European Journal of Nuclear Medicine and Molecular Imaging最新文献

{"title":"A visual whole-body tumor-burden classification based on PSMA PET/CT to predict response to novel androgen receptor signaling inhibitors for metastatic hormone-sensitive prostate cancer patients","authors":"Xuhe Liao, Shanshi Li, Hongwei Sun, Xueqi Chen, Xiaojiang Duan, Meng Liu, Peimin Zhou, Wei Yu, Jianhua Zhang, Yan Fan","doi":"10.1007/s00259-025-07300-4","DOIUrl":"https://doi.org/10.1007/s00259-025-07300-4","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>The incidence rates of metastatic hormone-sensitive prostate cancer (mHSPC) have increased rapidly. Androgen deprivation therapy (ADT) with AR signaling inhibitors (ARSIs) has been determined survival benefit for mHSPC patients in several randomized trials. However, patients do not respond uniformly. Whole-body tumor-burden schemes guided by prostate-specific membrane antigen (PSMA) PET/CT have been proven to be a useful predictive tool for PSMA-targeted radioligand therapy (RLT), while the value for hormone therapy was unclear. We hypothesized a visual whole-body tumor-burden classification based on PSMA PET/CT can enable selective patient stratification and prognostic evaluation for hormone treatment.</p><h3 data-test=\"abstract-sub-heading\">Materials and methods</h3><p>Patients diagnosed with de novo mHSPC through pathological test and [<sup>18</sup>F]F-PSMA PET/CT between February 2022 and December 2023 who received ADT alone or ADT plus first-generation antiandrogens or ADT plus second-generation/novel ARSIs in our hospital were included. Only can hormone treatments (ADT or ADT plus first-generation antiandrogens or ADT plus novel ARSIs) be adopted at least six months after initial diagnosis. Prostate Cancer Multidisciplinary Team (MDT) of our hospital proposed a newly visual whole-body tumor-burden scheme based on PSMA PET/CT (MDT scheme: high vs. low): MDT high group (fulfilling any one of the three following criteria): (I) the number of metastatic lesions is more than 10 (diffused involvement of single bone is counted as 4 lesions) and PSMA uptake levels of 80% lesions are higher than that of parotid glands, (II) the presence of visceral metastases, (III) at least 4 bone metastases (≥ 1 beyond the vertebral bodies or the pelvis). In addition, other three tumor-burden classification methods (PSMA-CHAARTED, PSMA-LATITUDE, revised-vPSG schemes) were also assessed in this study. A series of other parameters including SUV-derived features of PSMA PET/CT and potential clinical and pathological factors were evaluated. SUV-derived features were determined for measurable locations and included: SUVmax, SUVpeak, SUVmean and tumor volume (TV) of prostatic primary lesions, the highest SUVmax of all lesions in whole body (wbSUVmax), primary-tumor SUVmax ratio backgrounds (including blood pool of liver/ spleen/ mediastinum/parotid glands), wbSUVmax ratio backgrounds above. Serum prostate-specific antigen (PSA) lower than 0.2 ng/ml after six-month hormone treatment was set as the primary endpoint for prediction of PSA response. PSA99 (PSA reduction ≥ 99%) was the second endpoint for survival analysis. All parameters above including the four tumor-burden classification schemes were evaluated for the predictive and prognostic value according to the endpoints using logistic and Cox proportional hazards regression analysis, respectively. All <i>P</i> values < 0.05 were considered significant.</p><h3 data","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"75 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873028","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":"Head-to-head comparison of fibroblast activation protein inhibitors (FAPI) radiopharmaceuticals and [18F]FDG in gynaecological malignancies: systematic literature review and meta-analysis","authors":"Anita Florit, Elizabeth J. de Koster, Serena Sassano, Lejla Alic, Giusi Pisano, Floris H. P. van Velden, Salvatore Annunziata, Irina Primac, Maria Rosaria Ruggiero, Cristina Müller, Evis Sala, Wolfgang P. Fendler, Giovanni Scambia, Lioe-Fee de Geus-Oei, Anna Fagotti, Vittoria Rufini, Angela Collarino","doi":"10.1007/s00259-025-07277-0","DOIUrl":"https://doi.org/10.1007/s00259-025-07277-0","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>This study aims to systematically review and perform a meta-analysis to compare the diagnostic performance of fibroblast activation protein inhibitors (FAPI) radiopharmaceuticals and 2-deoxy-2-[¹⁸F]fluoro-D-glucose ([¹⁸F]FDG) in gynaecological cancers.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A comprehensive search of PubMed/MEDLINE and EMBASE was conducted and updated to October 25, 2024, to identify clinical studies evaluating FAPI and [¹⁸F]FDG PET/CT or PET/MR in patients with gynaecological cancer. Quality was assessed using the QUADAS-2 tool (Quality Assessment of Diagnostic Accuracy Studies). Per-lesion pooled estimates of sensitivity, specificity, positive predictive value, and negative predictive value were calculated with 95% confidence intervals.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Ten studies were included for qualitative assessment and five studies focusing on ovarian cancer were included in the meta-analysis. The detection rates of primary cervical cancer ranged from 96 to 100% for both radiopharmaceuticals. For the primary tumour in ovarian cancer, the pooled sensitivities of ⁶⁸Ga-FAPI and [¹⁸F]FDG were 95% and 92%, and the pooled specificities were 81% for both radiopharmaceuticals. Nodal metastases detection was higher with ⁶⁸Ga-FAPI compared with [¹⁸F]FDG in cervical cancer. Similarly, in ovarian cancer the estimated pooled sensitivities of ⁶⁸Ga-FAPI and [¹⁸F]FDG were 97% and 88%, and the pooled specificities were 83% and 41%, respectively. At peritoneal metastases analysis in ovarian cancer, the pooled sensitivities of ⁶⁸Ga-FAPI and [¹⁸F]FDG were 97% and 70%, and the pooled specificities were 93% and 88%, respectively. At the visual assessment of peritoneal cancer scores, such as peritoneal cancer index, ⁶⁸Ga-FAPI detected a greater tumour burden compared with [¹⁸F]FDG. A comparative analysis of the PET semiquantitative parameters was also performed.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Despite limited literature data, radiopharmaceuticals based on FAPIs are a promising alternative to [¹⁸F]FDG for imaging gynaecological cancers, in particular for the detection of nodal metastases in cervical and ovarian cancers, as well as for detecting peritoneal metastases in ovarian cancers. Larger prospective studies are needed to confirm these results and promote the inclusion of FAPI radiopharmaceuticals in clinical practice.</p><h3 data-test=\"abstract-sub-heading\">Clinical trial number</h3><p>Not applicable.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"42 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873033","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":"Lung lesion detectability on images obtained from decimated and CNN-based denoised [18F]-FDG PET/CT scan: an observer-based study for lung-cancer screening","authors":"Daphné Faist, Silvano Gnesin, Siria Medici, Alysée Khan, Marie Nicod Lalonde, Niklaus Schaefer, Adrien Depeursinge, Maurizio Conti, Joshua Schaefferkoetter, John O. Prior, Mario Jreige","doi":"10.1007/s00259-025-07259-2","DOIUrl":"https://doi.org/10.1007/s00259-025-07259-2","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>To assess feasibility of lung cancer screening, we analysed lung lesion detectability simulating low-dose and convolutional neural network (CNN) denoised [¹⁸F]-FDG PET/CT reconstructions.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Retrospectively, we analysed lung lesions on full statistics and decimated [¹⁸F]-FDG PET/CT. Reduced count PET data were emulated according to various percentage levels of total. Full and reduced statistics datasets were denoised using a CNN algorithm trained to recreate full statistics PET. Two readers assessed a detectability score from 3 to 0 for each lesion. The resulting detectability score and quantitative measurements were compared between full statistics and the different decimation levels (100%, 30%, 5%, 2%, 1%) with and without denoising.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>We analysed 141 lung lesions from 49 patients across 588 reconstructions. The dichotomised lung lesion malignancy score was significantly different from 10% decimation without denoising (<i>p</i> &lt; 0.029) and from 5% decimation with denoising (<i>p</i> &lt; 0.001). Compared to full statistics, detectability score distribution differed significantly from 2% decimation without denoising (<i>p</i> &lt; 0.001) and from 5% decimation with denoising (<i>p</i> &lt; 0.001). Detectability scores at same decimation levels with or without denoising differed significantly at 10%, 2%, and 1% decimation (<i>p</i> &lt; 0.019); dichotomised scores did not differ significantly. Denoising significantly increased the proportion of lung lesion scores with a high diagnostic confidence (3 and 0) (<i>p</i> &lt; 0.038).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Lung lesion detectability was preserved down to 30% of injected activity without denoising and to 10% with denoising. These results support the feasibility of reduced-activity [¹⁸F]-FDG PET/CT as a potential tool for lung lesion detection. Further studies are warranted to compare this approach with low-dose CT in screening settings.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"7 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873027","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 and 18F-FAPI PET/CT for detection of nodal metastases prior radical cystectomy in high-risk urothelial carcinoma patients","authors":"Lena M. Unterrainer, Hans P. Schmid, Sophie C. Kunte, Adrien Holzgreve, Johannes Toms, Paula Menold, Clemens C. Cyran, Alexander Karl, Stephan Tschirdewahn, Stephan T. Ledderose, Lennert Eismann, Alexander J. Tamalunas, Maximilian Scheifele, Christian G. Stief, Marcus Unterrainer, Jozefina Casuscelli, Gerald B. Schulz","doi":"10.1007/s00259-025-07239-6","DOIUrl":"https://doi.org/10.1007/s00259-025-07239-6","url":null,"abstract":"&lt;h3 data-test=\"abstract-sub-heading\"&gt;Introduction&lt;/h3&gt;&lt;p&gt;To determine the best therapeutic strategy for muscle-invasive bladder cancer (BC), the accuracy of lymph node staging is of paramount importance. However, diagnostic performance of conventional computed tomography in BC prior to radical cystectomy (RC) remains unsatisfactory. There is an increased interest in evaluating &lt;sup&gt;18&lt;/sup&gt;F-FAPI PET/CT for hybrid imaging due to their logistical advantages compared to [&lt;sup&gt;68&lt;/sup&gt;Ga]Ga-based FAPI tracers in clinical routine. Recently, the potential diagnostic value of [&lt;sup&gt;68&lt;/sup&gt;Ga]Ga-FAPI- 46 PET/CT was demonstrated in BC. Thus, we aimed to examine the diagnostic performance of [&lt;sup&gt;18&lt;/sup&gt;F]F-FAPI- 74 and [&lt;sup&gt;68&lt;/sup&gt;Ga]Ga-FAPI- 46 PET/CT for preoperative evaluation of locoregional lymph node metastases.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Methods&lt;/h3&gt;&lt;p&gt;Fifty-one patients underwent FAPI PET/CT with either [&lt;sup&gt;68&lt;/sup&gt;Ga]Ga-FAPI- 46 (&lt;i&gt;n&lt;/i&gt; = 23) or [&lt;sup&gt;18&lt;/sup&gt;F]F-FAPI- 74 (&lt;i&gt;n&lt;/i&gt; = 28) prior to RC and PLND. SUV&lt;sub&gt;max&lt;/sub&gt;, SUV&lt;sub&gt;mean&lt;/sub&gt; and the ratio between the SUV&lt;sub&gt;max&lt;/sub&gt; of lymph nodes and the SUV&lt;sub&gt;mean&lt;/sub&gt; of the background (SUV&lt;sub&gt;max_lymph node&lt;/sub&gt;/SUV&lt;sub&gt;mean&lt;/sub&gt;_&lt;sub&gt;background&lt;/sub&gt;) were assessed. Additionally, short axis diameter (SAD) for a representative lymph node were documented in each lymph node region (&lt;i&gt;n&lt;/i&gt; = 123) and compared to histopathological findings. Each scan was interpreted visually and quantitatively. ROC-analyses were performed to determine cut-off values with highest diagnostic accuracy.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Results&lt;/h3&gt;&lt;p&gt;20/123 (16.3%) lymph node regions showed UC lymph node metastases. Histopathologically positive lymph nodes were associated with a significantly higher FAPI uptake compared to negative lymph nodes regarding SUV&lt;sub&gt;max&lt;/sub&gt;, SUV&lt;sub&gt;mean&lt;/sub&gt; values and SUV&lt;sub&gt;max_lymph node&lt;/sub&gt;/SUV&lt;sub&gt;mean&lt;/sub&gt;_&lt;sub&gt;background&lt;/sub&gt; ratios. Visual analysis based on FAPI uptake showed a sensitivity and specificity, PPV and NPV of 63.6%, 95.8%, 77.7%, and 92.0% for [&lt;sup&gt;68&lt;/sup&gt;Ga]Ga-FAPI- 46 and 55.5%, 98.1%, 83.3%, and 93.1% for [&lt;sup&gt;18&lt;/sup&gt;F]F-FAPI- 74, respectively. ROC analysis revealed an optimal cut-off for SUV&lt;sub&gt;max&lt;/sub&gt;, SUV&lt;sub&gt;mean&lt;/sub&gt; and SUV&lt;sub&gt;max_lymph node&lt;/sub&gt;/SUV&lt;sub&gt;mean&lt;/sub&gt;_&lt;sub&gt;background&lt;/sub&gt; of 1.35, 1.20 and 5.95 for [&lt;sup&gt;68&lt;/sup&gt;Ga]Ga-FAPI- 46 and 1.55, 1.25 and 4.15 for [&lt;sup&gt;18&lt;/sup&gt;F]F-FAPI- 74 to discriminate between histopathologically proven lymph node metastases and non-malignant lymph nodes resulting for example using SUV&lt;sub&gt;max&lt;/sub&gt; in a sensitivity and specificity, PPV and NPV of 81.8%, 89.5%, 64.2%, 95.5% for [&lt;sup&gt;68&lt;/sup&gt;Ga]Ga-FAPI- 46 and 100%, 81.8%, 47.3%, 100% for [&lt;sup&gt;18&lt;/sup&gt;F]F-FAPI- 74, respectively. CT visual analysis of locoregional lymph nodes showed a sensitivity, specificity, PPV and NPV of 30.0%, 97.0%, 66.6% and 87.7%, respectively. ROC analysis regarding SAD revealed ","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"2 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866851","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 the diagnostic value of [68Ga]Ga-FAP-2286 PET/CT and [18F]-FDG PET/CT imaging in different types of pleural and peritoneal metastatic tumors","authors":"Huajun Liu, Junzheng Wang, Yang Ji, Xinyi Lin, Kan Wang, Zhihan Yao, Min Wang, Chunyin Zhang","doi":"10.1007/s00259-025-07265-4","DOIUrl":"https://doi.org/10.1007/s00259-025-07265-4","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objective</h3><p>To compare the diagnostic value of [⁶⁸Ga]Ga-FAP-2286 PET/CT and [¹⁸F]-FDG PET/CT imaging in different types of pleural/peritoneal metastatic tumors.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A retrospective analysis was conducted on patients who underwent both [¹⁸F]-FDG and [⁶⁸Ga]Ga-FAP-2286 PET/CT in our department between January 2022 and November 2024. The maximum standardized uptake value (SUVmax), peak SUV (SUVpeak), and tumor-to-background ratio (TBR) of pleural/peritoneal metastatic lesions were measured, and the results obtained from the two imaging modalities were compared.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 92 patients suspected of having pleural/peritoneal metastases were included in the study. The [⁶⁸Ga]Ga-FAP-2286 PET/CT showed higher SUVmax, SUVpeak, TBR, and sensitivity compared to [¹⁸F]-FDG PET/CT (7.87 vs. 6.28; <i>P</i> = 0.002; 5.88 vs. 4.65; <i>P</i> &lt; 0.001; 6.27 vs. 3.85; <i>P</i> &lt; 0.001; 95.3% vs. 84.7%; <i>P</i> = 0.035), especially for peritoneal metastases (8.25 vs. 5.75; <i>P</i> &lt; 0.001; 6.18 vs. 4.29; <i>P</i> &lt; 0.001; 6.54 vs. 3.50; <i>P</i> &lt; 0.001). Among various tumors, [⁶⁸Ga]Ga-FAP-2286 PET/CT showed better detection results for hepatobiliary and pancreatic tumors (7.88 vs. 6.02, 5.88 vs. 4.33, 6.15 vs. 3.67), gastrointestinal tumors (8.27 vs. 5.69, 6.28 vs. 4.30, 7.03 vs. 3.50), and adenocarcinomas (8.30 vs. 5.80, 6.17 vs. 4.30, 6.60 vs. 3.55).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>For pleural/peritoneal metastases, [⁶⁸Ga]Ga-FAP-2286 PET/CT has a higher detection rate compared to [¹⁸F]-FDG PET/CT, providing better diagnostic efficacy, particularly for peritoneal metastases. Among various tumors, [⁶⁸Ga]Ga-FAP-2286 PET/CT has higher diagnostic value in hepatobiliary and pancreatic tumors, gastrointestinal tumors, and adenocarcinomas.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"32 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866850","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":"Molecular radiotherapy for adult type metastatic neuroendocrine tumours in children","authors":"Connie Peet, Caroline Elmaraghi, Tarek Abdel-Aziz, Huang Hian Liang, Jennifer E. Gains, Trung Nguyen, Simon Wan, Jamshed B. Bomanji, Mark N. Gaze","doi":"10.1007/s00259-025-07247-6","DOIUrl":"https://doi.org/10.1007/s00259-025-07247-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Paraganglioma, phaeochromocytoma and gastroenteropancreatic neuroendocrine tumours are rare in childhood. Molecular radiotherapy is one potential treatment for locally inoperable or metastatic disease. This study reviews the use and efficacy of molecular radiotherapy with both [¹³¹I] meta iodobenzylguanidine (mIBG) and [¹⁷⁷Lu] DOTATATE in this patient group.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This is an observational cohort study of all patients aged less than 18 years with adult type metastatic neuroendocrine cancers treated with molecular radiotherapy from 2003 to 2023 in one national referral centre.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Twelve patients, six male and six female, were treated. The median age at diagnosis was 12 years 3 months (range 7 years 11 months to 15 years 5 months), and at first molecular radiotherapy treatment was 13 years 7 months (range 8 years 8 months to 16 years 2 months). Nine had paraganglioma or phaeochromocytoma, three had other neuroendocrine tumours. Three received [¹⁷⁷Lu] DOTATATE only, four received [¹³¹I] mIBG only, and five received both radiopharmaceuticals. Three patients had rapid disease progression and died within a year. Following initial treatment of the others, two had a complete response, four had a partial response, one had stable disease, and two had a mixed response. Nine patients remain alive, at a median of 5 years 0 months (range 2 years 4 months to 21 years 5 months) after start of treatment.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Molecular radiotherapy can be beneficial, and may provide good disease control for long periods in a proportion of these patients. Combining different radiopharmaceuticals may be of value.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"13 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866646","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 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}