European Journal of Nuclear Medicine and Molecular Imaging最新文献

{"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":"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":"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":"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":"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}

{"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":"Interpreting [¹⁸F]FDG-avid fractures after induction therapy in multiple myeloma: insights from the PET/CT sub-study of the Phase 3 GMMG-HD7 trial.","authors":"Christos Sachpekidis, Marina Hajiyianni, Markus Wennmann, Annette Kopp-Schneider, Lukas John, Sandra Sauer, Ulrike Dapunt, Niels Weinhold, Ekaterina Menis, Anna Jauch, Uta Bertsch, Michael Hundemer, Alexander Brobeil, Jens Hillengass, Marc S Raab, Elias K Mai, Antonia Dimitrakopoulou-Strauss, Hartmut Goldschmidt","doi":"10.1007/s00259-026-07962-8","DOIUrl":"10.1007/s00259-026-07962-8","url":null,"abstract":"","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":"6605-6609"},"PeriodicalIF":7.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149104","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":"Fraction-dependent dose dynamics and clinical safety in high-risk neuroblastoma treated with [¹⁷⁷Lu]Lu-DOTATATE: results from the LuDO-N trial.","authors":"Se Whee Sammy Park, Fredrik Sundquist, Leonor Teles, Rob van Rooij, Daniel Thor, Kasper Karlsson, Arthur J A T Braat, Jakob Stenman, Joachim N Nilsson","doi":"10.1007/s00259-026-07984-2","DOIUrl":"10.1007/s00259-026-07984-2","url":null,"abstract":"<p><strong>Purpose: </strong>Neuroblastoma frequently overexpresses somatostatin receptors (SSTR), enabling molecular radiotherapy with [¹⁷⁷Lu]Lu-DOTATATE (¹⁷⁷Lu-DOTATATE). Based on prior studies suggesting that dose intensification is required to achieve objective responses, the LuDO-N trial employs a two-fraction, high-activity treatment regimen. This study aimed to evaluate fraction-dependent changes in tumour and risk-organ absorbed doses, as well as the clinical safety of the intensified ¹⁷⁷Lu-DOTATATE treatment approach.</p><p><strong>Methods: </strong>Fourteen patients with high-risk recurrent or refractory neuroblastoma received ¹⁷⁷Lu-DOTATATE in a dose-intensified, dosimetry-guided regimen. Treatment was given in two fractions 2-3 weeks apart, targeting a cumulative dose of either 2.4 Gy to the whole body or 23 Gy to either kidney. The first fraction was administered at 200 MBq/kg, while the second fraction was individually adjusted to achieve the dosimetric targets.</p><p><strong>Results: </strong>Tumour-to-kidney and tumour-to-whole-body absorbed dose ratios both decreased significantly by 44% after the second fraction, compared to the first. Tumours received a median 53% lower absorbed dose per administered activity in the second fraction, while kidney and whole-body doses per activity were reduced by 24% and 18%, respectively. Four of fourteen patients (29%) underwent peripheral blood stem cell reinfusion. No sustained renal toxicity was observed.</p><p><strong>Conclusions: </strong>These findings support a front-loaded ¹⁷⁷Lu-DOTATATE strategy to maximise tumour irradiation while maintaining exposure to risk organs within safety limits. Accordingly, the LuDO-N protocol has been amended to increase administered activity to 400 MBq/kg in the first fraction for subsequent patients. Together, this work contributes to the ongoing optimisation of dosimetry-guided and intensified treatment strategies for SSTR-targeted molecular radiotherapy for high-risk neuroblastoma.</p><p><strong>Clinical trial registration: </strong>EU Clinical Trials Register, EU CT 2023-503684-42-00. Registered 2021-05-21. https://euclinicaltrials.eu/search-for-clinical-trials/?lang=en&EUCT=2023-503684-42-00 .</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":"6398-6409"},"PeriodicalIF":7.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276282","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":"Pulmonary [¹⁸F]FDG uptake demonstrates phenotypic PET behaviour in non-specific interstitial pneumonitis and refines risk stratification.","authors":"Hannah Torlot, Balaji Ganeshan, Thida Win, Helen Garthwaite, Luke R Hoy, Darren Walls, Raymond Endozo, Robert I Shortman, Francesco Fraioli, Nicholas J Screaton, Joanna C Porter, Ashley M Groves","doi":"10.1007/s00259-026-08052-5","DOIUrl":"10.1007/s00259-026-08052-5","url":null,"abstract":"<p><strong>Rationale: </strong>Effective prognostic biomarkers in Non-specific Interstitial Pneumonitis (NSIP) are limited.</p><p><strong>Objective: </strong>To investigate the potential of [¹⁸F]FDG PET/CT to predict mortality in NSIP and to assess its relationship with physiological indices and the Interstitial Lung Disease - Gender-Age-Physiology (ILD-GAP) score.</p><p><strong>Methods: </strong>Ninety-six patients with a multidisciplinary team-confirmed diagnosis of NSIP (40 male, 56 female; mean age 59.8 ± 9.8 years) underwent baseline [¹⁸F]FDG PET/CT and 83 patients completed full pulmonary function testing. Pulmonary uptake of [¹⁸F]FDG was quantified using region-of-interest analysis as the maximum uptake in diseased lung (SUV_max) and the background uptake in visually normal lung (SUV_min). A target-to-background (TBR) ratio was calculated as SUV_max /SUV_min. Kaplan-Meier survival analysis examined associations between the [¹⁸F]FDG PET/CT metrics, the pulmonary function tests and ILD-GAP scores. Stepwise forward Wald multivariable Cox regression assessed independence of the significant [¹⁸F]FDG PET/CT parameters from the ILD-GAP index. The modified ILD-GAP (mGAP) models were generated by incorporating the [¹⁸F]FDG PET/CT data into the ILD-GAP index.</p><p><strong>Results: </strong>65 patients died during a mean follow up of 83.2 ± 48.2 months. Mean ± SD SUV_max, SUV_min and TBR were 3.2 ± 1.2, 0.6 ± 0.3 and 6.0 ± 2.4, respectively. Mortality was associated with higher SUV_max (median cutoff ≥ 2.9, p = 0.038) and higher SUV_min (optimised cutoff ≥ 0.675, p < 0.001), whereas TBR was not prognostic (p = 0.48). Multivariable Cox regression confirmed median SUV_max as independent of ILD-GAP index (p = 0.031), although optimised SUV_min was not independent. Incorporating either parameter into a modified ILD-GAP model improved survival stratification compared with ILD-GAP index alone (p < 0.01, log-rank test).</p><p><strong>Conclusion: </strong>High pulmonary [¹⁸F]FDG PET/CT uptake predicts increased mortality in NSIP. Median SUV_max is an independent predictor of mortality and adding [¹⁸F]FDG PET/CT parameters to the ILD-GAP index enhances prognostic discrimination. These findings support a disease-specific interpretation of [¹⁸F]FDG PET/CT metrics in ILD, where SUV_max and SUV_min are dominant prognostic markers in diffuse NSIP.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":"6641-6650"},"PeriodicalIF":7.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583817","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}