Journal of nuclear medicine technology最新文献

{"title":"Prostate Cancer, Part 1: Contemporary Radioligands.","authors":"Geoffrey M Currie, Eric M Rohren","doi":"10.2967/jnmt.125.271978","DOIUrl":"10.2967/jnmt.125.271978","url":null,"abstract":"<p><p>Prostate cancer is one of the most prevalent malignancies in men and remains a leading cause of cancer-related morbidity and mortality worldwide. For many, prostate cancer follows an indolent course, while others demonstrate aggressive biologic behavior. This highlights the importance of early detection, accurate staging, and biologically informed treatment selection. Nuclear medicine plays a central role in the contemporary management of prostate cancer, providing molecular insights that extend beyond anatomy to interrogate tumor metabolism, proliferation, hypoxia, stromal interactions, and receptor expression. These biologic dimensions are the foundation of both diagnostic imaging and targeted radionuclide therapy. This article provides a biologically structured overview of contemporary non-prostate-specific membrane antigen (PSMA) radiopharmaceuticals used in prostate cancer imaging and therapy, emphasizing the molecular and cellular mechanisms that determine their suitability for diagnostic, therapeutic, or theranostic application. Key determinants of radioligand performance are explored, including physical radionuclide properties, radiochemical stability, molecular internalization and retention, and pharmacologic biodistribution. These factors explain why imaging and therapeutic ligands, although conceptually linked, are not interchangeable and must be carefully matched to biologic behavior and clinical intent. Major biologic imaging pathways relevant to prostate cancer, including glycolytic metabolism, hypoxia, lipid and phospholipid synthesis, amino acid transport and protein synthesis, nucleoside metabolism, androgen receptor signaling, fibroblast activation protein targeting, and skeletal metastasis imaging are reviewed. For each pathway, the molecular rationale for tracer uptake, strengths, and limitations in prostate cancer phenotypes and implications for prognosis and therapy selection are outlined. Importantly, prostate cancer is not a single-pathway disease. Tumor heterogeneity, metabolic plasticity, and microenvironmental adaptation, particularly in castration-resistant disease, necessitate a broader molecular imaging perspective beyond PSMA alone. Although PSMA-targeted imaging and therapy have become clinical mainstays, non-PSMA radioligands retain critical complementary roles in selected clinical scenarios, translational research, and therapy development. This article provides a biologically grounded framework for understanding contemporary prostate cancer radioligands and establishes the foundation for part 2 of this series, which will focus on PSMA-based and emerging molecular strategies shaping the future of prostate cancer theranostics.</p>","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":" ","pages":"127-135"},"PeriodicalIF":1.3,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673938","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":"Prostate Cancer, Part 2: PSMA and Beyond.","authors":"Geoffrey M Currie, Eric M Rohren","doi":"10.2967/jnmt.125.271979","DOIUrl":"10.2967/jnmt.125.271979","url":null,"abstract":"<p><p>Prostate-specific membrane antigen (PSMA) has fundamentally reshaped prostate cancer imaging and therapy, delivering an unprecedented combination of high lesion conspicuity, broad clinical applicability, and direct theranostic linkage between molecular imaging and radionuclide treatment. Building on the broader non-PSMA radioligand landscape reviewed in part 1, this companion article focuses on PSMA biology, the mechanistic basis for PSMA radiopharmaceutical performance, and emerging molecular strategies that address heterogeneity, treatment resistance, and access constraints. This article summarizes contemporary PSMA PET agents and PSMA-directed radioligand therapy, highlighting how chelator chemistry, linker design, and accessory binding sites influence pharmacokinetics, affinity, internalization, and suitability for imaging versus therapy. β-emitting therapy with ¹⁷⁷Lu-PSMA-617 is supported by high-level evidence and regulatory approvals, demonstrating improved progression-free and overall survival in metastatic castration-resistant prostate cancer. In parallel, α-emitting strategies such as ²²⁵Ac-PSMA exploit high linear energy transfer and short path length to treat micrometastatic and radioresistant disease, including post-β-therapy progression, but are constrained by toxicity risk, daughter redistribution, complex dosimetry, and limited radionuclide supply. Emerging radionuclides and ligand-engineering approaches are discussed as routes to improve tumor retention, enable true theranostic pairing, and expand global feasibility. The next wave of strategies that broaden molecular coverage beyond PSMA alone, including gastrin-releasing peptide receptor- and fibroblast activation protein-targeted agents and dual-target heterodimers, designed to address inter- and intrapatient heterogeneity and PSMA-insufficient disease, are also outlined. These advances shift prostate cancer theranostics from a single-target paradigm toward a more nuanced ecosystem requiring rational selection, sequencing, and personalization of radioligand choice across the disease continuum.</p>","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":" ","pages":"136-143"},"PeriodicalIF":1.3,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774252","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":"Prostate Imaging-PET: ¹⁸F-Fluciclovine (Axumin).","authors":"Mary Beth Farrell, Kathy S Thomas, Eleanor S Mantel, Jessica Settle","doi":"10.2967/jnmt.126.272483","DOIUrl":"10.2967/jnmt.126.272483","url":null,"abstract":"","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":" ","pages":"164-165"},"PeriodicalIF":1.3,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592820","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":"A Year of Growth, Change, and Momentum.","authors":"Cybil J Nielsen","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":"54 2","pages":"7A-8A"},"PeriodicalIF":1.3,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156573","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":"Prostate Cancer: Staging, Progression, and Treatment.","authors":"Nicole LaBrecque, Alexia Romano, Jared LeBlanc, David Gilmore","doi":"10.2967/jnmt.126.272212","DOIUrl":"10.2967/jnmt.126.272212","url":null,"abstract":"<p><p>Although prostate cancer has traditionally been regarded as a disease of older men, emerging evidence suggests a shift toward diagnosis at younger ages. Increased prostate-specific antigen screening has been proposed as a contributing factor to the rising rate of prostate cancer in younger men. There is no single laboratory test that can conclude a prostate cancer diagnosis; however, there is evidence that a higher prostate-specific antigen level can signify a higher likelihood of prostate cancer. Treatment of prostate cancer is dependent on disease stage, risk category, symptoms, age, comorbidities, and patient preferences; thus, management of the disease can vary. When discussing cancer, especially prostate cancer, staging is a vital step in the diagnosis and evaluation of the disease. Imaging and assessment tools used in the staging process of a prostate cancer diagnosis and treatment management include CT, MRI, nuclear medicine bone scans, PSMA PET/CT, and Gleason score assessment.</p>","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":"54 2","pages":"121-126"},"PeriodicalIF":1.3,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156829","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":"Prostate Cancer: We've Come a Long Way.","authors":"Jennifer Prekeges","doi":"10.2967/jnmt.126.272544","DOIUrl":"https://doi.org/10.2967/jnmt.126.272544","url":null,"abstract":"","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":"54 2","pages":"111-112"},"PeriodicalIF":1.3,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156837","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":"Prostate Imaging-PET: ¹⁸F-Flotufolastat (Posluma).","authors":"Mary Beth Farrell, Kathy S Thomas, Eleanor S Mantel, Jessica Settle","doi":"10.2967/jnmt.126.272486","DOIUrl":"10.2967/jnmt.126.272486","url":null,"abstract":"","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":" ","pages":"162-163"},"PeriodicalIF":1.3,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592854","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":"Integration of PSMA PET into the New Recommendations from Prostate Cancer Working Group 4 for Prostate Cancer Trials.","authors":"Phillip H Kuo, Michael J Morris","doi":"10.2967/jnmt.126.272507","DOIUrl":"10.2967/jnmt.126.272507","url":null,"abstract":"<p><p>The Prostate Cancer Working Group 4 guidelines (PCWG4) represent a significant evolution in the framework used to evaluate prostate cancer progression and treatment response in clinical trials. Building on the foundations established by the Prostate Cancer Working Group 3, PCWG4 incorporates advances in imaging technologies, particularly prostate-specific membrane antigen (PSMA) PET, and introduces updated terminology. This review summarizes the updates and additions to PCWG4 guidelines as well as the rationales underpinning these changes. Key developments include replacement of traditional \"castration-sensitive\" and \"castration-resistant\" terminology with androgen pathway modulation-based classifications, incorporation of PSMA PET throughout the disease continuum, and further refinement of conventional imaging response criteria. Although conventional imaging modalities such as CT, MRI, and bone scintigraphy remain validated endpoints for regulatory purposes, PSMA PET is increasingly integrated into clinical trial frameworks as noninvestigational for staging and recurrence and as an investigational modality for response assessment. The PCWG4 framework emphasizes standardized visual evaluation, careful classification of new metastatic lesions, and systematic data collection to support future validation of PSMA PET as a clinical trial endpoint. These updates aim to improve the accuracy of disease characterization, facilitate biomarker-driven therapeutic evaluation, and lay the groundwork for further methodologic advancements anticipated in future iterations of the guidelines.</p>","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":"54 2","pages":"168-172"},"PeriodicalIF":1.3,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156486","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":"Transforming Challenges into Training Resources: Establishing a Sustainable FDG Production System with Radiology Technologist Education.","authors":"Hiroshi Yamaguchi","doi":"10.2967/jnmt.125.271428","DOIUrl":"10.2967/jnmt.125.271428","url":null,"abstract":"<p><p>In-house production of FDG is increasingly necessary to ensure a stable supply of PET tracers. However, the establishment of new production facilities is often accompanied by unforeseen technical challenges. Transforming such challenges into educational experiences may play an important role in developing skilled radiology technologists. In-house FDG production training that incorporates real-world troubleshooting cases fosters skilled and confident technologists. This study aimed to evaluate the effectiveness of an educational approach that integrates real-world troubleshooting experiences encountered during the establishment of an FDG production system into training for radiology technologists. <b>Methods:</b> At our newly launched theranostics center, 4 radiology technologists were trained to perform FDG synthesis using a cyclotron and an automated synthesis module. Challenges encountered in the early phase (e.g., cassette-loading errors, errors in gas supply operation, mistakes in handling reagents) were systematically documented. These cases were incorporated into training manuals, simulation sessions, and on-site drills. Educational outcomes were evaluated qualitatively through feedback, competency assessments, and operational stability. Radiation exposure was monitored as a supplemental safety measure. <b>Results:</b> The documentation and sharing of early-stage troubleshooting cases facilitated the development of practical manuals and scenario-based simulations for FDG production. Radiology technologists demonstrated improved confidence and decision-making in handling synthesis tasks. The FDG production process achieved stable operation within several months. Occupational doses for technologists remained well below regulatory limits, supporting the safety of the training approach. <b>Conclusion:</b> Educational use of early troubleshooting experiences effectively enhanced radiology technologists' competencies in FDG production. This strategy provides a sustainable model for workforce development in nuclear medicine facilities worldwide.</p>","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":" ","pages":"207-209"},"PeriodicalIF":1.3,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157394","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":"Prostate Anatomy: What Is Relevant for a Nuclear Medicine Practitioner.","authors":"Juliana H Kim, Michelle Mao, Abtin Doroudinia, Patrick M Colletti","doi":"10.2967/jnmt.126.272229","DOIUrl":"10.2967/jnmt.126.272229","url":null,"abstract":"<p><p>PSMA PET has become central to prostate cancer imaging as advanced disease incidence rises and prostate-specific membrane antigen (PSMA)-targeted theranostics expand clinical use, yet accurate interpretation requires an understanding of prostate anatomy and physiology that extends beyond rote imaging patterns. Here we review prostate zonal anatomy, multimodality imaging features from ultrasound, multiparametric MRI, and PSMA PET/CT, and the underlying biology of PSMA expression, and androgen receptor signaling, and tumor dedifferentiation. We highlight physiologic and pathologic variations in PSMA uptake, common diagnostic pitfalls, and characteristic imaging changes after androgen-deprivation therapy, radiation, and prostatectomy. By relating anatomy, molecular physiology, and treatment effects to PSMA PET findings, this article provides nuclear medicine practitioners with a practical foundation to improve diagnostic accuracy and optimize patient selection for PSMA-based imaging and therapy.</p>","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":"54 2","pages":"114-120"},"PeriodicalIF":1.3,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156507","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}