC). This study evaluated interobserver agreement of PET/CT interpretation for NSCLC surveillance in a multicenter setting.METHODSNine teams from seven centers, each team consisting of a nuclear medicine specialist and a radiologist, participated in the study. A total of 150 PET/CT scans were selected, and each was independently reviewed by two randomly assigned teams. Scans were performed six months post-treatment for scheduled recurrence assessment in stage Ia-IIIc NSCLC patients. Each scan was evaluated for suspicion of recurrence using two methods; without any pre-specified criteria (conventional assessment) and using pre-specified, qualitative criteria (Hopkins criteria). Both scoring methods were compared to a reference standard to assess accuracy.RESULTSConventional assessment showed moderate interobserver agreement (κ = 0.55, 95% CI 0.41-0.69; 79% overall agreement) for the diagnosis of recurrence. Hopkins criteria demonstrated substantial agreement (κ = 0.61, 95% CI 0.45-0.77; 87% overall agreement). There was no difference in the area under the curve (AUC) between conventional assessment (0.80, 95% CI 0.72-0.88) and Hopkins criteria (0.82, 95% CI 0.74-0.90) compared to the reference standard (p = 0.21).CONCLUSIONSInterobserver agreement for [18F]FDG PET/CT interpretation in NSCLC surveillance was moderate to substantial. While applying pre-specified reporting criteria did not significantly improve the agreement, it did not hinder the diagnostic accuracy. Efforts to reduce the variability of reporting, including continuous training and structured reporting, could improve the clinical impact of this technology.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"12 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335367","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":"Imaging-based whole brain-level neural circuit visualization.","authors":"Chentao Jin,Xiaoyun Luo,Yan Zhong,Rui Zhou,Xiaohui Zhang,Jing Wang,Mei Tian,Hong Zhang","doi":"10.1007/s00259-025-07419-4","DOIUrl":"https://doi.org/10.1007/s00259-025-07419-4","url":null,"abstract":"","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"21 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328938","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":"PET/CT imaging of esophageal cancer targeting tumor cell specific αvβ6-integrin expression.","authors":"Kateřina Dvořáková Bendová,Tanja Groll,Barbora Neužilová,Kristýna Krasulová,Zbyněk Nový,Falco Reissig,Katja Steiger,Melanie Boxberg,Elisabeth Eppard,Jan Wuestemann,Marián Hajdúch,Moritz Jesinghaus,Jakub Šimeček,Michael C Kreissl,Miloš Petřík,Johannes Notni","doi":"10.1007/s00259-025-07408-7","DOIUrl":"https://doi.org/10.1007/s00259-025-07408-7","url":null,"abstract":"PURPOSETo assess the potential of αvβ6-integrin as a theranostic target in esophageal cancer.METHODSMembranous β6-integrin (ITGB6) expression was analyzed in 306 specimens of human esophageal squamous cell carcinoma (ESCC) obtained by immunohistochemistry (IHC) from 100 patient cases (1, 37, 58, and 4 of grade G1, G2, G3, and G4, respectively). Ga-68 labeling of D0103 was done manually for preclinical experiments and fully automated for clinical application. Preclinical characterization of Ga-68-D0103 was performed in SCID mice bearing subcutaneous xenografts of H2009 (αvβ6-positive) or MDA-MB-231 (αvβ6-negative) carcinoma cell lines, by ex vivo biodistribution (10, 30, 90, and 180 min p.i) and PET imaging (30, 90, and 180 min p.i.)., without and with co-injection of gelofusine (4% succinylated gelatin). A patient with type-II diabetes (f, 68y, 115 kg) with proximal G2 ESCC was investigated by Ga-68-D0103 PET/CT (193 MBq) at 15, 45, 90, and 104 min p.i..RESULTS99% of ESCC cases were found β6-integrin positive by IHC, of which 48%, 31%, and 20% showed strong, moderate, and low ITGB6 expression, respectively, with no correlation to tumor grade. Ex vivo biodistribution of Ga-68-D0103 in H2009 xenografted mice after 30, 90, and 180 min showed tumor-to-blood ratios of 6.8, 37, and 124, respectively; tumor-to-muscle ratios of 12, 14, and 36, respectively; tumor-to-liver ratios of 10, 17, and 14, respectively; and tumor-to-pancreas ratios of 20, 47, and 56, respectively. Co-administration of gelofusine did not change the tumor uptake but reduced the kidney uptake by 89% (from 178%iA/g to 19.1%iA/g, 90 min p.i.), resulting in an 8.7-fold higher tumor/kidney ratio. µPET imaging in H2009 xenografted mice confirmed a high tumor uptake and low background already 30 min p.i.. Blockade biodistribution and µPET in αvβ6-(-) MDA-MB-231 mice demonstrated target specificity. Clinical PET/CT of a patient with ESCC showed increasing tracer uptake over time in the primary tumor (SUVmax 9.0 and 11.3 at 15 and 104 min p.i., respectively) and in a lymph node metastasis (SUVmax 19.5 and 28.3, respectively), and a decreasing blood pool activity (SUVmean 2.75 and 0.98, respectively).CONCLUSIONSHigh (99%) membranous expression frequency and density on tumor cells underscores the potential of αvβ6-integrin as a theranostic target in ESCC, suggesting that αvβ6-integrin PET/CT imaging may adopt a role in re-staging and therapy guidance in this cancer type. The prolonged tumor retention furthermore indicates a therapeutic potential of αvβ6-integrin targeted radiopharmaceuticals when labeled with radionuclides such as lutetium-177, terbium-161, or actinium-225.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"8 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328937","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]-fluorocholine long-axial-field of view PET-CT accurately localises intrathyroid parathyroid adenoma in 5-month pregnant patient.","authors":"Beverley F Holman,Tamar Willson,Jane Edwards,Bruno Ferreira,Piyumi Wijewickrama,Thomas Wagner","doi":"10.1007/s00259-025-07417-6","DOIUrl":"https://doi.org/10.1007/s00259-025-07417-6","url":null,"abstract":"","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"40 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320330","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":"Added value of multiparametric MRI for diagnosing subcentimeter functional adrenal nodules in primary aldosteronism using CXCR4-targeted PET/MRI.","authors":"Xiaoli Meng,Zhiyong Quan,Linni Fan,Mingru Zhang,Guiyu Li,Mengwei Xu,Jia Wang,Wenhui Ma,Weidong Yang,Bo Yang,Jing Wang,Fei Kang","doi":"10.1007/s00259-025-07415-8","DOIUrl":"https://doi.org/10.1007/s00259-025-07415-8","url":null,"abstract":"OBJECTIVEThis study aims to evaluate the clinical utility of 68Ga-pentixafor PET/MRI in diagnosing primary aldosteronism (PA) in functional adrenal nodules, with a particular focus on subcentimeter nodules. Additionally, the diagnostic performance of integrated PET/MRI is compared to single-modality PET imaging.METHODSA total of 62 patients with clinical suspicion of PA were enrolled from a tertiary hospital in China. Prior to adrenalectomy, all patients underwent 68Ga-pentixafor PET/MRI, followed by CXCR4 and CYP11B2 immunohistochemical analysis post-surgery. Adrenal lesions were stratified into two size groups: ≥ 1 cm and < 1 cm. Quantitative PET parameters, including SUVmax, SUVmean, and lesion-to-liver uptake ratio (LLR), were evaluated alongside MRI parameters such as outphase/inphase signal ratio (OIR), relative percent washout (RPW), T2-weighted image intensity, apparent diffusion coefficient (ADC). Receiver operating characteristic (ROC) curve analysis was performed to establish diagnostic thresholds. Comparative analyses were conducted between single-modality PET and integrated PET/MRI for diagnostic accuracy.RESULTSAmong 62 patients, 74 adrenal lesions were confirmed pathologically, comprising 37 aldosterone-producing adenomas (APA, ≥ 1 cm), 21 aldosterone-producing micronodules (micro-APA, < 1 cm), and 16 non-functioning adenomas (NFA). Key PET/MRI parameters, including SUVmax, SUVmean, LLR, OIR, and RPW, showed significant differentiation between functional adrenal nodules and normal adrenal glands (P < 0.001). For nodules ≥ 1 cm, the PET SUVmax threshold of 7.87 achieved a sensitivity of 92.3% and specificity of 95.0% for APA diagnosis. For nodules < 1 cm, the PET SUVmax threshold of 6.49 yielded a sensitivity of 68.8% and specificity of 83.3% for micro-APA diagnosis. Integrated PET/MRI significantly improved the diagnostic sensitivity for PA subcentimeter nodules from 68.8% (with PET alone) to 87.5%, and increased the area under the ROC curve from 0.760 to 0.854, with no significant reduction in diagnostic specificity.CONCLUSION68Ga-Pentixafor PET/MRI demonstrated high diagnostic accuracy for functional adrenal nodules in PA, particularly enhanced sensitivity for subcentimeter nodules compared to PET alone.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"600 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320333","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}