Nuclear Medicine and Molecular Imaging最新文献

{"title":"The Role of Serum Thyroglobulin Doubling Time in Predicting Recurrences/Metastasis on ¹⁸F-FDG PET/CT and Prognosis of Differentiated Thyroid Cancer Patients with High Thyroglobulin and Negative Whole-Body Radioactive Iodine Scintigraphy.","authors":"Nguyen Thi Phuong, Mai Hong Son, Nong Thanh Ha, Chu Khanh Linh, Le Ngoc Ha","doi":"10.1007/s13139-025-00912-6","DOIUrl":"10.1007/s13139-025-00912-6","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the value of thyroglobulin doubling time (Tg-DT) in predicting ¹⁸F-FDG PET/CT findings and clinical outcomes in differentiated thyroid cancer (DTC) patients with high thyroglobulin (Tg) level and negative ¹³¹I whole-body scan (¹³¹I WBS).</p><p><strong>Materials and methods: </strong>188 DTC patients with Tg levels ≥ 10 ng/ml and negative ¹³¹I WBS underwent ¹⁸F-FDG PET/CT scan. Three last consecutive values of unstimulated Tg were used to calculate Tg doubling time (Tg-DT). ROC curve analysis was performed to determine the optimal thresholds of Tg-DT in predicting ¹⁸F-FDG PET/CT results. Patients were followed up for at least 12 months after PET/CT scan. The Kaplan-Meier curve was used to estimate progression-free survival (PFS) and overall survival (OS). Cox regression analyses were conducted to identify factors significantly associated with PFS and OS.</p><p><strong>Results: </strong>The specificity and positive predictive value of Tg-DT for predicting ¹⁸F-FDG PET/CT findings were 93.94%, and 92.6%, respectively, while those for Tg levels were 78.79% and 83.53% (<i>p</i> < 0.001). This study revealed that stimulated Tg and Tg-DT can predict disease progression and survival in DTC patients. Age > 55, distant metastasis on ¹⁸F-FDG PET/CT, and Tg-DT ≤ 12 months were independent predictors of PFS. Distant metastasis and Tg-DT ≤ 12 months were independent prognostic factors for OS.</p><p><strong>Conclusion: </strong>Tg-DT is a valuable biomarker in predicting positive ¹⁸F-FDG PET/CT findings in DTC patients with high Tg level and negative ¹³¹I WBS. Along with distant metastases, Tg-DT ≤ 12 months is the only independent prognostic factor for PFS and OS.</p>","PeriodicalId":19384,"journal":{"name":"Nuclear Medicine and Molecular Imaging","volume":"59 4","pages":"246-254"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Score as a Predictive Marker in Intermediate-Risk Prostate Cancer: Insights from PSMA PET/CT Imaging.","authors":"Laura Evangelista, Lorenzo Muraglia, Priscilla Guglielmo, Roberta Zanca, Carlo Vallone, Jelena Jandric, Demetrio Aricò, Nicolò Buffi, Giovanni Lughezzani","doi":"10.1007/s13139-025-00920-6","DOIUrl":"https://doi.org/10.1007/s13139-025-00920-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine whether the PRIMARY Score on prostate specific membrane antigen (PSMA) positron emission tomography/compute tomography (PET/CT) can predict adverse pathology and prognosis in patients with intermediate-risk prostate cancer (PCa).</p><p><strong>Materials and methods: </strong>This is a retrospective, multicenter analysis of patients diagnosed with intermediate risk PCa. Patients were staged using pelvic multiparametric magnetic resonance imaging (mpMRI) and radiolabeled PSMA PET/CT, either [68 Ga]Ga-PSMA-11 or [18F]F-PSMA1007, to evaluate the extent of disease before initiating appropriate treatment. PI-RADS Version 2.1 and PRIMARY score were used for a quantitative analysis, respectively for mpMRI and PSMA PET/CT. Biochemical recurrence of disease was defined as a post-operative serum PSA > 0.2 ng/ml on two separate occasions at minimum 2-week intervals.</p><p><strong>Results: </strong>Seventy-eight intermediate-risk PCa patients were enrolled. PRIMARY scores > 3 was found in 62% of favorable (n = 50) and 71% of unfavorable cases (n = 28). Gleason score changes occurred in 20% of favorable-risk patients, with 90% having a PRIMARY score > 3. Biochemical recurrence was observed in 17% of patients during follow-up, predominantly among favorable-risk cases (13%), where most had Gleason score changes and a PRIMARY score > 3.</p><p><strong>Conclusions: </strong>These results highlight the predictive value of the PRIMARY score for Gleason score changes.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13139-025-00920-6.</p>","PeriodicalId":19384,"journal":{"name":"Nuclear Medicine and Molecular Imaging","volume":"59 4","pages":"255-260"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare Urachal Metastases in Prostate Cancer: A Case Highlighting the Utility of ¹⁸F-PSMA-1007 PET/CT.","authors":"Raza Abbas Mahdi, Janarthanan Ilangovan, Harmandeep Singh, Bhagwant Rai Mittal, Rajender Kumar, Ashwani Sood, Shikha Goyal","doi":"10.1007/s13139-025-00926-0","DOIUrl":"https://doi.org/10.1007/s13139-025-00926-0","url":null,"abstract":"","PeriodicalId":19384,"journal":{"name":"Nuclear Medicine and Molecular Imaging","volume":"59 4","pages":"272-273"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¹⁸F-FAPI-04 PET/CT Imaging of Rare Brain Metastasis from Myxoid Pleomorphic Liposarcoma.","authors":"Yong Wang, Kelin Wang, Dongfang Meng, Kai Teng, Zhiguo Liu, Man Hu","doi":"10.1007/s13139-024-00901-1","DOIUrl":"10.1007/s13139-024-00901-1","url":null,"abstract":"<p><p>This study reports the first case of solitary brain metastasis from myxoid pleomorphic liposarcoma (MPLS) evaluated using ¹⁸F-FAPI-04 PET/CT. The imaging revealed a distinct \"Halo Sign,\" reflecting the infiltration characteristics of cancer-associated fibroblasts (CAFs) within this rare tumor type. These findings highlight the utility of ¹⁸F-FAPI-04 PET/CT in characterizing tumor heterogeneity and underscore its potential to improve the diagnosis of rare brain metastases while informing future therapeutic strategies.</p>","PeriodicalId":19384,"journal":{"name":"Nuclear Medicine and Molecular Imaging","volume":"59 4","pages":"269-271"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-Arterial Drug Delivery of Both a Small and Large Molecule Theranostic Radiotracer Probe into an Orthotopic OncoPIG Liver Tumor Model After Pseudovascular Isolation.","authors":"Samuel L Rice, Fernando Gómez Muñoz, Jamaal Benjamin, Seung Kim, Auh Whan Park, Joseph R Osborne, Regina Beets-Tan","doi":"10.1007/s13139-024-00892-z","DOIUrl":"https://doi.org/10.1007/s13139-024-00892-z","url":null,"abstract":"<p><strong>Purpose: </strong>Directed therapies employing small (SM) and large (LM) molecule drugs to target tumor antigens are used for treatment. Theranostics radiolabels them for imaging and radiation treatment. Poor radiopharmaceutical kinetics, prolonged circulating times, and high nontarget radiation to normal tissues after intravenous (i.v) injection limits translation. Intra-arterial (i.a.) procedures locally concentrate nonspecific chemotherapies or radiation to treat hepatic tumors (HT). Pseudovascular isolation (PVI), embolizes the HT arterioles, blocking efferent flow into capillaries isolating the HT from the systemic vasculature maximizing uptake to provide curative tumor specific absorbed radiation.</p><p><strong>Methods: </strong>[¹⁸F]Fluorodeoxyglucose (FDG) SM and ^99mTc-labeled macroaggregated albumin (MAA) LM surrogates were used to assess biodistribution in a porcine HT. Injected dose per gram (%ID/g) of the tracers obtained from 1 to 120 min after control (i.v) and experimental i.a. infusion with PVI.</p><p><strong>Results: </strong>SM drug delivered to HT was 290-366% greater for PVI vs. i.v (60 min %ID/g 31.26 ± 2.55 vs. 8.83 ± 0.55, <i>p</i> = 0.033; 120 min 29.28 ± 1.44 vs. 8.94 ± 0.96, <i>p</i> = 0.145). Mean HT uptake of LM with PVI was up to 760% greater than i.v. without washout (60 min %ID/g 80.01 ± 2.87 vs. 10.61 ± 0.96 <i>p</i> = 0.001; 81.72 ± 3.0 vs. 11.98 ± 0.3 <i>p</i> = 0.001 at 120 min).</p><p><strong>Conclusion: </strong>PVI significantly increases the concentration of both SM and LM drugs within a HT compared to i.v. infusion. PVI with tumor specific drugs offers an opportunity to locally cure HT using a drug that specifically targets tumor antigens.</p>","PeriodicalId":19384,"journal":{"name":"Nuclear Medicine and Molecular Imaging","volume":"59 4","pages":"217-228"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Semiquantitative parameters on hepatobiliary scintigraphy to differentiate biliary atresia from neonatal hepatitis in patients with no identifiable biliary to bowel transit.","authors":"Tejasvini Singhal, Parneet Singh, Girish Kumar Parida, Ralph Emerson, Ashique Rehman, Aditi, Kanhaiyalal Agrawal, P Sai Sradha Patro","doi":"10.1007/s13139-025-00909-1","DOIUrl":"https://doi.org/10.1007/s13139-025-00909-1","url":null,"abstract":"<p><strong>Introduction: </strong>The current gold standard for imaging to rule out extra-hepatic biliary atresia (EHBA) is hepatobiliary scintigraphy (HBS), which involves visually assessing the tracer appearance in the bowel. However, in cases where hepatic function is impaired, biliary-to-bowel transit may not be observable, even in neonatal hepatitis (NH) cases. This study aims to assess the utility of semi-quantitative parameters on HBS to distinguish biliary atresia (BA) from NH when there is a lack of biliary-to-bowel transit for up to 24 h.</p><p><strong>Materials and methods: </strong>The study involved retrospective analysis of patients with the diagnosis of neonatal cholestasis where HBS failed to differentiate BA and NH. Histopathological examination was taken as the gold standard. Semiquantitative parameters calculated include: Liver: blood pool (LBR) and liver: kidney ratios (LKR) at 5 min, 30 min, 1 h and 24 h. Mean values for the two groups were calculated. Student's t-test was employed to assess the statistical significance of difference of mean between the two groups. Receiver operating characteristic (ROC) curve was also drawn to determine a cut-off of these ratios to differentiate between the two groups using SPSS v26.0. P-value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The study included 53 patients (37 males) with a median age of 3 months (range: 24 days to 10 months). Of these, 32 patients had a histopathological diagnosis of BA, while 21 had NH. Mean LBR and LKR at 24 h were statistically different in the two groups (p-value < 0.05). Receiver operating characteristic (ROC) curve analyses showed highest AUC for LBR at 24 h 0.683 (CI:0.532-0.834, p-value 0.017) and LKR at 24 h - 0.669 (CI: 0.511-0.827, p-value:0.036). For diagnosis of BA a cut-off value of <i>≤</i> 4.18 for LBR at 24 h (sensitivity and specificity of 62.5% and 61.9% respectively) and <i>≤</i> 4.64 for LKR at 24 h (sensitivity and specificity of 68.8% and 66.7% respectively) were found to be pertinent.</p><p><strong>Conclusion: </strong>HBS serves as non-invasive imaging of choice to rule out EHBA. Semi-quantitative indices LBR and LKR at the 24-hour can differentiate between EHBA and NH even in cases with compromised hepatic function where traditional visual interpretation of tracer transit proves inadequate.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13139-025-00909-1.</p>","PeriodicalId":19384,"journal":{"name":"Nuclear Medicine and Molecular Imaging","volume":"59 4","pages":"239-245"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Jordanian's Knowledge of the Risks of Radiation Exposure.","authors":"Haneen M Hazaymeh, Naser Obeidat, Rana A Ghawanmeh, Mohammed H Anagreh, Khaled S Abu Alkheir","doi":"10.1007/s13139-025-00919-z","DOIUrl":"10.1007/s13139-025-00919-z","url":null,"abstract":"<p><strong>Purpose: </strong>The growing use of ionizing radiation in medical imaging requires balancing diagnostic benefits with radiation risks. This study assesses awareness and knowledge of radiation doses and risks among Jordanians.</p><p><strong>Methods: </strong>This cross-sectional study surveyed 582 Jordanian social media users online between December and February 2023, using 24 multiple-choice questions on demographics, radiological health risks, and precautionary awareness.</p><p><strong>Results: </strong>The cohort consisted of 321 (55%) males and 261 (45%) females, with most patients (54%) being from the 18-30 age group. Findings revealed a 42% incidence of direct radiation exposure within the past six months, predominantly advised by physicians (82%). Notably, 94% of participants recognized the risk of radiation exposure to pregnant women's pelvic and abdominal regions. Awareness of the carcinogenic potential of radiation was high (92%), yet only 18% reported wearing protective gear during exposure. There was a significant difference between medical and non-medical respondents in the awareness of wearing protective gear (25% vs. 11%, <i>p</i>-value < 0.001), risk of cancer, infertility, cataracts, and the effect of spiral CT scans to 100-800 X-rays (83% vs. 69%, <i>p</i>-value < 0.001). In addition, 37% of medical respondents thought warning signs are enough for comprehensive explanation compared to 27% in non-medical respondents (<i>p</i>-value = 0.012).</p><p><strong>Conclusion: </strong>The study reveals satisfactory awareness of medical radiation hazards among Jordanians, with disparities between medical and non-medical respondents. However, low protective gear usage and knowledge gaps indicate the need for improved education in radiology and public health campaigns on radiation safety.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13139-025-00919-z.</p>","PeriodicalId":19384,"journal":{"name":"Nuclear Medicine and Molecular Imaging","volume":"59 4","pages":"261-268"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of SPECT/CT in Serendipitous Finding of Urinary Bladder Hernia in ^99mTc-labelled RBC Scintigraphy.","authors":"Raza Abbas Mahdi, Komal Preet, Ashwani Sood, Kritin Shankar, Bhagwant Rai Mittal","doi":"10.1007/s13139-024-00890-1","DOIUrl":"10.1007/s13139-024-00890-1","url":null,"abstract":"<p><p>RBC scintigraphy has shown to be a sensitive imaging technique for detecting gastrointestinal bleed. There may be a time interval between the initiation of bleed and appearance of symptoms. This study can help in localizing the site of active bleed; though, false positive results may be seen. A patient of chronic liver disease presented with dark stools and falling hemoglobin who after initial management, showed focal tracer uptake in the pelvis on 99mTc-labelled RBC scintigraphy planar imaging suggesting gastrointestinal bleed. However, SPECT/CT accurately localized the tracer activity in a previously undiagnosed urinary bladder hernia in the inguinal canal and scrotum.</p>","PeriodicalId":19384,"journal":{"name":"Nuclear Medicine and Molecular Imaging","volume":"59 4","pages":"274-276"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutoff SUVR of [¹⁸F]Florapronol PET for Differentiating Alzheimer's Dementia from Normal Controls: Insights from ROC Analysis and Partial Volume Correction.","authors":"Su Yeon Park, Inki Lee, Ilhan Lim, Byung Il Kim, Chang Woon Choi, In Ok Ko, Byung Hyun Byun, Jeong Ho Ha","doi":"10.1007/s13139-025-00911-7","DOIUrl":"10.1007/s13139-025-00911-7","url":null,"abstract":"<p><strong>Objectives: </strong>The primary endpoint of this study is to establish a reliable SUVR cutoff threshold to distinguish patients with Alzheimer's disease (AD), excluding those with mild cognitive impairment (MCI), from normal control (NC) individuals using [¹⁸F]florapronol PET imaging and deep learning-based automated quantification software. The secondary endpoint is to evaluate whether combining partial volume correction (PVC) with SUVR analysis improves diagnostic accuracy in detecting AD.</p><p><strong>Methods: </strong>A total of 141 participants, including 55 AD patients (excluding MCI) and 86 NC controls, were enrolled. Each participant underwent [¹⁸F]florapronol PET imaging, and SUVR values were calculated for six amyloid-prone brain regions using deep learning-based software. SUVRs were computed with and without PVC, using the cerebellar cortex as the reference region. Receiver operating characteristic (ROC) analysis identified optimal SUVR thresholds for distinguishing AD (excluding MCI) from NC and for determining visual positivity. Age-matched subgroup analyses ensured consistent diagnostic performance across different age groups.</p><p><strong>Results: </strong>In the full cohort (<i>n</i> = 141), visual analysis achieved a sensitivity of 90.9% and specificity of 94.1% for distinguishing AD from NC. SUVR without PVC reached a similar sensitivity of 90.9% and specificity of 86.0% (optimal threshold > 1.26), while PVC-adjusted SUVR further improved accuracy with a sensitivity of 90.9% and specificity of 94.2% at a threshold of > 1.31. For visual positivity, SUVR without PVC achieved 92.7% sensitivity and 89.5% specificity, while PVC-adjusted SUVR improved these metrics to 96.4% sensitivity and 94.2% specificity. Age-matched analyses confirmed diagnostic consistency across different age groups. The visual analysis and the quantitative analysis using SUVR with PVC as the threshold were consistent in 134 out of 141 subjects (95.0%).</p><p><strong>Conclusions: </strong>Automated SUVR quantification with PVC adjustment provides a reliable and objective method for distinguishing AD from NC, aligning closely with visual assessment accuracy and supporting clinical use of [¹⁸F]florapronol PET imaging for AD diagnosis. This standardized approach enhances diagnostic consistency, particularly in settings with limited access to PET specialists, and establishes robust SUVR thresholds for broader clinical application in amyloid PET imaging.</p>","PeriodicalId":19384,"journal":{"name":"Nuclear Medicine and Molecular Imaging","volume":"59 4","pages":"229-238"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FDG-PET Image Classification in Alzheimer's Disease: from Traditional Visual Analysis to Advanced Transfer Learning.","authors":"Shailendra Mohan Tripathi, Christopher J McNeil, Roger T Staff, Alison D Murray, Claude M Wischik, Bjoern Schelter, Gordan D Waiter","doi":"10.1007/s13139-025-00908-2","DOIUrl":"10.1007/s13139-025-00908-2","url":null,"abstract":"<p><strong>Purpose: </strong>Alzheimer's disease (AD) often coexists with other brain pathologies, and we aimed to classify people with AD using 18 F- Flouro-Deoxy-Glucose-Positron Emission Tomography (FDG-PET).</p><p><strong>Method: </strong>Baseline FDG-PET data were collected as part of two large scale Phase III clinical trials of a novel tau aggregation inhibitor drug, Leuco-Methylthioninium (LMTX®). A total of 794, well-characterised probable AD subjects were included in the study and the images were classified into \"typical AD\"(temporoparietal hypometabolism) and \"mixed\" (patchy hypo-metabolism in other vascular territories of brain such as frontal and cerebellar regions along with temporo-parietal hypo-metabolism) patterns based on visual interpretation. The differences in the two groups were further assessed with region-of-interest based analysis of Standardized Uptake Value Ratio (SUVR) and automated classification using transfer learning with visual classification as the gold standard.</p><p><strong>Results: </strong>Of the total of 794 (438 female) participants, 533 (284 female) were classified as typical AD and 261 (154 female) participants classified as mixed. A subset of 50 images each from typical and mixed subtypes were used for transfer learning and sensitivity, specificity and accuracy for one of the cross-validation loops was 94.73%, 95.23% and 95% respectively. The average accuracy to distinguish the two subtypes after 5-fold cross validation was found to be 97.5%.</p><p><strong>Conclusions: </strong>This study is first of its kind to distinguish two subtypes of AD through visual interpretation of FDG-PET images and exploring the findings with a semi-quantitative method followed by transfer learning, which has been used to predict the two subtypes with high accuracy, sensitivity and specificity.</p>","PeriodicalId":19384,"journal":{"name":"Nuclear Medicine and Molecular Imaging","volume":"59 3","pages":"201-208"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}