Journal of nuclear medicine technology最新文献

{"title":"Phase I Study of ⁶⁸Ga-NOTA-HL for PET/CT Imaging of Hepatic Asialoglycoprotein Receptors in Healthy Volunteers.","authors":"Ching-Liang Kuo, Rhoh-Fang Yen, Yao-Ming Wu, Mei-Hui Wang","doi":"10.2967/jnmt.124.268430","DOIUrl":"https://doi.org/10.2967/jnmt.124.268430","url":null,"abstract":"<p><p>This study investigated the safety, biodistribution, and dosimetry of ⁶⁸Ga-hexavalent lactoside (⁶⁸Ga-NOTA-HL), a PET tracer targeting asialoglycoprotein receptors (ASGPRs) on hepatocytes. ASGPRs, key for glycoprotein homeostasis, serve as a valuable biomarker of liver function. ⁶⁸Ga-NOTA-HL demonstrated excellent safety in 12 healthy volunteers with no adverse events. Biodistribution studies revealed high liver uptake with minimal uptake in other organs, consistent with ASGPR targeting. The effective dose was 0.0289 mSv/MBq, indicating low radiation exposure. These findings suggest ⁶⁸Ga-NOTA-HL PET/CT holds significant promise as a safe and effective imaging technique for assessing liver function. The high liver specificity and extremely low background activity provide a strong foundation for further clinical investigations into its potential for evaluating liver function in various clinical settings, including the assessment of liver reserve in patients with liver diseases.</p>","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Large Language Models' Performance on 600 Nuclear Medicine Technology Board Examination-Style Questions.","authors":"Michael A Oumano, Shawn M Pickett","doi":"10.2967/jnmt.124.269335","DOIUrl":"https://doi.org/10.2967/jnmt.124.269335","url":null,"abstract":"<p><p>This study investigated the application of large language models (LLMs) with and without retrieval-augmented generation (RAG) in nuclear medicine, particularly their performance across various topics relevant to the field, to evaluate their potential use as reliable tools for professional education and clinical decision-making. <b>Methods:</b> We evaluated the performance of LLMs, including the OpenAI GPT-4o series, Google Gemini, Cohere, Anthropic, and Meta Llama3, across 15 nuclear medicine topics. The models' accuracy was assessed using a set of 600 sample questions, covering a range of clinical and technical domains in nuclear medicine. Overall accuracy was measured by averaging performance across these topics. Additional performance comparisons were conducted across individual models. <b>Results:</b> OpenAI's models, particularly openai_nvidia_gpt-4o_final and openai_mxbai_gpt-4o_final, demonstrated the highest overall accuracy, achieving scores of 0.787 and 0.783, respectively, when RAG was implemented. Anthropic Opus and Google Gemini 1.5 Pro followed closely, with competitive overall accuracy scores of 0.773 and 0.750 with RAG. Cohere and Llama3 models showed more variability in performance, with the Llama3 ollama_llama3 model (without RAG) achieving the lowest accuracy. Discrepancies were noted in question interpretation, particularly in complex clinical guidelines and imaging-based queries. <b>Conclusion:</b> LLMs show promising potential in nuclear medicine, improving diagnostic accuracy, especially in areas like radiation safety and skeletal system scintigraphy. This study also demonstrates that adding a RAG workflow can increase the accuracy of an off-the-shelf model. However, challenges persist in handling nuanced guidelines and visual data, emphasizing the need for further optimization in LLMs for medical applications.</p>","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Adenocarcinoma Revealed by Parathyroid Scintigraphy: An Incidental Case to Remember.","authors":"Patricia M Udholm, Søren Møller","doi":"10.2967/jnmt.125.269484","DOIUrl":"https://doi.org/10.2967/jnmt.125.269484","url":null,"abstract":"<p><p>A 70-y-old woman was referred for a dual-isotope subtraction scintigraphy with ¹²³I and ^99mTc-sestamibi in combination with SPECT/CT and ultrasound for the localization of parathyroid adenoma. Aside from a possible parathyroid adenoma, the SPECT/CT scan showed increased and focal ^99mTc-sestamibi uptake in the right upper lung. A biopsy revealed a primary non-small cell lung adenocarcinoma. Nonparathyroid findings during parathyroid scintigraphy are frequent and can lead to newly diagnosed malignant or premalignant lesions, providing an important opportunity to optimize treatment.</p>","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early 10-Minute Postinjection [¹⁸F]F-FAPI-42 uEXPLORER Total-Body PET/CT Scanning Protocol for Staging Lung Cancer Using HYPER Iterative Reconstruction.","authors":"Hanyun Yang, Lijuan Wang, Ganghua Tang, Wenlan Zhou, Ying Tian, Yin Zhang, Yanchao Huang, Li Chen, Meng Wang, Yanjiang Han, Hubing Wu","doi":"10.2967/jnmt.125.269735","DOIUrl":"https://doi.org/10.2967/jnmt.125.269735","url":null,"abstract":"<p><p>Sensitive detection of small metastatic lesions, which is highly dependent on lesion visualization, is crucial for staging lung cancer. We investigated the potential benefit of HYPER Iterative for improving the visualization of small metastatic lesions of lung cancer on early ¹⁸F-labeled fibroblast activation protein inhibitor (FAPI) PET/CT. <b>Methods:</b> A total of 19 patients with lung cancer underwent a 60-min [¹⁸F]F-FAPI-42 dynamic total-body uEXPLORER PET/CT scan. PET images with a 5-min acquisition time were extracted at 10, 30 min, and 60 min after tracer injection. Ordered-subset expectation maximization (OSEM) and HYPER Iterative were used for image reconstruction. SUV_max, tumor-to-liver ratio, tumor-to-blood ratio, and tumor-to-adjacent-nontumor ratio were calculated and compared between the 2 reconstruction methods and at 10, 30, and 60 min after injection. <b>Results:</b> All HYPER and OSEM PET images were of high quality, with HYPER PET images showing superior clarity. Small positive lesions (maximum diameter, ≤1 cm) were depicted clearer on HYPER PET than on OSEM PET images at all time points, particularly at 10 min after injection, where 16.4% of lesions were poorly visualized on OSEM PET but clearly depicted on HYPER PET images. The tumor-to-liver ratio, tumor-to-blood ratio, and tumor-to-nontumor ratio at 10, 30, and 60 min after injection scan on HYPER PET images were significantly higher than those on OSEM images at corresponding time points (<i>P</i> ≥ 0.05 for all comparisons). SUV_max was more than 2-fold greater in large positive lesions (maximum diameter, >1.0 cm) than in small positive lesions (maximum diameter, ≤1 cm) on both OSEM and HYPER PET images at 10, 30, and 60 min after injection (<i>P</i> < 0.05 for all comparisons). The visualization of large positive lesions was not significantly affected by reconstruction methods or scan times. <b>Conclusion:</b> HYPER Iterative reconstruction enhanced the visualization of small metastatic lesions in lung cancer when compared with conventional OSEM, enabling effective early imaging using [¹⁸F]F-FAPI-42 uEXPLORER total-body PET/CT at 10 min after tracer injection.</p>","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial Sympathetic Innervation Imaging.","authors":"Justin G Peacock, Mary Beth Farrell","doi":"10.2967/jnmt.125.270093","DOIUrl":"https://doi.org/10.2967/jnmt.125.270093","url":null,"abstract":"","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct Correlation of Tumor Absorbed Dose with Overall Survival in Metastatic Castration-Resistant Prostate Cancer Treated with ¹⁷⁷Lu Prostate-Specific Membrane Antigen.","authors":"Yung Hsiang Kao","doi":"10.2967/jnmt.125.269658","DOIUrl":"https://doi.org/10.2967/jnmt.125.269658","url":null,"abstract":"<p><p>In systemic radiopharmaceutical therapy, a direct dosimetric correlation between the tumor absorbed dose and overall survival, that is, Grays to months, has never been explicitly defined. This dosimetric analysis expounds this relationship in the context of metastatic castration-resistant prostate cancer treated with ¹⁷⁷Lu prostate-specific membrane antigen (¹⁷⁷Lu-PSMA). <b>Methods:</b> The average tumor absorbed dose per unit of administered activity from the first to sixth treatments was extrapolated from population data. This was used to calculate the cumulative tumor absorbed doses above the response threshold for 2 empiric randomized ¹⁷⁷Lu-PSMA clinical trials (VISION and TheraP). This was correlated to the difference in overall survival between these 2 trials to derive the tumor absorbed dose-survival relationship. This result was used to calculate the overall survival for a hypothetical optimized first strike in the context of personalized predictive dosimetry. <b>Results:</b> The tumor absorbed dose-survival relationship is calculated to be approximately 1 mo of overall survival per 1 Gy above the response threshold. An optimized first strike can double the overall survival compared with empiric regimens, delivers a higher cumulative tumor absorbed dose in fewer treatments, and avoids futile whole-body irradiation. Overall survival is proportional to the area bounded by the tumor absorbed dose curve and the response threshold absorbed dose curve. This suggests that, in addition to an optimized first strike, overall survival may also be improved by the concurrent administration of other systemic agents that modify tumor radiobiology to lower the response threshold, such as radiosensitization. <b>Conclusion:</b> Dosimetric evidence advocates for personalized prescription based on predictive dosimetry to optimize overall survival by exploiting radiobiologic synergy between the first strike and tumor radiosensitization.</p>","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Sensitivity Troponin Elevation in a Young Woman with Typical Chest Pain: The Heart of the Matter.","authors":"Rahul Annabathula, Wengen Chen, Scott Jerome","doi":"10.2967/jnmt.125.269733","DOIUrl":"https://doi.org/10.2967/jnmt.125.269733","url":null,"abstract":"<p><p>In the era of high-sensitivity troponin, minor elevations are often attributed to noncardiac etiologies. However, in patients who present with characteristic symptoms, any troponin elevation is concerning. We detail a case of a 37-y-old woman who presented to an outside hospital with typical chest pain and had a mild elevation in high-sensitivity troponin. Given her overall stability, she was discharged with outpatient cardiology follow-up. ⁸²Rb PET/CT myocardial perfusion imaging test demonstrated a large, reversible anteroseptal perfusion defect. Coronary angiography revealed severe (80%) stenosis in the proximal left anterior descending artery treated with a single stent. This case highlights the need to have a high index of suspicion in young people with minor troponin elevations and pursue timely imaging.</p>","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prominent Right Ventricular Tracer Uptake: A Harbinger of Multivessel Coronary Artery Disease.","authors":"Adam Adam, Saurabh Malhotra","doi":"10.2967/jnmt.125.270002","DOIUrl":"https://doi.org/10.2967/jnmt.125.270002","url":null,"abstract":"<p><p>A 65-y-old woman with multiple cardiovascular risk factors presented with atypical chest pain, prompting a 1-d pharmacologic stress myocardial perfusion test using ^99mTc sestamibi. Initial interpretation suggested ischemia, but closer inspection revealed increased right ventricular uptake and increased left ventricular chamber size at stress, indicative of significant 3-vessel coronary artery disease (CAD). These findings were confirmed by cardiac catheterization, showing 3-vessel disease, including significant left main CAD. The patient underwent coronary artery bypass graft surgery. This case highlights the importance of meticulous SPECT image interpretation, particularly focusing on right ventricular uptake and transient ischemic dilation, to accurately diagnose severe CAD and improve cardiovascular outcomes.</p>","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single- Versus Dual-Time-Point Imaging for Transthyretin Cardiac Amyloid Using ^99mTc-Pyrophosphate.","authors":"Wesley Ng, Kunthi Pathmaraj, Natalia Kovaleva, Aurora Poon, Peter Kench, Steven Meikle, Andrew Scott, Raef Boktor","doi":"10.2967/jnmt.124.269395","DOIUrl":"https://doi.org/10.2967/jnmt.124.269395","url":null,"abstract":"<p><p>Nuclear medicine scintigraphy using ^99mTc-pyrophosphate has proven valuable in the diagnosis of cardiac transthyretin amyloidosis in recent years. However, there is still confusion over the optimal imaging time points. The American Society of Nuclear Cardiology has recommended different imaging time points over the last decade. We aimed to determine whether single- or dual-time-point imaging is required for reporting purposes and which time point would be the most appropriate if a single time point was to be considered. <b>Methods:</b> Cardiac amyloid scans using ^99mTc-pyrophosphate acquired from 2017 to 2023 were retrieved from our Picture Archiving and Communications System. Scans with static views and SPECT/CT images of the chest for both imaging time points, at 1 h (early) and 3 h (delayed) after injection, were included. Each study was independently read by 3 nuclear medicine physicians. Original clinical reports using both imaging time points were used as a reference to calculate the accuracy of a single time point. <b>Results:</b> In total, 70 patients were included in this study. Reports of cardiac amyloid studies using any single-time-point imaging were highly sensitive, accurate, and specific. There was agreement among all readers. Of the 140 datasets reported by each reader, 4 scans were classified as equivocal, requiring more imaging for confident reporting. <b>Conclusion:</b> Single-time-point imaging showed an accuracy comparable to the dual-time-point imaging in diagnosing cardiac transthyretin amyloidosis. This was further validated by agreement among the 3 readers. Early time-point imaging is preferred, and additional delayed imaging can be acquired when the early result is equivocal.</p>","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Motion During Cardiac PET Imaging.","authors":"Sunil R Selvin, Erin Stevens, Mary Beth Farrell, Gary V Heller","doi":"10.2967/jnmt.125.269911","DOIUrl":"https://doi.org/10.2967/jnmt.125.269911","url":null,"abstract":"<p><p>Cardiac PET imaging is increasingly used for myocardial perfusion studies because of its high diagnostic accuracy and low radiation exposure to the patient. However, patient motion can be challenging, affecting a large number of studies. Motion artifacts can lead to inconclusive or false-positive results, complicating clinical interpretation. This article explores the causes of motion artifacts and their characteristic appearance in cardiac PET imaging, highlighting their distinction from true perfusion abnormalities. Strategies for minimizing motion through effective patient positioning and communication are discussed. Understanding and addressing motion artifacts are crucial for optimizing diagnostic accuracy and ensuring the full benefit of cardiac PET imaging.</p>","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}