Hellenic journal of nuclear medicine最新文献

{"title":"Clinical value of early-phase ^99mTc-MIBI SPECT in rapid washout parathyroid adenomas.","authors":"Yiğithan Okar, Ceren Uğurlu","doi":"10.1967/s002449912943","DOIUrl":"10.1967/s002449912943","url":null,"abstract":"<p><strong>Objective: </strong>Parathyroid adenomas with rapid tracer washout may be missed on delayed-phase technetium-99m-sestamibi (^99mTc-MIBI) imaging, potentially leading to false-negative localization. This retrospective single-center study evaluated the clinical value of early-phase single photon emission computed tomography (SPECT) compared with delayed-phase SPECT in detecting rapid washout parathyroid adenomas, particularly in centers without access to SPECT/computed tomography (CT), and assessed whether this washout pattern could be predicted by biochemical parameters.</p><p><strong>Subjects and methods: </strong>Eighteen patients with surgically and histopathologically confirmed parathyroid adenomas who underwent dual-phase ^99mTc-MIBI SPECT imaging were included. Early-phase and delayed-phase SPECT images were independently reviewed by two experienced nuclear medicine physicians. Lesion detection rates were compared using McNemar's test, interobserver agreement was assessed using Cohen's kappa coefficient, and preoperative biochemical parameters were compared between adenomas detected only on early-phase imaging and those visible on delayed-phase imaging.</p><p><strong>Results: </strong>Early-phase SPECT enabled detection of all surgically confirmed adenomas, whereas delayed-phase SPECT failed to identify 8 of 18 lesions (44%) due to rapid tracer washout, with a statistically significant difference between the two phases (P<0.01). No significant differences were observed in preoperative biochemical parameters between rapid washout and persistent uptake groups, indicating that early washout could not be reliably predicted clinically. Despite localization being achieved using SPECT without CT correlation, postoperative parathyroid hormone levels normalized in all patients, confirming surgical success. Interobserver agreement was excellent for both imaging phases (κ=1.00).</p><p><strong>Conclusion: </strong>These findings indicate that early-phase ^99mTc-MIBI SPECT significantly improves detection of rapid washout parathyroid adenomas and, as this pattern cannot be anticipated biochemically, its routine inclusion represents a simple and cost-effective strategy with direct relevance for routine clinical practice in centers without SPECT/CT.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":" ","pages":"26-33"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722726","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":"OncoSil - A new radionuclide therapy for pancreatic cancer.","authors":"Christina Fragkaki","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Gastrointestinal cancer, poses a significant global health challenge, encompassing a spectrum of malignancies affecting various parts of the digestive system and account for a substantial portion of cancer-related morbidity and mortality worldwide. Cancers of the digestive tract can develop anywhere between the stomach and the intestinal canal, from the esophagus down to the anus. Most cancers that start in the digestive tract, start in the gland cells lining the gastrointestinal tract - adenocarcinomas. Tumor types such as melanomas, neuroendocrine tumors, gastrointestinal stromal tumors and sarcomas can also occur.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":"29 Suppl ","pages":"13-15"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497394","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":"PSMA PET/CT in contemporary prostate cancer management: From initial staging to biochemical recurrence.","authors":"Emmanouil Panagiotidis, George Angelidis, Filippos Koinis, Varvara Valotassiou, Dimitrios Psimadas, Dimitra Tsivaka, Ioannis Tsougos, Athanasios Kotsakis, Panagiotis Georgoulias","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Prostate-Specific Membrane Antigen (PSMA) PET/CT has rapidly become the preferred first-line imaging modality for primary staging of unfavourable intermediate-risk, high-risk, and very high-risk prostate cancer, and for restaging at biochemical recurrence. The objective of this review is to provide nuclear medicine physicians with a comprehensive and practical framework for PSMA PET/CT interpretation, structured reporting, and clinical decision integration, with emphasis on primary staging evidence, biochemical recurrence (BCR) detection rates, imaging pitfalls, and the PSMA-RADS reporting system.</p><p><strong>Methods: </strong>A narrative review of published evidence was performed, encompassing landmark randomised controlled trials and guideline documents from the EAU, EANM, and NCCN. Key trials reviewed included proPSMA, OSPREY, PRIMARY, CONDOR, and VISION.</p><p><strong>Results: </strong>PSMA PET/CT demonstrated diagnostic accuracy (AUC) of 0.92 versus 0.38 for conventional imaging in primary staging (proPSMA). Detection rates in BCR ranged from 38% at PSA <0.2ng/mL to 97% at PSA >2ng/mL. In a phase 3 RCT, ¹⁸F-PSMA-1007 demonstrated superiority over ¹⁸F-Choline (84% vs 69%, OR 2.53, p<0.001).</p><p><strong>Conclusion: </strong>PSMA PET/CT provides superior staging accuracy, enables detection of recurrence at low PSA levels, guides oligometastasis-directed therapy, and serves as the mandatory gatekeeper for ¹⁷⁷Lu-PSMA-617 theranostic eligibility. Structured reporting using PSMA-RADS and rigorous CT correlation - particularly to exclude unspecific bone uptakes (UBUs) with ¹⁸F-PSMA-1007 - are core professional competencies of the nuclear medicine physician.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":"29 Suppl ","pages":"53-61"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497463","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":"Quantitative imaging in Nuclear Medicine.","authors":"Anastasios Vatalis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Quantitative imaging in nuclear medicine has evolved from simple photon counting to the estimation of absolute physical quantities such as activity concentration. This transition enhances diagnostic accuracy and supports personalized treatment planning. The present work reviews the principles of quantitative imaging in SPECT and PET, highlighting major degrading factors and correction techniques. Emphasis is placed on clinical applications including dosimetry, theranostics, and functional organ assessment, as well as on dynamic imaging approaches. Finally, current developments and future perspectives toward standardized and automated quantification are discussed.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":"29 Suppl ","pages":"92-95"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497497","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":"Theranostics of prostate cancer: PSMA and new targets.","authors":"Dimitrios Priftakis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of this presentation is to transfer the experience of the Institute of Nuclear Medicine at University College London Hospital with prostate cancer theranostics as a leading clinical and academic centre in the UK as well as to open a discussion on the current state and potential future developments in this field.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":"29 Suppl ","pages":"75-80"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497506","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":"An auxiliary ¹⁸F-FDG uptake pattern clarifying equivocal adrenal gland mass after dual-tracer imaging with ¹²³I-mIBG SPECT/CT and ¹⁸F-FDG PET/CT.","authors":"Emil Novruzov, Sandra Jaschinski, Irene Esposito, Gerald Antoch, Alexandra Ljimani, Eduards Mamlins, Frederik L Giesel","doi":"10.1967/s002449912949","DOIUrl":"10.1967/s002449912949","url":null,"abstract":"<p><p>Pheochromocytomas are rare catecholamine-producing neuroendocrine tumors arising from the adrenal medulla. Several studies have reported activation of brown adipose tissue (BAT) in up to 30% of patients with pheochromocytoma. Brown adipose tissue is characterized by abundant mitochondria to provide heat generation rather than energy storage. Pheochromocytoma seems to act on BAT via two parallel mechanisms. These include the trans-differentiation of white to brown adipocyte as well as the hypertrophy of existing brown adipocytes and increased glucose uptake by noradrenergic (β-AR) sympathetic nervous system stimulation.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":" ","pages":"52-53"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722673","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":"The role of ¹⁸F-FDG PET/CT in the imaging of patients with breast cancer.","authors":"Evangelia Skoura","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Diagnosis of the Primary Tumor In initial diagnosis, ¹⁸F-FDG PET/CT has questionable clinical value and, for this reason, is not used in routine practice to evaluate potential primary breast tumors. It has low sensitivity but high positive predictive value (PPV) (PPV 81%-100%). So, if increased uptake is found on ¹⁸F-FDG PET/CT in a breast lesion as an incidental finding, there is a high probability that it is due to malignancy. The sensitivity of ¹⁸F-FDG PET/CT depends on tumor size, histological type (invasive ductal carcinoma has a higher SUVmax than lobular carcinoma, and hormone receptor expression.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":"29 Suppl ","pages":"84-86"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497574","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":"Multiple metastatic small cell carcinoma with extensive tumor thrombosis in the inferior mesenteric vein on ¹⁸F-FDG PET/CT.","authors":"Junjun Cheng, Xiaohong Ou","doi":"10.1967/s002449912947","DOIUrl":"10.1967/s002449912947","url":null,"abstract":"<p><p>The presence of intravascular tumor thrombus alters the staging, prognosis, and treatment paradigms of cancer patients. It most commonly complicates renal cell carcinoma, adrenocortical carcinoma, and hepatocellular carcinoma. Small cell carcinoma is a highly aggressive malignant neoplasm; however, venous tumor thrombus associated with small cell carcinoma is extremely rare. Herein, we report the fluorine-18-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) findings in an 87-year-old woman presenting with diffuse metastatic small cell carcinoma and superior mesenteric vein tumor thrombosis.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":" ","pages":"48-49"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722681","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":"Quantitative bone SPECT/CT useful for selecting medical or surgery treatment in heterotopic ossification.","authors":"Kazuhiro Kitajima, Takayuki Kawaguchi, Toshiya Tachibana, Rika Yoshida, Yukihisa Tamaki, Masakatsu Tsurusaki, Koichiro Yamakado","doi":"10.1967/s002449912941","DOIUrl":"10.1967/s002449912941","url":null,"abstract":"<p><strong>Objective: </strong>Mature lamellar bone formation in extra-skeletal soft tissue is termed heterotopic ossification (HO). Surgical resection of HO is performed to preserve joint mobility, though timing is very important, as resection prior to HO maturation very often results in incomplete or inadequate excision, leading to recurrence. The present study was conducted to evaluate whether standardized uptake values (SUV) derived from quantitative bone single-photon emission computed tomography/computed tomography (SPECT/CT) are useful for assessing HO maturity and determining the appropriate timing of surgical resection.</p><p><strong>Subjects and methods: </strong>Eleven quantitative bone SPECT/CT scans from six patients with HO were analyzed.</p><p><strong>Results: </strong>Four of the patients with a total of 10 lesions received medical treatment (bisphosphonates), and their mean SUVmax, SUVpeak, SUVmean, metabolic bone volume (MBV), and total bone uptake (TBU) values were 13.12±12.39 (range 4.41-44.35), 11.81±11.27 (4.12-40.53), 7.64±7.16 (3.02-26.05), 81.83±111.02 (15.68-290.64), and 781.30±1,301.78 (61.87-3,301.87), respectively. The two patients who underwent surgery had a total of two lesions and those mean values in those cases were 3.21±1.67 (2.03, 4.39), 2.99±1.65 (1.82, 4.15), 2.22±1.27 (1.32, 3.11), 6.77±2.21 (5.2, 8.33), and 16.39±13.46 (6.87, 25.9), respectively. Two who were evaluated with use of serial bone SPECT/CT scanning for assessment of medical treatment response showed a gradual decrease in SUV, reflecting the effectiveness of bisphosphonate therapy (SUVmax 9.01-8.94-6.11-5.37 and 6.93-5.93-4.41, respectively).</p><p><strong>Conclusion: </strong>Standardized uptake value derived from quantitative bone SPECT/CT scanning is useful for monitoring HO metabolic activity and determining the appropriate timing of surgical resection.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":" ","pages":"10-15"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722720","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":"Metabolic changes in reticuloendothelial system following Tisagenlecleucel chimeric antigen receptor T cell (CAR-T) therapy using ¹⁸F-FDG PET/CT.","authors":"Shashi B Singh, Om H Gandhi, Cameron Haghshenas, Bimash B Shrestha, Malia Ahmed, Jaskeerat Gujral, Saira Khan Niazi, Kishor Khanal, Rajshree Singh, Niloofaralsadat Motamedi, Miraziz Ismoilov, Cyrus Ayubcha, Sahith Valluru, Navpreet Khurana, Patrick Glennan, Vanessa Shehu, Thomas J Werner, Mona E Revheim, Abass Alavi","doi":"10.1967/s002449912940","DOIUrl":"10.1967/s002449912940","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate changes in metabolic activity in lymphoma adenopathy and other reticuloendothelial organs-bone marrow, spleen, and liver, in patients with diffuse large B-cell lymphoma (DLBCL) following Tisagenlecleucel therapy, using fluorine-18-fluorodeoxyglucse (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT).</p><p><strong>Materials and methods: </strong>Fluorine-18-FDG-PET/CT scans from 41 DLBCL patients (25 males, 16 females; age: 59.15±13.78, range: 29-81 years) treated with Tisagenlecleucel were retrospectively analyzed. Metabolic activity was quantified in lymphoma adenopathy, bone marrow, spleen, and liver at baseline and post-treatment, with a mean interval of 121.2±63.9 days (range: 35-437 days) between scans. The partial volume-corrected total lesion glycolysis (pvcTLG) and total metabolic tumor volume (TMTV) for lymphoma adenopathy, and average mean standardized uptake value (SUVmean) for bone marrow before and after treatment, were compared using the Wilcoxon signed-rank test, whereas the average SUVmean of spleen and liver was compared using a two-tailed paired t-test.</p><p><strong>Results: </strong>Fluorine-18-FDG PET/CT showed significant reductions in metabolic activity of lymphoma adenopathy, bone marrow, and spleen after treatment. For lymphoma adenopathy, pvcTLG decreased from 539.22±831.00 to 491.27±1068.35 (P<0.001), with reduction observed in 80.5% of patients, and TMTV decreased from 46.06±63.07 to 30.40±41.62 (P<0.001). Mean SUV of bone marrow and spleen decreased significantly from 1.31±0.37 to 1.16±0.33 (P=0.002), and from 1.96±0.68 to 1.77±0.45 (P=0.017), respectively. However, hepatic SUVmean showed no statistically significant changes from 2.30±0.42 to 2.31±0.40 (P=0.21).</p><p><strong>Conclusion: </strong>Fluorine-18-FDG PET/CT demonstrated a decrease in metabolic activity of lymphoma adenopathy, bone marrow, and spleen, after tisagenlecleucel therapy. However, changes in the liver were not statistically significant. These findings suggest that Tisagenlecleucel chimeric antigen receptor T cell (CAR-T) therapy induces a broad systemic metabolic response within the reticuloendothelial system.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":" ","pages":"2-9"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722658","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}