Nuclear Medicine Communications最新文献

{"title":"Diagnostic pitfalls in [68Ga]Ga-DOTATATE PET/CT imaging: a systematic review.","authors":"Ahmed Saad Abdlkadir, Dhuha Al-Adhami, Mohammed Al Rammahi, Mohannad Badarneh, Salem Al Yasjeen, Khalid Al Busaidi, Aysar Khalaf, Haider Al-Alawi, Hasan Al-Alawi, Akram Al-Ibraheem","doi":"10.1097/MNM.0000000000001987","DOIUrl":"10.1097/MNM.0000000000001987","url":null,"abstract":"<p><p>[68Ga]Ga-DOTA-Tyr3-octreotate ([68Ga]Ga-DOTATATE) is an established somatostatin receptor imaging agent that has demonstrated superior efficacy in visualizing neuroendocrine tumors (NETs) and meningiomas compared with traditional [ 111 In]In-octreotide imaging. Despite its enhanced affinity and sensitivity, [68Ga]Ga-DOTATATE imaging is not without challenges. To date, numerous diagnostic pitfalls and false-positive findings have been reported. This systematic review investigates the currently recognized diagnostic pitfalls in [68Ga]Ga-DOTATATE positron imaging. A systematic literature search was conducted using PubMed, Scopus, and Web of Science databases, with the most recent update on 8 March 2024. Two authors screened the titles and abstracts of retrieved articles and selected studies based on predefined inclusion and exclusion criteria. Qualitative analysis of 70 included research articles, encompassing 199 patients, identified 234 diagnostic pitfalls. Malignant neoplastic etiologies predominated, constituting 56% of pitfalls, followed by nononcologic pitfalls (32.1%), and benign oncologic tumors (11.9%). Anatomically, the head and neck region was the most frequent site for pitfalls (35.5%), followed by the musculoskeletal system (27.4%), abdomen (17.5%), and chest (16.6%). Pelvic-related pitfalls were least common, accounting for only 3% of cases. This study details potential diagnostic pitfalls, predominantly occurring in the head-neck regions - primary sites for meningiomas and paragangliomas. Understanding these diagnostic pitfalls is crucial for accurate diagnosis. Moreover, recognizing these diagnostic pitfalls may lead to novel applications of [68Ga]Ga-DOTATATE beyond its conventional use in NETs and meningiomas, potentially expanding its diagnostic utility.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"651-661"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026573","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":"PET image nonuniformity texture features for metastasis risk prediction in osteosarcoma.","authors":"Muath Almaslamani, Byung-Hyun Byun, Kanghyon Song, Chang-Bae Kong, Sang-Keun Woo","doi":"10.1097/MNM.0000000000001989","DOIUrl":"10.1097/MNM.0000000000001989","url":null,"abstract":"<p><strong>Objective: </strong>PET image analysis provides tumor heterogeneity data related to neoadjuvant chemotherapy response (NACR) and metastatic risk in osteosarcoma. Ki-67 expression is used to predict metastasis. The accuracy of prediction models with image quantitative features can be improved by including genetic information. Here, we aimed to evaluate the accuracy of a combination of heterogeneous 18 F-fluorodeoxyglucose PET image texture features and Ki-67 expression as predictive indicators of metastasis.</p><p><strong>Methods: </strong>PET images and clinical data of 82 patients with osteosarcoma before and after treatment were collected. Quantitative features were extracted from the PET images obtained before treatment, and the area under the receiver operating characteristic curve (AUC) for NACR and metastatic event was calculated. Relative risk and odds analyses of the quantitative features of the entire image were performed. Kaplan-Meier survival analysis was performed to determine the relationship between image quantitative features and clinical information. The machine learning prediction model was evaluated using valid image quantitative features and various algorithms of the univariate analysis.</p><p><strong>Results: </strong>Forty-seven image textures were obtained. The AUC values were 0.504-0.62 for NACR and 0.510-0.598 for metastatic events. The NACR and metastatic risk were related to the gray-level run length matrix (GLRLM) run length nonuniformity (RLNU) (relative risk: 1.3846, P  = 0.0138 for NACR; relative risk: 2.1284, P  = 0.049 for metastatic event) in the univariate analysis. The accuracy of the prediction model using the random forest algorithm with GLRLM RLNU, Ki-67 expression, and NACR was 0.91 for metastatic risk. NACR and metastatic risk were predicted with high accuracy using the nonuniformity in PET image texture.</p><p><strong>Conclusion: </strong>Combining PET image texture nonuniformity with Ki-67 expression and clinical data can enhance the accuracy of metastasis prediction in osteosarcoma. This multimodal approach may support metastasis risk prediction in osteosarcoma and aid in personalized treatment planning.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"738-745"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972581","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":"Advances in the application of 18 F-sodium fluoride PET in the assessment of atherosclerosis.","authors":"Yan Wang, Mingyuan Hou, Taiyang Zuo","doi":"10.1097/MNM.0000000000001988","DOIUrl":"10.1097/MNM.0000000000001988","url":null,"abstract":"<p><p>Atherosclerosis serves as the primary cause of cardiovascular diseases (CVDs), with its pathological processes encompassing lipid deposition, inflammatory responses, and calcification. Traditional imaging techniques, such as computed tomography angiography and MRI, are primarily utilized for detecting arterial stenosis and calcified plaques, yet they face challenges in accurately assessing plaque activity and instability. 18 F-sodium fluoride PET ( 18 F-NaF PET) offers a novel approach for plaque activity and stability assessment by labeling and quantifying arterial wall calcification. This article reviews the advances in the application of 18 F-NaF PET in the assessment of atherosclerosis.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"662-672"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031342","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":"Association of quantitative growth plate uptake parameters on bone scintigraphy with growth velocity in children.","authors":"Ki Jin Jung, Sun-Pyo Hong, Ik Dong Yoo, Sang Mi Lee, Jeong Won Lee","doi":"10.1097/MNM.0000000000001992","DOIUrl":"10.1097/MNM.0000000000001992","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to examine the association between quantitative growth plate uptake parameters in bone scintigraphy and growth velocity among children.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 30 pediatric patients (21 male and nine female; age range, 3-15 years) who underwent planar bone scintigraphy. Ratios of maximum growth plate uptake to mean diaphyseal uptake (GP max /D) and mean growth plate uptake to mean diaphyseal uptake (GP mean /D) were calculated for both femurs on anterior and posterior bone scintigraphy images. A total of eight GP max /D parameters and eight GP mean /D parameters were measured. The relationships of growth plate uptake parameters with age and growth velocity (cm/year) were assessed.</p><p><strong>Results: </strong>Correlation analysis with growth velocity revealed that the anterior GP max /D (numerical mean of GP max /D between the right and left femurs on an anterior image) exhibited the highest correlation coefficient (0.409) among the bone scintigraphy parameters ( P  = 0.034). The anterior GP max /D also demonstrated a significant negative correlation with age ( P  = 0.042, correlation coefficient: -0.373). In a multiple regression analysis to predict growth velocity with adjusting for age and sex, the model that included left GP mean /D (geometric mean of GP mean /D between anterior and posterior images of the left femur) yielded the highest adjusted R2 value (0.786), followed by anterior GP max /D (0.734).</p><p><strong>Conclusion: </strong>Quantitative growth plate uptake parameters on the distal femur in bone scintigraphy are significantly associated with growth velocity. These findings suggest that growth plate uptake in bone scintigraphy could potentially serve as a predictive marker of growth in children.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"720-725"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094282","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":"Leveraging wastewater data to enhance understanding of medical radionuclide usage in the UK.","authors":"Alexandra Adrych-Brunning, James W Scuffham, Lakshmi Sasi, Nadia A S Smith, Rebecca Nutbrown","doi":"10.1097/MNM.0000000000002001","DOIUrl":"10.1097/MNM.0000000000002001","url":null,"abstract":"<p><strong>Objective: </strong>The secure supply of medical radionuclides, such as Tc-99m and I-131, is at risk because of aging production facilities worldwide. To advocate for investment in radionuclide production infrastructure in the UK, it is essential to understand current radionuclide usage. Accessing hospital data to determine the types and numbers of procedures performed with radionuclides is challenging, and reporting is inconsistent across the devolved nations. By utilising open-source records of radioactive waste discharge held by environmental agencies and creating an interactive map that visualizes the amount and types of radionuclides used in healthcare centers across the UK, we can gain insights into the UK's radionuclide usage and provide valuable information to inform future policies and address geographic disparities.</p><p><strong>Methods: </strong>Waste discharge records from different environmental agencies were interrogated to calculate the amount of administered radionuclide radioactivity at healthcare sites across the UK, which was cross-checked against hospital workload data of procedures performed with Tc-99m, I-131, and Lu-177.</p><p><strong>Results: </strong>The findings indicate that the wastewater data provides a reliable overview of radionuclide use, particularly for Lu-177 and I-131, with agreement between reported and calculated excreted activity within 10%. For Tc-99m, the agreement was within 40%, likely because of variations in clinical practices.</p><p><strong>Conclusion: </strong>The wastewater-reported data offers an independent and valuable source for understanding radionuclide usage across the UK. Enhancing coordination between environmental agencies and improving data collection practices would help improve the interrogation of radionuclide usage in the UK and hence support national strategy and planning for medical radionuclide supply.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"673-681"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310226","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 safety and clinical impact of ultra-low-dose FDG-PET imaging in pregnancy-associated breast cancer: the experience of a major tertiary oncology referral centre in the UK and suggested imaging protocol.","authors":"Karen Desouza, Petros Fessas, Emma Spurrell, Elisavet Papadimitraki, Fharat Raja, Rebecca Roylance, Diego Ottaviani, Joanna Franks, Dibendu Betal, Mahwash Babar, Irene Athanasiou, Massimilano Cariati, Neill Patani, Sirwan Hadad, Yusuf Kayani, Darren Walls, Catherine Scott, Marilena Rega, Mubarik Arshad, Jamshed Bomanji, Stefan Vöö","doi":"10.1097/MNM.0000000000001997","DOIUrl":"10.1097/MNM.0000000000001997","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy-associated breast cancer (PABC) is a complex condition affecting 1 in 3000 pregnancies worldwide. While clinical management has improved, the optimal staging approach for PABC remains uncertain. 18 F-fluorodeoxyglucose PET (FDG-PET) imaging is a standard diagnostic tool for many cancers. However, its use in PABC staging is controversial due to potential radiation risks to the foetus.</p><p><strong>Methods: </strong>This retrospective case series analysed clinical data from six patients with high-risk PABC who underwent FDG-PET imaging for staging between 2022 and 2023. FDG-PET was based on locally implemented ultra-low-dose imaging protocols. The radiation doses to the foetus were dosimetrically estimated based on dose-per-unit activity values and correlated with postpartum neonatal outcomes.</p><p><strong>Results: </strong>The median foetal radiation dose was 0.975 mGy (range 0.6-1.5 mGy) and was below the threshold for deterministic toxicities. PET imaging upstaged nodal involvement in 33% of patients and influenced treatment decisions. FDG-PET imaging provided valuable staging information in all cases. No adverse foetal effects were observed.</p><p><strong>Conclusion: </strong>Ultra-low-dose FDG-PET imaging is a valuable tool providing accurate staging information to guide treatment decisions. The low radiation dose associated with this technique makes it a clinically acceptable modality for cancer staging in pregnant women. A larger case series is needed to precisely quantify foetal radiation doses and assess long-term safety.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"772-779"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malignancy classification of thyroid incidentalomas using 18F-fluorodeoxy-d-glucose PET/computed tomography-derived radiomics.","authors":"Melda Yeghaian, Marceline W Piek, Annemarieke Bartels-Rutten, Mohamed A Abdelatty, Marina Herrero-Huertas, Wouter V Vogel, Jan Paul de Boer, Koen J Hartemink, Zuhir Bodalal, Regina G H Beets-Tan, Stefano Trebeschi, Iris M C van der Ploeg","doi":"10.1097/MNM.0000000000002031","DOIUrl":"https://doi.org/10.1097/MNM.0000000000002031","url":null,"abstract":"<p><strong>Background: </strong>Thyroid incidentalomas (TIs) are incidental thyroid lesions detected on fluorodeoxy-d-glucose (18F-FDG) PET/computed tomography (PET/CT) scans. This study aims to investigate the role of noninvasive PET/CT-derived radiomic features in characterizing 18F-FDG PET/CT TIs and distinguishing benign from malignant thyroid lesions in oncological patients.</p><p><strong>Materials and methods: </strong>We included 46 patients with PET/CT TIs who underwent thyroid ultrasound and thyroid surgery at our oncological referral hospital. Radiomic features extracted from regions of interest (ROI) in both PET and CT images and analyzed for their association with thyroid cancer and their predictive ability. The TIs were graded using the ultrasound TIRADS classification, and histopathological results served as the reference standard. Univariate and multivariate analyses were performed using features from each modality individually and combined. The performance of radiomic features was compared to the TIRADS classification.</p><p><strong>Results: </strong>Among the 46 included patients, 36 patients (78%) had malignant thyroid lesions, while 10 patients (22%) had benign lesions. The combined run length nonuniformity radiomic feature from PET and CT cubical ROIs demonstrated the highest area under the curve (AUC) of 0.88 (P < 0.05), with a negative correlation with malignancy. This performance was comparable to the TIRADS classification (AUC: 0.84, P < 0.05), which showed a positive correlation with thyroid cancer. Multivariate analysis showed higher predictive performance using CT-derived radiomics (AUC: 0.86 ± 0.13) compared to TIRADS (AUC: 0.80 ± 0.08).</p><p><strong>Conclusion: </strong>This study highlights the potential of 18F-FDG PET/CT-derived radiomics to distinguish benign from malignant thyroid lesions. Further studies with larger cohorts and deep learning-based methods could obtain more robust results.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699214","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":"Diagnostic value of 18F-prostate-specific membrane antigen-1007 PET/MRI versus 18F-prostate-specific membrane antigen-1007 PET/computed tomography for biochemical recurrence of prostate cancer after radical prostatectomy.","authors":"Yuping Zeng, Hengbin Liao, Guihua Jiang, Gongfa Wu, Junyuan Zhong","doi":"10.1097/MNM.0000000000002028","DOIUrl":"https://doi.org/10.1097/MNM.0000000000002028","url":null,"abstract":"<p><strong>Objective: </strong>To assess the diagnostic value of fluorine 18 (18F)-labeled prostate-specific membrane antigen (PSMA)-1007 PET/MRI and compare with that of 18F-PSMA-1007 PET/computed tomography (CT) for biochemical recurrence (BCR) of prostate cancer (PCa) after radical prostatectomy.</p><p><strong>Materials and methods: </strong>We enrolled 40 patients who underwent 18F-PSMA-1007 PET/CT and 18F-PSMA-1007 PET/MRI for BCR after radical prostatectomy. Two readers independently assessed the images and determined their overall assessment of positive lesions on PET/MRI and PET/CT. The association between the patients' clinical characteristics and positive detection results on the PET/CT and PET/MRI was explored. The PET/CT and PET/MRI results were verified during a 24-month follow-up to calculate their diagnostic accuracy.</p><p><strong>Results: </strong>The detection rate of positive patients on 18F-PSMA-1007 PET/CT and PET/MRI were consistent, with a value of 77.50%. The positive detection results were moderately associated with the patients' prostate-specific antigen (PSA) levels at examination, and the detection rate increased significantly with values of 50.00%, 72.73%, 90.91%, and 100% for PSA levels <0.5, 0.5-<1.0, 1.0-<2.0, and ≥2.0 ng/ml, respectively. Conclusive follow-up for affirmation or refutation of PCa recurrence was available for 33 patients. Compared with the follow-up results, on the patient-based level, the diagnostic accuracies for PET/MRI and PET/CT were both 100%. On the lesion-based level, PET/MRI excluded a false positive of bone metastasis on PET/CT.</p><p><strong>Conclusion: </strong>18F-PSMA-1007 PET/MRI and 18F-PSMA-1007 PET/CT demonstrate almost equal diagnostic value in detecting BCR, but PET/MRI can provide more lesion information, facilitating diagnosis and treatment due to its superior soft tissue resolution.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637702","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":"Ensure pancakes as an alternative recipe for egg-free gastric emptying studies.","authors":"Andrea Blesa Jiménez, Nuria Olcina Forner, Carmen Belén Otero Alonso, Manuel Valiente Alarcón, María Teresa Martínez Martínez","doi":"10.1097/MNM.0000000000002029","DOIUrl":"https://doi.org/10.1097/MNM.0000000000002029","url":null,"abstract":"<p><p>Gastric emptying scintigraphy provides a physiologic, noninvasive, and quantitative measurement of gastric emptying. Consensus guidelines recommended a standardized meal that consisted of an egg substitute equal to two whole eggs labeled with sulphur colloid ([99mTc]Tc-SC), two slices of bread, jam, and 120 mL of water. Previous studies reported the use of commercial liquid nutrient meal (LNM) as a suitable meal for patients with egg allergy. Our work proposes an alternative recipe based on cooking commercial LNM as a pancake, and evaluates the stability of binding of several radiopharmaceuticals in simulated gastric medium, concluding that [99mTc]Tc-MAA binds to LNM pancakes in percentages ≥90%, similar to scrambled eggs standardized meal, so that [99mTc]Tc-MAA-LNM in pancakes could be a good alternative for patients who have allergies to eggs, intolerance to LNM or difficulties for finishing the entire standard meal, as for instance pediatric patients for whom pancakes should be an attractive recipe.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637703","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":"Prognostic significance of total metabolic tumor volume on baseline 18 F-FDG PET/CT in patients with lung adenocarcinoma: further stratification of the ninth edition of TNM staging subgroups.","authors":"Ruiqiu Zhang, Xiaohui Zhang, Qiaoling Gao, Han Zhang, Lianyu Gu, Xiuyu Guo, Jingfeng Zhang, Jianjun Zheng, Maoqing Jiang","doi":"10.1097/MNM.0000000000001976","DOIUrl":"10.1097/MNM.0000000000001976","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the prognostic value of baseline total metabolic tumor volume (TMTV) on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography and its potential for further stratification within the ninth tumor-node-metastasis (TNM) staging system in patients with lung adenocarcinoma (LUAD).</p><p><strong>Methods: </strong>A cohort of 384 patients with LUAD who had undergone pretreatment PET/CT were included in this retrospective study. The optimal cutoff value for TMTV was determined through analysis of time-dependent receiver operating characteristic curves. The analysis of overall survival (OS) was conducted utilizing Kaplan-Meier curves. Predictive capacity was evaluated using the C statistic.</p><p><strong>Results: </strong>The optimal cutoff value for TMTV was 40.13 ml. The survival rates of patients varied significantly across stages I ( n  = 164), II ( n  = 37), III ( n  = 46), and IV ( n  = 137); however, there was no statistically significant difference between stages II and III ( P  = 0.440). In stages II-III and IV, the 2-year OS rates for patients with TMTV less than 40.13 ml were significantly higher at 81.7 and 86.7%, respectively, compared with patients with TMTV greater than equal to 40.13 ml who had rates of only 56.5 and 42.5%. No patients with stage I presented TMTV greater than or equal to 40.13 ml, and the 2-year OS rate was 98.3%. The C index did not reveal a significant difference between TNM and TMTV in their predictive ability for OS (0.83 vs. 0.85, P  = 0.159).</p><p><strong>Conclusion: </strong>The TNM staging system demonstrates robust prognostic utility in patients with LUAD, while the incorporation of baseline TMTV may offer additional risk stratification within distinct TNM stages.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"643-650"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625861","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}