Nuclear Medicine Communications最新文献

{"title":"Fluorodeoxyglucose PET/CT-derived Metabolic Peritoneal Cancer Index for survival assessment in peritoneal carcinomatosis.","authors":"Semra Demirtaş Şenlik, Alev Noyaner Çinar, Ceren Özge Engür Uyanik, Ayşenur Erdem Karaoğlu, Osman Sütçüoğlu, Berna Öksüzoğlu, Özlem Özmen","doi":"10.1097/MNM.0000000000002244","DOIUrl":"https://doi.org/10.1097/MNM.0000000000002244","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between the Metabolically active Peritoneal Cancer Index (M-PCI) derived from 18F-fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) and to assess its ability to predict overall survival (OS) in patients with peritoneal carcinomatosis.</p><p><strong>Methods: </strong>This retrospective study included 107 patients with pathologically confirmed peritoneal carcinomatosis who underwent 18F-FDG PET/CT between October 2022 and July 2025. M-PCI was calculated using a PET-adapted Peritoneal Cancer Index approach based on metabolically active peritoneal lesions across 13 anatomical regions. Patients were stratified using an M-PCI cutoff value of 20, with the appropriateness of this threshold additionally explored using receiver operating characteristic analysis. Survival analysis was performed using Kaplan-Meier analysis and univariable and multivariable Cox regression models.</p><p><strong>Results: </strong>During a median follow-up of 22 months, 78 deaths (72.9%) occurred. The median OS was 9 months. M-PCI was significantly associated with OS [hazard ratio = 1.050 per unit increase; 95% confidence interval (CI) = 1.019-1.082; P = 0.001]. Patients with M-PCI > 20 had significantly worse survival compared with those with M-PCI ≤ 20 (median OS = 3 vs. 10 months; log-rank P = 0.010), with nearly a two-fold increase in mortality risk (hazard ratio = 1.94; 95% CI = 1.14-3.32; P = 0.015). The prognostic impact of M-PCI was particularly pronounced in the gynecologic subgroup. In multivariable Cox regression analysis, M-PCI remained independently associated with OS after adjustment for tumor origin, treatment, extent of disease, ascites, and timing of peritoneal carcinomatosis (adjusted hazard ratio = 1.040; 95% CI = 1.002-1.080; P = 0.042).</p><p><strong>Conclusion: </strong>M-PCI derived from 18F-FDG PET/CT is a significant predictor of OS in patients with peritoneal carcinomatosis. By integrating metabolic activity with spatial disease distribution, M-PCI may provide clinically relevant prognostic information and improve risk stratification in this patient population.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963701","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 impact of risk organ involvement and metabolic parameters assessed by staging 18F-FDG PET/CT in pediatric Langerhans cell histiocytosis.","authors":"İpek Öztürk, Selin Gül Yaran, Özgü Hançerli, Enes Mustafa Kaya, Ali Ayçiçek, Meryem Kaya, Burcu Esen Akkaş","doi":"10.1097/MNM.0000000000002242","DOIUrl":"https://doi.org/10.1097/MNM.0000000000002242","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the prognostic impact of risk organ involvement and baseline metabolic activity assessed by staging 18F-fluorodeoxyglucose (FDG) PET/computed tomography (CT) in newly diagnosed pediatric Langerhans cell histiocytosis (LCH).</p><p><strong>Methods: </strong>Thirty-two children with histologically confirmed LCH who underwent baseline 18F-FDG PET/CT were retrospectively analyzed. Age, disease extent (single-system vs. multisystem), risk organ involvement (RO- vs. RO+), and baseline metabolic parameters [maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume, total lesion glycolysis (TLG), and tumor-to-background ratio (TBR)] were evaluated for their association with progression or relapse. Optimal cut-offs were derived from receiver operating characteristic analysis (Youden index). Survival outcomes were analyzed using Kaplan-Meier and Cox regression models.</p><p><strong>Results: </strong>Over a median follow-up of 33 months, disease progression or relapse occurred in 13 patients (40.6%) and was significantly associated with younger age (P = 0.040), higher SUVmax (P = 0.016), higher TBR (P = 0.007), and TLG (P = 0.033), multisystem LCH (P = 0.004), and risk organ positivity (P < 0.001). Risk-organ involvement was the strongest univariate predictor of adverse outcome (hazard ratio: 14.9, 95% confidence interval: 3.3-67; P < 0.001).</p><p><strong>Conclusion: </strong>Baseline 18F-FDG PET/CT provides important prognostic information in pediatric LCH, with risk organ involvement emerging as the strongest univariate prognostic factor in this cohort, supporting its role in early risk stratification, suggesting a potential role in future risk-adapted treatment planning. Higher SUVmax, TBR, and TLG were associated with progression/relapse in group comparisons, whereas only SUVmax and TBR were significantly associated with progression-free survival in univariate Cox analysis.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920385","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":"Predictive value of metabolic and tumor dissemination parameters in diffuse large B-cell lymphoma: can relapse be predicted despite adequate interim PET response?","authors":"Ezgi Basak Erdogan, Yusuf Yildiz, Ennur Ramadan, Ozlem Toluk, Mehmet Aydin, Guven Cetin","doi":"10.1097/MNM.0000000000002238","DOIUrl":"https://doi.org/10.1097/MNM.0000000000002238","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate associations of baseline and interim fluorine-18 fluorodeoxyglucose PET/computed tomography parameters with early clinical outcomes in diffuse large B-cell lymphoma (DLBCL) and identify prognostic/predictive biomarkers, including predictors of discordance between interim PET (iPET) response and clinical outcome.</p><p><strong>Methods: </strong>We retrospectively analyzed 112 patients with DLBCL. Baseline clinical/biochemical data and metabolic parameters from staging PET (sPET) and iPET were recorded, and delta (Δ) parameters were calculated. iPET response was classified by Deauville criteria, while follow-up outcomes were categorized as remission or refractory/progressive disease. Group comparisons and receiver operating characteristic analyses were performed.</p><p><strong>Results: </strong>iPET predicted outcomes with 79% sensitivity, 71% specificity, 74% accuracy, 82% negative predictive value, and 66% positive predictive value. Baseline dissemination metrics, including maximum distance between the two most distant lesions and maximum distance between the outermost voxels of the two most distant lesions PET (DmaxVoxPET), were higher in patients developing relapse/progression despite adequate iPET response [area under the curve (AUC): 0.81 and 0.77]; iPET-derived metabolic parameters - maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), peak standardized uptake value (SUVpeak), lesion-to-liver ratio (RLL), total lesion glycolysis, and ΔSUVmax, ΔSUVmean, ΔSUVpeak, and ΔRLL significantly predicted remission (AUC: 0.70-0.79), generally outperforming baseline parameters. SUV-based indices and RLL outperformed TLG, while SUV metrics performed comparably. Ferritin was the only predictive clinical/biochemical variable (AUC: 0.79). According to multivariate logistic regression analysis, advanced-stage disease (P = 0.002) and elevated ferritin levels (P = 0.009) were found to be independent risk factors for disease progression.</p><p><strong>Conclusion: </strong>iPET provides robust early response assessment and stronger predictive value than sPET in DLBCL, particularly through SUV-based parameters and RLL. While sPET reflects tumor burden and dissemination, baseline dissemination metrics may identify patients at risk of relapse despite favorable iPET findings, supporting risk-adapted management and closer surveillance.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920301","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":"Retrospective study of dynamic imaging acquisition length optimisation for sentinel lymph node scans.","authors":"Jan M Walukiewicz, Dave Ashworth, Heather Ann Williams","doi":"10.1097/MNM.0000000000002169","DOIUrl":"10.1097/MNM.0000000000002169","url":null,"abstract":"<p><p>Current guidance recommends dynamic imaging immediately post radiopharmaceutical injection for sentinel lymph node (SLN) scans. However, there is limited information on the recommended acquisition duration. We aimed to determine the time during a 30 min dynamic acquisition at which no additional SLNs were detected, and evaluate how applying a 20 min cut-off influenced clinical interpretation when considering all retrospectively acquired standard-of-care imaging. We retrospectively reviewed 106 SLN dynamic acquisitions for five primary sites: head and neck (19), limb (21), trunk (24), penis (21), and vulva (21). A qualified reporter identified studies in which lymph nodes appeared beyond 15 min. These datasets were independently reviewed by two expert reporters to find the time-point when no further SLNs were observed, and to evaluate differences in the number and location of identified SLNs using a 20-min protocol. We also conducted a survey of centres providing an SLN service to document the current practice of dynamic scan durations for contextual background. Across all studies, no new SLNs were detected after 25 min. When considering all acquired images, a 20 min dynamic identified the same SLNs. Interobserver agreement between expert reporters was 0.82 (95% confidence interval: 0.61-0.93). The eight survey responses revealed a median dynamic duration of 15 min (interquartile range: 13-28 min). While a 25 min dynamic captured all SLNs for all studies, incorporating reporting with all retrospectively acquired standard-of-care imaging indicates a 20 min dynamic duration appears unlikely to alter image reporting. Adopting a 20 min dynamic would reduce clinical workload and improve patient comfort without detriment to image interpretation.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"1111-1116"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777930","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":"Redefining bone metastasis imaging in breast cancer: whole body low-dose computed tomography compared with skeletal scintigraphy in a real-world cohort.","authors":"Lipton Mitra, Ankur Goyal, Nivedita Kundu, Shivam Pandey, Mohit Joshi, K P Haresh, H K Bhattacharjee, Raju Sharma, Rajinder Parshad, Suhani","doi":"10.1097/MNM.0000000000002172","DOIUrl":"10.1097/MNM.0000000000002172","url":null,"abstract":"<p><strong>Background: </strong>Skeletal scintigraphy is standard imaging to detect bone metastasis in breast cancer. Nuclear medicine facilities are limited in availability. As an alternative diagnostic modality, we evaluated whole-body low dose computed tomography (WBLDCT) scan for detection of bone metastasis.</p><p><strong>Methods: </strong>This cross-sectional exploratory study was conducted from November 2021 to May 2023 with an aim to study the clinical applicability of WBLDCT for detecting bone metastasis in patients with breast cancer. Patients with primary tumor measuring 5 cm or more, pathologically proven axillary lymph node metastasis, Stage III/IV disease, symptoms attributable to metastasis and suspected disease recurrence were included. Patients underwent WBLDCT and bone scan within 2 weeks. WBLDCT was done during the same time as conventional dose CT scan done as part of metastatic workup. Image analysis was performed by radiology and nuclear medicine experts in blinded fashion. Agreement amongst WBLDCT, bone scan and combination of these was calculated using inter-rater agreement.</p><p><strong>Results: </strong>One hundred seven patients underwent WBLDCT and bone scan. The mean age was 48.5 years and three-fourth had Stage III disease. Both bone scan and WBLDCT detected bone metastasis in 19 patients. Bone scan picked up additional metastasis in two patients. WBLDCT detected bone metastasis additionally in three patients. Specificity of bone scan and WBLDCT was 87.5 and 91.7%, respectively. Concordance rate of bone scan and WBLDCT with the combination was 0.889 and 0.945, respectively.</p><p><strong>Conclusion: </strong>WBLDCT can be used as an alternative imaging modality to detect bone metastasis in breast cancer patients.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"1014-1020"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841315","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":"Role of fluorodeoxyglucose positron emission tomography scan in assessing the extent of myocardial viability in patients with left ventricular dysfunction and its impact on patient outcome.","authors":"Janpreet Singh, Natasha Singh, Melvika Pereira, Divya Shivdasani","doi":"10.1097/MNM.0000000000002168","DOIUrl":"10.1097/MNM.0000000000002168","url":null,"abstract":"<p><strong>Aim: </strong>To assess the utility of fluorodeoxyglucose (FDG) PET-based myocardial viability in patients with left ventricular (LV) dysfunction, its role in guiding therapeutic decision-making, and its impact on patient outcomes.</p><p><strong>Materials and methods: </strong>This retro-prospective study included 70 patients of coronary artery disease, with myocardial infarction and LV dysfunction [left ventricular ejection fraction (LVEF) ≤ 35%]. All patients underwent rest single-photon emission computerized tomography myocardial perfusion imaging and FDG PET cardiac viability imaging. Viability was assessed qualitatively and quantitatively as the percentage of viable hibernating myocardium. Patients were categorized as having predominantly viable myocardium (≥7% viable hibernating LV myocardium) or predominantly scarred myocardium (<7%). Management decisions included surgical revascularization or medical therapy. Outcomes at 6-month followup included improvement in LVEF (≥5%), cardiac events, and cardiac-related death.</p><p><strong>Results: </strong>During follow up, two patients died of noncardiac causes. Among 68 patients (mean LVEF 25.58%), 88.2% ( n  = 60) had predominantly viable myocardium and 11.8% ( n  = 8) had scarred myocardium on FDG PET cardiac scan. Of viable patients, 89.8% (44/49) undergoing revascularization showed LVEF improvement at least 5% vs. 45.5% (5/11) medically managed ( P  = 0.002784). Cardiac events occurred in 4.1% vs. 27.3%, respectively ( P  = 0.039). No significant association was found between treatment type and outcomes in the scarred group ( P  = 0.464).</p><p><strong>Conclusion: </strong>FDG PET-based myocardial viability assessment can potentially play a role in guiding therapeutic decision-making in patients with LV dysfunction by identifying those with predominantly viable hibernating myocardium who are more likely to benefit from revascularization and have better outcomes in terms of improved LV function and fewer cardiac events compared to those managed medically.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"1081-1087"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777878","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":"Assessment of fundal accommodation in solid meal gastric emptying scintigraphy: a retrospective analysis.","authors":"Hussein Farghaly, Abdullah Alahmari, Abdulrahman Albatly, Omar Almukhailed, Sami Almutairy, Nsreen R A Mohamadien, Hatem Nasr","doi":"10.1097/MNM.0000000000002167","DOIUrl":"10.1097/MNM.0000000000002167","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the feasibility of both quantitative and qualitative assessment of fundal accommodation during solid meal gastric emptying (SGE) scintigraphy.</p><p><strong>Methods: </strong>SGE scintigraphy studies of 72 patients were retrospectively evaluated. Regions of interest (ROIs) were generated on the stomach at different times (0, 30 min, 1, 2, 3, and 4 h), and the corresponding retention percentages were calculated. Counts as geometric means from anterior and posterior ROIs over proximal stomach half and whole stomach at zero-time were used to calculate gastric fundal accommodation ratio (FAR). The radioactivity at the fundus was visually assessed at zero-time image to generate a four-point fundal accommodation visual score (1 = abnormal, 2 = probably abnormal, 3 = probably normal, and 4 = normal).</p><p><strong>Results: </strong>Fifty patients had normal SGE, and 22 had delayed SGE. The mean FAR was 0.753 ± 0.151. The fundal accommodation visual score and the FAR were significantly moderately correlated ( ρ = 0.455, P < 0.0001). Receiver operating characteristic curve analysis revealed a FAR cut-off value of 0.669 distinguishing normal from abnormal FAR (area under the curve = 0.873; P < 0.001) with 70% sensitivity and 92.3% specificity. A comparison of the fundal accommodation visual score and FAR revealed highly significant agreement ( P < 0.0001).</p><p><strong>Conclusion: </strong>A fundal radioactivity to total stomach ratio of 0.669 at zero-time image was an appropriate threshold for detecting abnormal fundal accommodation. Given the high correlation between visual scoring and quantitative ratios, visual assessment may be regarded as a quick and dependable way to evaluate fundal accommodation.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"1007-1013"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777857","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":"A nomogram predicting dysphagia risk after adjuvant iodine-131 therapy in patients with papillary thyroid carcinoma.","authors":"Hanji Jiang, Jiayu Chen, Hui Zhu, Zhiyong Li","doi":"10.1097/MNM.0000000000002171","DOIUrl":"10.1097/MNM.0000000000002171","url":null,"abstract":"<p><strong>Objectives: </strong>To identify clinical risk factors for dysphagia after iodine-131 ( 131 I) therapy in patients with papillary thyroid carcinoma (PTC) and develop a validated risk-prediction nomogram.</p><p><strong>Methods: </strong>Adult PTC patients treated with 131 I at the Department of Nuclear Medicine, Affiliated Hospital of Xuzhou Medical University, between January 2022 and October 2024 were retrospectively reviewed. All patients underwent total or partial thyroidectomy, had satisfactory postoperative wound healing, and had histopathologically confirmed PTC. Baseline clinical data, laboratory parameters, and pretreatment salivary gland function assessed by dynamic pertechnetate single-photon emission computed tomography/computed tomography were collected. Swallowing function was evaluated before treatment and at 6-month follow-up using the MD Anderson Dysphagia Inventory; dysphagia was defined as a total score less than 50. Variables significant in univariate analysis were entered into backward stepwise multivariate logistic regression. Independent predictors were used to construct a nomogram, which was assessed by area under the curve (AUC), bootstrap calibration, and decision curve analysis.</p><p><strong>Results: </strong>Among 201 patients, 68 (33.8%) developed dysphagia. Higher cumulative 131 I dose, smoking history, and baseline salivary gland dysfunction were independent predictors of dysphagia. The nomogram incorporating these factors showed excellent discrimination, with an AUC of 0.913, good calibration with a bootstrap mean absolute error of 0.013, and favorable clinical net benefit.</p><p><strong>Conclusion: </strong>Higher 131 I dose, smoking history, and pre-existing salivary gland dysfunction independently predict dysphagia after 131 I therapy in PTC patients. This nomogram may support individualized risk assessment and preventive counseling before treatment.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"1021-1028"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13440551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841301","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":"Comparison of automated robotic arm-assisted PET/computed tomography-guided metabolic bone marrow biopsy with conventional bone marrow trephine biopsy for evaluating bone marrow infiltration in newly diagnosed lymphoma.","authors":"Raza Abbas Mahdi, Vaishnavi Dasagrathi, Rajender Kumar, Harmandeep Singh, Bhagwant Rai Mittal, Gaurav Prakash, Pankaj Malhotra, Amanjit Bal, Shano Naseem","doi":"10.1097/MNM.0000000000002170","DOIUrl":"10.1097/MNM.0000000000002170","url":null,"abstract":"<p><strong>Objectives: </strong>Bone marrow involvement (BMI) upstages lymphoma and influences prognosis and treatment. Conventional bone marrow trephine biopsy (BMTB) may miss patchy or extrapelvic disease. This study compared the diagnostic performance of automated-robotic-arm (ARA)-assisted 18 F-fluorodeoxyglucose (FDG) PET/computed tomography (CT)-guided bone marrow biopsy with BMTB in treatment-naive lymphoma.</p><p><strong>Methods: </strong>In this prospective single-centre study, 169 treatment-naive lymphoma patients underwent baseline 18 F-FDG PET/CT and bilateral posterior iliac crest BMTB. Among these, 44 patients with focal FDG-avid marrow lesions (unifocal or multifocal) underwent ARA-assisted PET/CT-guided bone marrow biopsy. Histopathological findings from PET/CT-guided biopsy and BMTB were used to establish the final diagnosis of BMI. Diagnostic performance parameters were calculated with 95% confidence intervals (CIs) using Wilson score method. Comparisons were performed using Fisher's exact test.</p><p><strong>Results: </strong>Of the 44 patients with focal FDG-avid marrow lesions, 40 had lymphomatous BMI on final diagnosis. PET/CT-guided biopsy yielded 37 true positives, four true negatives, and three false-negatives, with no false-positive. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 92.5% (95% CI: 80.1-97.4%), 100% (95% CI: 51.0-100.0%), 100% (95% CI: 90.6-100.0%), 57.1% (95% CI: 25.0-84.2%), and 93.2% (95% CI: 81.8-97.7%), respectively. Conventional BMTB demonstrated significantly lower sensitivity (52.5%) and accuracy (56.8%) ( P  < 0.001).</p><p><strong>Conclusion: </strong>ARA-assisted PET/CT-guided metabolic bone marrow biopsy demonstrates superior sensitivity and accuracy than conventional iliac crest trephine biopsy. It improves detection of lymphomatous BMI, boosts diagnostic confidence and reduces over-staging risk. It may play a selective problem-solving tool for focal FDG-avid marrow lesions.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"1102-1110"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841330","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":"Efficacy of intra-arterial [ 177 Lu]Lu-DOTATATE vs. continuation intravenous [ 177 Lu]Lu-DOTATATE peptide receptor radionuclide therapy in nonresponding locally advanced inoperable or liver-dominant metastatic gastroenteropancreatic neuroendocrine tumors.","authors":"Rangat Bagasariya, Rahul Vithalrao Parghane, Nitin Shetty, Kunal Gala, Suyash Kulkarni, Sandip Basu","doi":"10.1097/MNM.0000000000002173","DOIUrl":"10.1097/MNM.0000000000002173","url":null,"abstract":"<p><strong>Background: </strong>Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) demonstrating liver-dominant inoperable metastatic diseases or locally advanced inoperable tumors may at times show reduced efficacy for intravenous peptide receptor radionuclide therapy (PRRT).</p><p><strong>Aims and objectives: </strong>To determine and compare the outcome of intra-arterial [ 177 Lu]Lu-DOTATATE PRRT in GEP-NET with locally advanced inoperable primary or liver-dominant metastases who had shown no response after at least two cycles of intravenous [ 177 Lu]Lu-DOTATATE, as compared to those patients who continued intravenous [ 177 Lu]Lu-DOTATATE only.</p><p><strong>Materials and methods: </strong>GEP-NET patients with locally advanced inoperable primary or liver metastatic disease, who exhibited nonresponsive disease (either stable or progressive disease on anatomical imaging evaluation) after at least two cycles of intravenous [ 177 Lu]Lu-DOTATATE PRRT, were administered intra-arterial [ 177 Lu]Lu-DOTATATE PRRT (group A). For comparison, matched controls [age, gender, primary site, tumor grade, proliferation index, disease burden, and [ 18 F]fluorodeoxyglucose (FDG) PET/computed tomography status] who had received only intravenous [ 177 Lu]Lu-DOTATATE PRRT (group B) were selected retrospectively. The data were compared and analyzed for response assessments across three categories (symptomatic, including various quality-of-life scores; biochemical; and imaging), survival outcomes, and toxicity profiles.</p><p><strong>Results: </strong>A total of 33 GEP-NET patients (group A-11 and group B-22) were included. Symptomatic alleviation was slightly higher in group A compared with group B (75 vs. 66.8%), with higher quality-of-life (QoL) scores in group A. According to RECIST 1.1, group A had a 36.3% objective response rate compared with 13.6% in group B. Group A had a higher disease control rate (90.8%) than group B (77.2%). The median progression-free survival (PFS) was significantly longer in group A (not attained) compared with group B (median PFS of 22 months; P < 0.05). No major toxicity was observed in either group.</p><p><strong>Conclusion: </strong>Intra-arterial [ 177 Lu]Lu-DOTATATE resulted in a higher response rate, symptomatic relief, improved QoL, and prolonged PFS in patients whose disease remained nonresponsive after intravenous [ 177 Lu]Lu-DOTATATE. Prospective randomized controlled trials can further validate the incorporation of intra-arterial PRRT into the management of GEP-NETs.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"1029-1040"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988591","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}