European Journal of Nuclear Medicine and Molecular Imaging最新文献

{"title":"Baseline amyloid deposition phenotypes inform the spatial distribution of early amyloid clearance with lecanemab in Alzheimer's disease.","authors":"Xiaofeng Dou, Daoyan Hu, Jing Wang, Yan Zhong, Congcong Yu, Hongwei Zhan, Yanxing Chen, Rui Zhou, Xiaohui Zhang, Baorong Zhang, Jiong Zhou, Mei Tian, Hong Zhang, Yaping Yan, Chentao Jin","doi":"10.1007/s00259-026-07989-x","DOIUrl":"10.1007/s00259-026-07989-x","url":null,"abstract":"<p><strong>Objective: </strong>Lecanemab effectively reduces brain amyloid-β (Aβ) burden in early Alzheimer's disease (AD). However, Aβ deposition is spatially heterogeneous.The aim of this study is to test whether baseline β-amyloid (Aβ) deposition phenotype influences lecanemab-related Aβ clearance on Aβ-PET.</p><p><strong>Methods: </strong>An Aβ Subtype and Stage Inference (SuStaIn) model was trained to identify Aβ progression phenotypes using cross-sectional Aβ-PET SUVRs from seven brain regions in 303 individuals (249 Aβ+/tau + PET-confirmed Alzheimer's disease and 54 Aβ-/tau- controls). This trained model was then applied to 39 lecanemab-treated patients with paired baseline and 6‑month Aβ-PET. Global and regional Aβ burden was quantified in Centiloids (CL) and SUVR, respectively. Subtype differences in ΔCL and ΔSUVR were tested. By defining baseline topology and clearance topology using posterior-to-anterior dominance indices (Topo_occ-fron = SUVR of occipital lobe - SUVR of frontal lobe), topology-clearance coupling was assessed using correlation and regression analysis. Additionally, spatial topological correspondence was quantified by modeling ROI-level clearance as a function of ROI-level baseline SUVR within a mixed-effects model with a subject-level random intercept.</p><p><strong>Results: </strong>SuStaIn identified two dominant phenotypes consistent with an occipital-onset pattern (subtype 1) and a precuneus-frontal-onset pattern (subtype 2). In the lecanemab cohort, CL decreased by a mean ΔCL of - 27.77 ± 24.51. ΔCL did not differ between subtype 1 (n = 16) and subtype 2 (n = 17), whereas baseline CL strongly predicted ΔCL (r = -0.68, P < 0.001). ROI-wise ΔSUVR differences were not significant after FDR correction, while the ΔSUVR was significantly correlated with baseline SUVR (r = -0.64, P < 0.0001). In subtype-assigned patients (n = 33), a posterior-dominant baseline topology predicted greater posterior clearance. The changed Topo_occ-fron is correlated with baseline values (r = 0.514, P < 0.01) and remained significant after adjusting for baseline CL (β=-0.273, P < 0.01). ROI-level clearance magnitude increased with baseline regional SUVR (mixed-effects β = 0.264, p < 0.001), quantifying high spatial correspondence between deposition and clearance.</p><p><strong>Conclusion: </strong>While baseline Aβ phenotype did not influence the magnitude of early global amyloid removal, it predicted the spatial pattern of regional clearance. Quantitative topological correspondence between baseline deposition and early clearance provides in vivo evidence of target engagement and supports topology-informed PET monitoring beyond global CL.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":"6264-6273"},"PeriodicalIF":7.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257823","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":"Identifing two distinct cortical progression subtypes of Parkinson's disease through multimodal neuroimaging.","authors":"Qinwei Yu, Xueyi Guan, Jinfeng Wu, Xun Sun, Quan Chen, Danfang Yu, Long Liu, Guiying Kuang, Jingwen Li, Xinyu Hu, Hoiyin Cheung, Fanyong Xu, Jian Gong, Fei Du, Xiaoli Lan, Nian Xiong, Jie Wang","doi":"10.1007/s00259-026-07975-3","DOIUrl":"10.1007/s00259-026-07975-3","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate whether distinct patterns of cortical involvement exist in Parkinson's disease (PD) and to characterize their potential progression trajectories using multimodal neuroimaging and data-driven disease progression modeling.</p><p><strong>Methods: </strong>In this cross-sectional multimodal imaging study, we enrolled 317 patients with clinically diagnosed PD and 61 healthy controls. All participants underwent simultaneous FDG-PET and MRI scanning. We applied the Subtype and Stage Inference (SuStaIn) model to cortical glucose metabolism and thickness data to identify latent disease progression patterns. Network-level characteristics were further examined within a whole-brain gradient framework. Robustness was assessed through age- and sex-balanced sensitivity analyses in the local cohort and external validation using harmonized T1-weighted MRI data from the Parkinson's Progression Markers Initiative (PPMI) dataset.</p><p><strong>Results: </strong>Two distinct cortical involvement subtypes were identified. One subtype showed predominant alterations in higher-order association networks, including the default mode and frontoparietal networks, whereas the other was characterized by greater involvement of lower-order sensorimotor and limbic systems. These subtype patterns remained stable across sensitivity analyses and external validation. Disease duration showed a significant correlation with the inferred disease stage (r = 0.15, p = 0.01). Imaging findings further revealed hypermetabolism in brainstem and trans-entorhinal regions accompanied by widespread cortical hypometabolism.</p><p><strong>Conclusions: </strong>Our findings reveal two robust cortical progression patterns in PD, highlighting substantial heterogeneity in network-level metabolic and structural involvement. This framework provides new insights into PD phenotypic variability and may support future efforts toward disease stratification and personalized research.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":"6212-6225"},"PeriodicalIF":7.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216979","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":"Comparative analysis of PSMA-RADS Version 2.0 versus bone uptake metastatic probability (BUMP) score for characterising focal bone uptake on [18F]PSMA-1007 PET/CT in prostate cancer - a multicentre evaluation.","authors":"James Cairns, Salman Arain, Amarnath Challapalli, Amalia Stavropoulos, Tamir Ali, Daniel Ward, John Sage, Georgia Ionescu, Julien M Y Willaime, Russell Frood, Amit Bahl, George Petrides, Andrew Scarsbrook","doi":"10.1007/s00259-026-08154-0","DOIUrl":"https://doi.org/10.1007/s00259-026-08154-0","url":null,"abstract":"<p><strong>Purpose: </strong>Prostate-specific membrane antigen (PSMA) PET/CT is widely used in prostate cancer management, but unspecific bone uptake (UBU) remains a diagnostic challenge particularly with [18F]PSMA-1007. Bone uptake metastatic probability (BUMP) score - a composite imaging-clinical model, was compared with PSMA Reporting and Data System (PSMA-RADS, Version 2) for predicting skeletal metastases in UBU.</p><p><strong>Methods: </strong>A real-world cohort of [18F]PSMA-1007 PET/CT scans performed at three tertiary cancer centres was retrospectively analysed. Bone lesions with focal PSMA uptake were evaluated. SUV_max, CT-derived mean Hounsfield unit and androgen deprivation therapy status were recorded to calculate BUMP score for each lesion. Lesional PSMA-RADS scores were assigned by experienced radiologists. Ground truth was established using follow-up imaging, prostate-specific antigen (PSA) kinetics and multidisciplinary consensus. Receiver operating characteristic (ROC) analyses assessed diagnostic performance.</p><p><strong>Results: </strong>130 patients (median age 70 years) with 412 bone lesions were analysed; 60.9% (n = 251) of lesions were metastatic. Median SUV_max was higher in malignant than benign lesions: 7.54 (Interquartile range (IQR) 10.3) versus 3.53 (IQR 1.51). BUMP achieved an AUROC of 0.812 (95% CI: 0.636-0.931), the optimal threshold was 0.134 yielding an F1 score of 0.800. PSMA-RADS v2.0 outperformed BUMP with higher sensitivity and specificity (98% and 96%, versus 74% and 80%). In equivocal PSMA-RADS Score 3 lesions (n = 44), BUMP showed reduced discrimination (AUROC 0.61, 95% CI 0.457-0.781).</p><p><strong>Conclusion: </strong>BUMP had good predictive ability for classifying bone metastases but underperformed compared with human-led PSMA-RADS assessment. For equivocal lesions BUMP offered limited added value, highlighting the importance of expert interpretation.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873241","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":"Effects of androgen receptor signaling inhibitors on absorbed doses in mCRPC patients undergoing [¹⁷⁷Lu]Lu-PSMA-617 or [¹⁷⁷Lu]Lu-PSMA-I&T therapy: dosimetry results.","authors":"Josef Zahner, Astrid Delker, Zachary Ells, Ana Antic Nikolic, Adrien Holzgreve, Sophie C Siegmund, Maximilian Tiling, Mathias J Zacherl, Elena Berg, Can D Aydogdu, Alexander Dierks, Marcus Unterrainer, Guido Böning, Christian Stief, Jeremie Calais, Constantin Lapa, Rudolf A Werner, Jozefina Casuscelli, Lena M Unterrainer","doi":"10.1007/s00259-026-07967-3","DOIUrl":"10.1007/s00259-026-07967-3","url":null,"abstract":"<p><strong>Background: </strong>Androgen receptor signaling inhibitors (ARSi) have significantly improved clinical outcomes in men with prostate cancer (PCa). Preliminary data suggest the potential for ARSi to enhance PSMA expression in patients with mCRPC. In this analysis, we present preliminary dosimetry results from mCRPC patients treated with either [¹⁷⁷Lu]Lu-PSMA-617 or [¹⁷⁷Lu]Lu-PSMA-I&T radioligand therapy (RLT) in combination with ARSi compared to a Control Group of patients receiving [¹⁷⁷Lu]Lu-PSMA-617 or [¹⁷⁷Lu]Lu-PSMA-I&T monotherapy.</p><p><strong>Methods: </strong>This retrospective analysis was performed at a single center, including 50 patients diagnosed with mCRPC who underwent their first cycle of [¹⁷⁷Lu]Lu-PSMA-617 (n = 37) or [¹⁷⁷Lu]Lu-PSMA-I&T (n = 13) RLT ± concomitant ARSi treatment (abiraterone or enzalutamide). Patients were divided into a Combination Group (RLT + ARSi, n = 25) and a Control Group (RLT only, n = 25). Quantitative SPECT imaging was performed at 3 time points: 24 h (+ CT), 48 h, and 72 h post-administration of the initial cycle of RLT. Tumor lesions were segmented using the 24 h SPECT images, while organs-at-risk (kidney, spleen, liver) were delineated on the corresponding CT. Absorbed doses were calculated by applying a mono-exponential curve fit, incorporating local density scaling. Dosimetry results were evaluated separately for each radioligand.</p><p><strong>Results: </strong>Overall, 148 tumor lesions were included in this analysis (median 3 lesions per patient). The median tumor absorbed dose was comparable between the Combination Group and the Control Group: [¹⁷⁷Lu]Lu-PSMA-617 (2.1 ± 4.0 Gy/GBq vs 1.5 ± 1.7 Gy/GBq, p = 0.24) and [¹⁷⁷Lu]Lu-PSMA-I&T (1.2 ± 1.2 Gy/GBq vs 1.2 ± 3.5 Gy/GBq, p = 0.21). Furthermore, the median absorbed dose in organs-at-risk was comparable between the two groups in [¹⁷⁷Lu]Lu-PSMA-617: Kidneys: 0.28 ± 0.11 Gy/GBq vs 0.27 ± 0.13 Gy/GBq, p = 0.90; Spleen: 0.05 ± 0.05 Gy/GBq vs 0.06 ± 0.05 Gy/GBq, p = 0.75; Liver: 0.08 ± 0.03 Gy/GBq vs 0.07 ± 0.04 Gy/GBq, p = 0.75). A statistically significant difference was noted in kidneys and liver for [¹⁷⁷Lu]Lu-PSMA-I&T: Kidneys: 0.21 ± 0.10 Gy/GBq vs 0.30 ± 0.08 Gy/GBq, p = 0.01; Spleen: 0.02 ± 0.02 Gy/GBq vs 0.04 ± 0.03 Gy/GBq, p = 0.20; Liver: 0.02 ± 0.01 Gy/GBq vs 0.04 ± 0.01 Gy/GBq, p = 0.01.</p><p><strong>Conclusion: </strong>In this pilot cohort, concomitant ARSi therapy did not significantly enhance tumor absorbed doses in patients receiving [¹⁷⁷Lu]Lu-PSMA-617 or [¹⁷⁷Lu]Lu-PSMA-I&T RLT. Further prospective studies with larger patient numbers are needed to evaluate the impact of concomitant ARSi treatment on the absorbed doses in mCRPC tumor lesions.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":"6442-6451"},"PeriodicalIF":7.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-in-human EphA2-targeting PET imaging with the bicyclic radiotracer [⁶⁸Ga]Ga-BCY18469 in pancreatic cancer patients: biodistribution, dosimetry and initial findings.","authors":"Ann-Christin Eder, Christoph-Ferdinand Wielenberg, Mohamed Aymen Omrane, Aikaterini Klotsotyra, Katia Brüggemann, Mohamed El Fakiri, Heiko Becker, Michael Quante, Michael Mix, Matthias Eder, Philipp T Meyer, Martin T Freitag","doi":"10.1007/s00259-026-07985-1","DOIUrl":"10.1007/s00259-026-07985-1","url":null,"abstract":"<p><strong>Purpose: </strong>Erythropoietin-producing hepatocellular receptor A2 (EphA2) is overexpressed in various malignancies, including pancreatic ductal adenocarcinoma (PDAC), in which it correlates with poor prognosis. Although EphA2 is considered a promising target receptor for theranostic applications, suitable radiotracers for clinical imaging have been lacking. This study reports first clinical experiences with [⁶⁸Ga]Ga-BCY18469, a bicyclic peptide radiotracer for EphA2-targeted PET imaging.</p><p><strong>Methods: </strong>Seven patients with histologically confirmed PDAC (5 after chemotherapy, 2 at initial staging) underwent PET/CT imaging. Four were scanned at 15, 30, 45, 60 and 180 min. and three at 45 min. after injection of [⁶⁸Ga]Ga-BCY18469. Dosimetry calculations were performed based on organ-specific time-activity curves from whole-body PET acquisitions. Imaging findings were compared with contrast-enhanced CT or MRI (interval: 9-50 days).</p><p><strong>Results: </strong>No adverse events were observed. The kidneys received the highest absorbed dose (0.31 ± 0.02 mGy/MBq), while the effective dose was 0.017 ± 0.002 mSv/MBq. [⁶⁸Ga]Ga-BCY18469 demonstrated rapid tumor uptake at 15 min. post-injection with predominantly renal excretion. Of 45 total lesions EphA2-PET detected 36 lesions with tracer uptake suspicious for metastasis. 11 of 45 lesions were detected only on EphA2-PET, whereas 9 of 45 lesions were detected only on CT and/or MRI. The tracer identified 13 liver metastases (SUV_max 6.9 ± 3.4) and 13 lymph node metastases (SUV_max 5.0 ± 1.1), among other findings.</p><p><strong>Conclusions: </strong>Our initial clinical experiences demonstrate that [⁶⁸Ga]Ga-BCY18469 enables safe, rapid, and high-contrast visualization of EphA2-expressing PDAC lesions. These results strongly support further investigation of [⁶⁸Ga]Ga-BCY18469 as a diagnostic tool for EphA2-positive malignancies.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":"6363-6374"},"PeriodicalIF":7.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individual-level metabolic connectivity captures cortical morphology and their coupling strengthens in the ageing brain.","authors":"Massimiliano Facca, Claudia Tarricone, Anna Ridolfo, Maurizio Corbetta, Andrei G Vlassenko, Manu S Goyal, Alessandra Bertoldo","doi":"10.1007/s00259-026-07968-2","DOIUrl":"10.1007/s00259-026-07968-2","url":null,"abstract":"<p><strong>Purpose: </strong>Cerebral glucose metabolism and cortical morphology are known to undergo significant changes across the lifespan, yet their network-level coordination remains poorly understood. This study aimed to investigate whether individual-level metabolic connectivity (MC) reflects underlying inter-areal morphometric similarity, and to determine how this metabolic-morphometric coupling evolves across the adult lifespan.</p><p><strong>Methods: </strong>Dynamic [¹⁸F]FDG-PET and structural MRI data were acquired from 67 healthy adults (age range: 38-86 years). Individual MC networks were estimated based on the similarity between regional time-activity curves. Corresponding structural similarity networks were generated using the morphometric inverse divergence (MIND) framework, which integrates multiple vertex-wise features of cortical morphology. The correspondence between metabolic and structural networks was quantified at both global and local scales using Spearman correlations. General linear models were employed to assess age-related effects on MC-MIND similarity.</p><p><strong>Results: </strong>MC demonstrated a robust positive association with cortical morphometric similarity (ρ = 0.32, p < 0.0001), an association that persisted after distance correction and was replicated at the individual level. Regional coupling followed a topographic gradient, peaking in heteromodal association cortices and reaching its minimum in paralimbic areas. Crucially, morphology-metabolism alignment systematically strengthened with age at the global level (β = 0.59, p < 0.001). Local age-related increases were spatially heterogeneous, predominantly affecting visual, dorsal parietal, and premotor cortices alongside adjacent multimodal regions.</p><p><strong>Conclusion: </strong>Individual-level MC captures the morphometric organisation of the brain. The age-related increase in morphology-metabolism coupling indicates that metabolic coordination becomes progressively more aligned with cortical architecture, consistent with reduced neuroenergetic flexibility in the ageing brain.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":"6184-6194"},"PeriodicalIF":7.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CXCR4-targeted [⁶⁸Ga]Ga-PentixaFor PET/CT improves staging and alters management in marginal zone lymphoma: a prospectively recruited head-to-head study with [¹⁸F]FDG.","authors":"Zitong Zhang, Haoyuan Hu, Xin Li, Yongzhao Xiang, Limin Gao, Yunyi Liu, Hexiao Huang, Liqun Zou, Ming Jiang, Chong Jiang, Rong Tian","doi":"10.1007/s00259-026-07978-0","DOIUrl":"10.1007/s00259-026-07978-0","url":null,"abstract":"<p><strong>Background: </strong>Marginal zone lymphoma (MZL) exhibits substantial clinical heterogeneity, necessitating accurate whole-body tumor burden assessment and early risk stratification. However, conventional [¹⁸F]FDG PET/CT is limited in both anatomical staging and in vivo biological characterization. This prospectively recruiting study conducted a head-to-head comparison of the CXCR4-targeted tracer [⁶⁸Ga]Ga-PentixaFor and [¹⁸F]FDG in treatment-naïve patients to evaluate their complementary value in improving staging accuracy and their association with early treatment response.</p><p><strong>Methods: </strong>Forty-one treatment-naïve MZL patients prospectively underwent dual-tracer PET/CT prior to therapy. Lesion detection rates, stage migration, and management modifications were systematically assessed. The prognostic value of baseline imaging parameters for interim treatment response was also analyzed.</p><p><strong>Results: </strong>[⁶⁸Ga]Ga-PentixaFor demonstrated significantly higher lesion detection rates than [¹⁸F]FDG, particularly for gastric (72.0% vs. 40.0%) and nodal involvement (97.4% vs. 39.7%), with a superior target-to-background ratio (median TBR_liver: 5.55 vs. 2.42, p < 0.01). CXCR4-targeted imaging resulted in disease upstaging in 26.8% of patients (overall stage migration: 29.3%) and led to management modifications in 56.1%. Regarding therapeutic outcomes, higher baseline [⁶⁸Ga]Ga-PentixaFor SUVmax (> 7.96) was associated with lower complete remission (CR) rates. Notably, dual-tracer phenotyping further demonstrated decreasing CR rates across double-negative, single-positive, and double-positive groups (100%, 61.5%, and 36.4%, respectively).</p><p><strong>Conclusion: </strong>[⁶⁸Ga]Ga-PentixaFor PET/CT significantly outperforms [¹⁸F]FDG in initial staging of MZL and has a substantial impact on clinical management. Importantly, dual-tracer imaging shows potential as a novel, non-invasive biomarker for in vivo phenotypic characterization, which is associated with early therapeutic outcomes and the identification of high-risk patients.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":"6375-6385"},"PeriodicalIF":7.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149084","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":"Is there a role for early SSTR-targeting PRRT in GEP-NET?","authors":"Giorgia Ricciardello, Greta Celesti, Matteo Bauckneht, Irene A Burger, Andrei Iagaru, Martina Arco, Sabrina Curatolo, Benedetta Pagano, Ernesto Amato, Lucrezia Auditore, Luca Fiorillo, Antonio Piras, Leandra Piscopo, Ahmad Shariftabrizi, Massimiliano Berretta, Sergio Lucio Vinci, Fabio Minutoli, Riccardo Laudicella","doi":"10.1007/s00259-026-07974-4","DOIUrl":"10.1007/s00259-026-07974-4","url":null,"abstract":"<p><strong>Purpose: </strong>Peptide receptor radionuclide therapy (PRRT) with radiolabelled somatostatin analogues, such as [¹⁷⁷Lu]Lu-DOTATATE, is approved as a second-line treatment for progressive, gastroenteropancreatic neuroendocrine tumors (GEP-NETs). However, emerging evidence suggests potential earlier roles for PRRT.</p><p><strong>Materials and methods: </strong>A systematic review was conducted in accordance with the PRISMA guidelines, including case reports, original papers, and clinical trial protocols evaluating neoadjuvant, adjuvant, or first-line PRRT in GEP-NETs. A systematic search of PubMed and clinicaltrials.gov (up to May 31, 2025) finally identified 25 eligible papers. For each paper, data were extracted regarding clinical setting, patient characteristics, treatment regimen, and oncologic and surgical outcomes.</p><p><strong>Results: </strong>The available preliminary data, comprising case reports, retrospective and prospective cohorts, show that neoadjuvant PRRT can induce tumor shrinkage, regression of vascular involvement, and conversion from unresectable to resectable disease in up to 45% of patients. Reported outcomes include high objective response rates (up to 70%), improved surgical feasibility, and a promising survival benefit, especially in patients who received PRRT before surgery. Also, preliminary results from the NETTER-2 trial support the use of [¹⁷⁷Lu]Lu-DOTATATE as first-line therapy in SSTR-positive G2-G3 GEP-NET, showing significant improvement in progression-free survival. Differently, the evidence for adjuvant use is missing.</p><p><strong>Conclusion: </strong>Current data suggest that PRRT, traditionally approved as a later-line therapy, may play a promising role in neoadjuvant and first-line settings for selected GEP-NET patients, enhancing resectability, improving surgical outcomes, and potentially prolonging survival. Further prospective, randomized studies are needed to define selection criteria, determine optimal timing, and assess the long-term impact on disease trajectory.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":"6594-6604"},"PeriodicalIF":7.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149069","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":"Chrónos and Káiros in theragnostics: re-assessing time toxicity in final-line radiopharmaceutical treatments.","authors":"Ian Alberts, Christos Sachpekidis, Sandy Buchman","doi":"10.1007/s00259-026-07954-8","DOIUrl":"10.1007/s00259-026-07954-8","url":null,"abstract":"","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":"6610-6616"},"PeriodicalIF":7.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210658","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":"CXCR4-targeted PET/CT in early systemic sclerosis-associated interstitial lung disease: a prospective proof-of-concept study of in vivo inflammatory activity.","authors":"Michael Gernert, Marc Schmalzing, Hannah Labinsky, Yingjun Zhi, Patrick-Pascal Strunz, Matthias Fröhlich, Philipp E Hartrampf, Andreas K Buck, Rudolf A Werner, Sebastian E Serfling","doi":"10.1007/s00259-026-08000-3","DOIUrl":"10.1007/s00259-026-08000-3","url":null,"abstract":"<p><strong>Introduction: </strong>Distinguishing active inflammatory or remodeling-associated processes from irreversible fibrosis in systemic sclerosis remains challenging using conventional imaging modalities. The tracer [⁶⁸Ga]Pentixafor targets the C-X-C motif chemokine receptor 4 (CXCR4) which is expressed on leukocytes. Uptake of [⁶⁸Ga]Pentixafor may provide complementary biological information on CXCR4-associated inflammatory and remodeling activity.</p><p><strong>Methods: </strong>This prospective cohort study included patients with early SSc (disease duration ≤ 5 years) and preexisting interstitial lung disease. All patients underwent [⁶⁸Ga]Pentixafor-PET/CT imaging. Normalized [⁶⁸Ga]Pentixafor uptake was quantified using the target-to-background ratio (TBR). Follow-up data on disease progression was collected. A control group comprised patients with giant cell arteritis.</p><p><strong>Results: </strong>Twelve patients with SSc were included. The highest [⁶⁸Ga]Pentixafor uptake was observed in the hilar and mediastinal lymph nodes, in fibrotic lung regions, and in the left ventricular myocardium. In all three regions, a significantly higher [⁶⁸Ga]Pentixafor uptake was measured in SSc compared to controls (median TBR of lymph nodes 3.5 [IQR 2.7 - 4.3] vs 1.6 [1.3 - 2.0] p < 0.0001; inferior lung lobes 2.3 [1.6 - 2.8] vs 0.8 [0.7 - 1.0], p < 0.0001; and left ventricle 2.0 [1.4 - 2.4] vs 1.3 [1.1 - 1.5], p = 0.0178). Patients who developed progressive lung disease during follow-up showed a higher [⁶⁸Ga]Pentixafor uptake compared to non-progressive patients reaching statistical significance in the left ventricle (TBR of progressive vs non-progressive patients: 2.5 (2.1 - 3.3) vs 1.5 (1.3 - 2.1), p = 0.0283) and showing a numerical increase in fibrotic lung regions (2.8 (2.2 - 3.3) vs 1.7 (1.1 - 2.8), p = 0.1535).</p><p><strong>Conclusion: </strong>These findings provide proof-of-concept evidence that CXCR4-targeted PET/CT may visualize biologically active inflammatory and/or remodeling processes in early-stage SSc-ILD.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":"6632-6640"},"PeriodicalIF":7.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}