Hellenic journal of nuclear medicine最新文献

{"title":"Tumor necrosis and ascites on baseline ¹⁸F-FDG PET/CT as independent prognostic imaging markers for double/triple-hit lymphoma.","authors":"Yue Teng, Chong Jiang, Ruihe Lai, Zitong Zhang, Ming Jiang, Chongyang Ding, Zhengyang Zhou","doi":"10.1967/s002449913006","DOIUrl":"10.1967/s002449913006","url":null,"abstract":"<p><strong>Objective: </strong>Double and triple hit lymphoma (DHL/THL) is a rare genetic subtype of diffuse large B-cell lymphoma (DLBCL) characterized by extremely aggressive behavior. Tumor necrosis and ascites are also commonly associated with a poor prognosis. This study aimed to assess the potential prognostic markers on baseline fluorine-18-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) in DHL/THL patients.</p><p><strong>Subjects and methods: </strong>A total of 36 DHL/THL patients, with myelocytomatosis (MYC) and B-cell lymphoma 2 (BCL2) and/or B-cell lymphoma 6 (BCL6) rearrangements from 3 independent medical centers, were retrospectively studied. These patients all underwent baseline ¹⁸F-FDG PET/CT scans between November 2012 and February 2024. Presence of tumor necrosis and ascites were visually assessed at PET and CT, as necrosis^PET and ascites^CT, respectively. Survival analyses were performed using Cox regression and Kaplan-Meier methods. Progression-free survival (PFS) and overall survival (OS) were used as endpoints. Time-dependent receiver operating characteristics (ROC) curves were used to assess the predictive power of necrosis^PET and ascites^CT.</p><p><strong>Results: </strong>Of the 36 patients, 14 experienced recurrence, and 12 died during the follow-up period. Multivariate analysis revealed that necrosis^PET (hazard ratio [HR]=5.272, P=0.009; HR=5.363, P=0.026) and ascites^CT (HR=5.558, P=0.008; HR=7.384, P=0.020) were independently prognostic factors for PFS and OS. Time-dependent ROC analysis showed that necrosis^PET and ascites^CT had good performance in predicting PFS (accuracy: 0.671-0.758) and OS (accuracy: 0.686-0.769) occurring within 1-4 years. The risk model, incorporating necrosis^PET and ascites^CT, can effectively stratify patients for PFS (χ²=11.804, P=0.003 and χ²=15.754, P<0.001, respectively) and OS (χ²=20.599, P<0.001 and χ²=18.369, P<0.001, respectively) in subgroup analyses of patients treated with R-CHOP and intensive regimens, respectively.</p><p><strong>Conclusion: </strong>Necrosis^PET and ascites^CT independently predict survival in DHL/THL patients and may improve risk stratification, potentially guiding personalized therapeutic strategies.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":" ","pages":"109-120"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two cases of positive ⁶⁸Ga-PSMA-11 PET imaging in stroke.","authors":"Bo Pan, X-X Zhu","doi":"10.1967/s002449913008","DOIUrl":"10.1967/s002449913008","url":null,"abstract":"<p><p>Gallium-68-prostate-specific membrane antigen (⁶⁸Ga-PSMA-11) positron emission tomography/computed tomography (PET/CT) is a key imaging modality for evaluating prostate cancer. Here we report two cases of unexpected positive ⁶⁸Ga-PSMA-11 uptake in stroke lesions during prostate cancer assessment. The first patient suffered from cerebral hemorrhage in the right frontal lobe, and the second patient was diagnosed with acute cerebral infarction in the right occipital lobe. The abnormal PSMA uptake in both lesions was attributed to pathological angiogenesis and activated endothelial cells in the process of tissue repair after stroke. Since stroke may mimic brain metastasis on ⁶⁸Ga-PSMA-11 PET/CT, radiologists and nuclear medicine physicians need to integrate clinical manifestations and multimodal imaging results for accurate diagnosis, so as to prevent diagnostic errors in clinical practice.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":" ","pages":"125-128"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 with Al¹⁸F-NOTA-Pentixather shows superior sensitivity to ¹⁸F-FDG in thyroid follicular lymphoma.","authors":"Caiqun Zhou, Yanqing Diao","doi":"10.1967/s002449913013","DOIUrl":"https://doi.org/10.1967/s002449913013","url":null,"abstract":"<p><p>Primary thyroid follicular lymphoma (FL) is exceedingly rare with frequently low fluorine-18-fluorodeoxyglucose (¹⁸F-FDG) avidity, challenging accurate staging. We report the case of a 49-year-old female who underwent left thyroid lobectomy for a thyroid imaging reporting and data system (TI-RADS) 4a nodule, with histopathology confirming low-grade FL. Postoperative ¹⁸F-FDG positron emission tomography/computed tomography (PET/CT) showed only mild uptake at the surgical bed and cervical lymph nodes, interpreted as reactive change. A subsequent aluminum fluoride-18-1,4,7-triazacyclononane-1,4,7-triacetic acid-Pentixather (Al¹⁸F-NOTA-Pentixather) C-X-C chemokine receptor type 4 (CXCR4)-targeted PET/CT, however, revealed multiple intensely avid cervical and abdominal nodal lesions and spleen involvement. This imaging discrepancy underscores the limitations of ¹⁸F-FDG in low-grade lymphomas and suggests that CXCR4-targeted PET/CT may offer a more accurate reflection of disease burden, with potential implications for staging and therapeutic management.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":"29 2","pages":"139-140"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction and assessment of response to anti-inflammatory therapy in medication-related osteonecrosis of the jaw using harmonized quantitative bone SPECT/CT: A multicenter study.","authors":"Kazuhiro Kitajima, Yu Iwabuchi, Yoshitaka Inui, Takashi Norikane, Kimiteru Ito, Hiromitsu Kishimoto, Hidetaka Miyashita, Tetsuro Shiina, Yumiko Ohbayashi, Takao Ueno, Hiromitsu Daisaki","doi":"10.1967/s002449913001","DOIUrl":"10.1967/s002449913001","url":null,"abstract":"<p><strong>Objective: </strong>The utility of harmonized quantitative bone single-photon emission computed tomography/computed tomography (SPECT/CT) parameters for prediction and assessment of treatment response to anti-inflammatory therapy for medication-related osteonecrosis of the jaw (MRONJ) was investigated in a multicenter study conducted in Japan.</p><p><strong>Subjects and methods: </strong>Thirty-eight patients (40 lesions) clinically diagnosed with MRONJ underwent bone SPECT/CT scanning before initiation of anti-inflammatory therapy and again after at least three months of treatment at five hospitals. Using the GI-BONE software package, quantitative parameters including standard uptake value (SUV) parameters (SUVmax, SUVpeak, and SUVmean), metabolic bone volume (MBV), and total bone uptake (TBU) were calculated. Changes in quantitative parameters between the first and second SPECT/CT examinations were analyzed using the Wilcoxon test in both responders (downstaged lesions) and non-responders (upstaged lesions or no stage change). Pre-treatment values were compared between responders and non-responders using Student's t-test.</p><p><strong>Results: </strong>Following therapy, harmonized SUVmax, SUVpeak, SUVmean, MBV, and TBU values decreased significantly in the 23 responder lesions (P<0.0001 for all). In contrast, no significant reductions were observed in the 17 non-responder lesions (P=0.18, P=0.26, P=0.19, P=0.86, and P=0.31, respectively). Changes in harmonized SUVmax differentiated responders from non-responders with a sensitivity of 91.3% and specificity of 88.2%, using an optimal cut-off value of -17.0%. The corresponding sensitivity and specificity values for harmonized TBU change were 82.6% and 94.1%, respectively, with an optimal cut-off value of -38.0%. Pre-treatment harmonized SUVmax and SUVpeak were significantly higher in responders than in non-responders (P=0.049 and P=0.047, respectively).</p><p><strong>Conclusion: </strong>Harmonized quantitative bone SPECT/CT parameters, including SUV-derived parameters, MBV, and TBU, were useful for predicting and assessing anti-inflammatory therapeutic response in patients with MRONJ. Furthermore, higher pre-treatment SUVmax and SUVpeak were associated with a favorable response to anti-inflammatory therapy.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":" ","pages":"70-75"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular imaging of dural microcalcification: Detection of active mineralization with ¹⁸F-NaF PET/CT.","authors":"Shiv Patil, Daniel Gharavi, Nirmal Patel, Robert Subtirelu, Om H Gandhi, Jaskeerat Gujral, Thomas J Werner, Poul F Høilund-Carlsen, Abass Alavi","doi":"10.1967/s002449912948","DOIUrl":"10.1967/s002449912948","url":null,"abstract":"<p><p>Dural calcification is frequently observed on computed tomography (CT) as an age-associated finding, yet its biological activity and potential for pathological progression remain poorly characterized. Fluorine-18-sodium fluoride (¹⁸F-NaF) is a positron emission tomography (PET) radiotracer that can detect biologically active microcalcification and may thus enable monitoring of such lesions. We describe a 73-year-old woman with hypertension, hypercholesterolemia, and atrial fibrillation who was incidentally found to have focal ¹⁸F-NaF uptake in the falx cerebri (mean standardized uptake value (SUVmean) 1.29, SUVmax 2.02) and tentorium cerebelli (SUVmean 1.08, SUVmax 1.76). This case highlights the novel capability of ¹⁸F-NaF PET to characterize dural mineralization at the molecular level and serve as a biomarker of lesion progression.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":" ","pages":"50-51"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of regional brain metabolic changes in metastatic melanoma using ¹⁸F-FDG PET/CT imaging: A case report.","authors":"Om H Gandhi, Jaskeerat Gujral, Amir A Amanullah, Shiv Patil, Robert C Subtirelu, Eric M Teichner, Sedra A A Mhana, Thomas J Werner, Abass Alavi, Mona E Revheim","doi":"10.1967/s002449912944","DOIUrl":"10.1967/s002449912944","url":null,"abstract":"<p><p>Brain metastases occur in 40%-60% of melanoma patients and represent a major clinical challenge with historically poor prognosis. While conventional neuroimaging modalities such as magnetic resonance imaging (MRI) delineate metastases with high specificity, they cannot capture the widespread cerebral metabolic disruptions that underlie neurological impairment associated with infiltrative lesions. This case report demonstrates the utility of fluorine-18-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography-computed tomography (PET/CT) in characterizing regional brain metabolic changes in metastatic melanoma. We present a case of a 78-year-old female diagnosed with metastatic melanoma who underwent ¹⁸F-FDG PET/CT restaging. The imaging findings revealed hypometabolism in regions adjacent to hypoattenuation in the left occipital area, which was subsequently confirmed as a discrete parietal lobe metastasis on MRI. Quantitative assessment using MIMneuro software across 84 brain regions revealed diffuse metabolic disturbances extending beyond the focal lesion. The most pronounced hypometabolism was observed in the cingulate gyri (z=-4.47), cerebellum (z=-2.29), pons (z=-2.22), and temporal regions (z=-2.18). In contrast, marked hypermetabolism was noted in occipital and parietal regions (z=5.71). These widespread patterns support the concept that brain metastases can result in systemic neurological defects, disrupting mechanisms related to diaschisis, vascular regulation, and immune-mediated pathways. These findings highlight the utility of ¹⁸F-FDG PET/CT in uncovering functional brain alterations not visible on conventional imaging, offering potential value in clinical decision making and disease assessment of melanoma patients with brain metastases.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":" ","pages":"34-38"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From uncertainty to clarity: The evolution of Nuclear Medicine towards precision theranostics and AI-driven digital twins.","authors":"Francesco Giammarile, Diana Paez, Anita Brink, Enrique E Lobato, Miriam Mikhail, Peter Knoll","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Nuclear medicine has progressed from an exploratory discipline, historically constrained by limited spatial resolution and qualitative interpretation, into a rigorously quantitative clinical specialty. This evolution represents a systematic conversion of uncertainty into actionable information. Uncertainty that was once implicit and observer-dependent is increasingly measured, modelled, and managed across the full imaging-therapy continuum. Early tracer work established the foundational diagnostic logic of assessing function before structure. Subsequent instrumentation advances, culminating in the contemporary deployment of long axial field-of-view total-body positron emission tomography (PET) and digital cadmium-zinc-telluride detectors, have compressed spatial ambiguity and enabled true dynamic, multi-organ kinetic modelling. Hybrid imaging further reduced uncertainty by coupling functional signals to anatomical context, while artificial intelligence has emerged as a transformative force, enabling synthetic attenuation correction, automated total tumour volume segmentation, and the deployment of 3D vision-language foundation models for multimodal analysis. Parallel progress in radiochemistry and target biology has shifted tracer development toward highly specific receptor and antigen ligands. This momentum catalysed the theranostics revolution, where diagnostic imaging serves as an explicit, quantitative gatekeeper for radiopharmaceutical therapy. As the field transitions into the \"Alpha-Era\"-characterized by the clinical maturation of targeted alpha therapies-dosimetry and radiobiology have become paramount. To harness this complexity, the discipline is adopting Theranostics Digital Twins, advanced computational frameworks that integrate physiologically-based radiopharmacokinetic models, radiobiological optimizers, and patient-specific multi-omics to predict dose-response and mitigate toxicity. Though modern nuclear medicine has not eliminated biological uncertainty, it has formalized its quantification, establishing a highly personalized and augmented therapeutic paradigm capable of overriding sub-clonal tumour resistance and redefining systemic oncology.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":"29 Suppl ","pages":"16-28"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radioiodine refractory thyroid cancer; Bridging multidisciplinary synergy.","authors":"Georgios Christantoniou, Maria Boudina","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Differentiated thyroid carcinoma (DTC) is the most frequent thyroid malignancy. It consists of papillary (85%), follicular (13%) with subtypes and anaplastic (<2%) thyroid cancer, derived from follicular dedifferentiation. DTC is typically associated with a favorable prognosis. However, a subset of patients progresses to a state of radioiodine (RAI) refractoriness (RAIR), necessitating complex multidisciplinary management. This article explores the diagnostic challenges, prognostic evaluation, and the evolving therapeutic landscape for RAIR-DTC, highlighting the importance of integrated oncology care.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":"29 Suppl ","pages":"111-117"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melanoma: from diagnosis to immunotherapy - The journey through molecular medicine.","authors":"Gerakina I Giannoula, Anastasios L Boutis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Malignant melanoma is one of the most aggressive skin neoplasms and a major example of progress in modern oncology. The objective of this article is to review the most recent therapeutic data and the transition from diagnosis to modern immunotherapy based on a comprehensive review of the current literature and pivotal clinical trials. The results demonstrate that the profound understanding of the relationship between cancer and the immune system, along with the development of immunotherapies (CTLA-4 and PD-1 inhibitors) and targeted therapies (BRAF/MEK inhibitors), have radically changed the therapeutic approach and patient prognosis. Today, a significant number of patients can achieve long-term disease remission, even in advanced stages. Furthermore, modern molecular medicine has highlighted the importance of biomarkers, while neoadjuvant and adjuvant treatments significantly reduce the risk of relapse. In conclusion, the transition from chemotherapy to targeted and immunological therapies marks a new era in oncology, where treatment personalization and the utilization of the immune system itself constitute the core of the modern oncological strategy.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":"29 Suppl ","pages":"130-134"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning models for predicting microvascular invasion in hepatocellular carcinoma with three-dimensional whole-lesion ¹⁸F-FDG PET radiomics.","authors":"Hong Yang, Dinghua Pang, Shilai Zhang, Zhi Yang, Meishe Gan, Linlin Wei, Ning Li, Hongjiao Wei, Guoyou Xiao, Hai Liao","doi":"10.1967/s002449912942","DOIUrl":"10.1967/s002449912942","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the performance of machine learning models based on preoperative three-dimensional whole-lesion radiomics features for predicting microvascular invasion (MVI) in hepatocellular carcinoma (HCC).</p><p><strong>Subjects and methods: </strong>This retrospective study included 106 individuals who underwent preoperative fluorine-18-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) and were pathologically diagnosed with HCC at Guangxi Medical University Cancer Hospital between January 2018 and December 2023. Individuals were randomly assigned to training (n=74) and validation (n=32) sets. A total of 2,016 radiomic features were extracted from three-dimensional whole-lesion PET images. Least absolute shrinkage and selection operator regression combined with recursive feature elimination identified the optimal feature subset. Logistic regression (LR), Light Gradient Boosting Machine (LightGBM), and multilayer perceptron (MLP) models were developed. Model performance in the validation set was evaluated using precision, area under the receiver operating characteristic curve (AUC), and F1-score.</p><p><strong>Results: </strong>Six key radiomic features were selected. In the validation set, the LR model achieved an AUC of 0.703, precision of 0.750, and F1-score of 0.765; the LightGBM model achieved an AUC of 0.654, precision of 0.688, and F1-score of 0.687; and the MLP model achieved an AUC of 0.629, precision of 0.625, and F1-score of 0.625.</p><p><strong>Conclusion: </strong>The LR model demonstrates the best overall performance and shows promise for noninvasive preoperative MVI assessment.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":" ","pages":"16-25"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}