Nuclear Medicine Communications最新文献

{"title":"PET/computed tomography radiomics combined with clinical features in predicting sarcopenia and prognosis of diffuse large B-cell lymphoma.","authors":"Fanghu Wang, Yang Chen, Xiaoyue Tan, Xu Han, Wantong Lu, Lijun Lu, Hui Yuan, Lei Jiang","doi":"10.1097/MNM.0000000000001925","DOIUrl":"10.1097/MNM.0000000000001925","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to assess the role of 18 F-fluorodeoxyglucose (FDG) PET/computed tomography (CT) radiomics combined with clinical features using machine learning (ML) in predicting sarcopenia and prognosis of patients with diffuse large B-cell lymphoma (DLBCL).</p><p><strong>Methods: </strong>A total of 178 DLBCL patients (118 and 60 applied for training and test sets, respectively) who underwent pretreatment 18 F-FDG PET/CT were retrospectively enrolled. Clinical characteristics and PET/CT radiomics features were analyzed, and feature selection was performed using univariate logistic regression and correlation analysis. Sarcopenia prediction models were built by ML algorithms and evaluated. Besides, prognostic models were also developed, and their associations with progression-free survival (PFS) and overall survival (OS) were identified.</p><p><strong>Results: </strong>Fourteen features were finally selected to build sarcopenia prediction and prognosis models, including two clinical (maximum standard uptake value of muscle and BMI), nine PET (seven gray-level and two first-order), and three CT (three gray-level) radiomics features. Among sarcopenia prediction models, combined clinical-PET/CT radiomics features models outperformed other models; especially the support vector machine algorithm achieved the highest area under curve of 0.862, with the sensitivity, specificity, and accuracy of 79.2, 83.3, and 78.3% in the test set. Furthermore, the consistency index based on the prognostic models was 0.753 and 0.807 for PFS and OS, respectively. The enrolled patients were subsequently divided into high-risk and low-risk groups with significant differences, regardless of PFS or OS ( P  < 0.05).</p><p><strong>Conclusion: </strong>ML models incorporating clinical and PET/CT radiomics features could effectively predict the presence of sarcopenia and assess the prognosis in patients with DLBCL.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"162-170"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576749","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":"Radioactive iodine therapy dose impact on recurrence and survival in N1 papillary thyroid cancer.","authors":"Elizabeth E Odil, Katelyn R Ward, Ryan T Davis, Jordan M Reilly, Fionna Sun, Heba Elassar, Morta Lapkus, Jacquelyn Pastewski, Diane M Studzinski, Rose E Callahan, Peter F Czako, Sapna Nagar","doi":"10.1097/MNM.0000000000001936","DOIUrl":"10.1097/MNM.0000000000001936","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to investigate radioactive iodine therapy (RAIT) dose impact on survival and recurrence in patients with papillary thyroid cancer (PTC) with regional lymph node metastasis (N1).</p><p><strong>Methods: </strong>A retrospective study of PTC patients with N1 disease from 2007 to 2011 at a tertiary academic hospital collected demographics, tumor characteristics, and RAIT treatment dose. RAIT dose was stratified by total dosage less than or greater than 150 mCi. Outcomes included recurrence, immediate RAIT side-effects, and mortality.</p><p><strong>Results: </strong>A total of 60 N1a and 21 N1b patients were studied with a median follow-up of about 9 years. No statistically significant differences were found between N1a PTC patients who received high-dose vs low-dose RAIT in recurrence rate (6.9% vs 6.7%, P  > 0.999) or immediate RAIT side effects (6.9% vs 16.1%, P  = 0.426). There were no mortalities in the N1a group. For patients with N1b PTC, there were no differences between high-dose and low-dose RAIT in recurrence rate (41.7% vs 44.4%, P  > 0.999), mortality (0% vs 16.7%, P  = 0.375), or immediate RAIT side effects (8.3% vs 11.1%, P  > 0.999).</p><p><strong>Conclusion: </strong>Dosages of RAIT ≥ 150 mCi do not appear to provide additional benefit in reducing recurrence compared to doses <150 mCi for N1a or N1b PTC patients. No differences in mortality or immediate RAIT side effects were observed between the two dosing regimens; however, interpretation is limited by low event rates. Large randomized trials are needed for further individualized recommendations regarding optimal RAIT dosage in N1 PTC.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"113-119"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739128","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 selection of target areas for orbital imaging, application of diethylenetriaminepentaacetic acid orbital imaging, clinical factors, alkaline phosphatase, and thyrotropin receptor antibodies in the staging and grading of thyroid-associated ophthalmopathy.","authors":"Min Yuan, Yiren Feng, Lin Guo, Ping Li, Yuting Liu, Yao Wang, Yusong Chen, Gang Jin","doi":"10.1097/MNM.0000000000001934","DOIUrl":"10.1097/MNM.0000000000001934","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the active phase of thyroid-associated ophthalmopathy (TAO), its correlations with clinical factors, serological tests, and orbital imaging parameters, and evaluate the diagnostic value of different orbital imaging target areas.</p><p><strong>Methods: </strong>A total of 45 patients with thyroid-related eye disease underwent imaging, serological tests, and clinical data collection. Clinical Activity Score (CAS) assessment, diplopia scores, and NOSPECS grading were conducted. Radioactive counts of extraocular muscles and tear glands were measured. Computed tomography scans assessed exophthalmos and extraocular muscle thickening. Correlations and differences among study parameters and grades were evaluated using receiver operating characteristic curves.</p><p><strong>Results: </strong>Active TAO correlated significantly with radioactive counts of muscles and tear glands, alkaline phosphatase (ALP), thyrotropin receptor antibody (TRAb), and age. Significant differences were found among NOSPECS grades for studied variables (except ALP and TRAb). Extraocular muscle thickening was confirmed as a reliable diagnostic criterion. High consistency was found between orbital imaging and CAS staging. Treatment showed varying degrees of improvement in active patients, while nonactive patients showed no progression during follow-up. Receiver operating characteristic curves demonstrated high diagnostic efficacy for tear gland radioactive counts.</p><p><strong>Conclusion: </strong>Tear glands and extraocular muscles have high diagnostic value in TAO, with tear glands showing a higher value. Orbital imaging provides an objective and comprehensive assessment compared with CAS scoring alone. ALP, TRAb, and age also play significant roles in staging.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"152-161"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739157","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":"Sublingual glyceryl trinitrate given during adenosine sestamibi myocardial perfusion imaging causes apparent transient ischaemic dilation in a propensity-matched analysis.","authors":"David S Rose, Bradley M Hector, Shanthi Kannan, Joseph C Lee","doi":"10.1097/MNM.0000000000001929","DOIUrl":"10.1097/MNM.0000000000001929","url":null,"abstract":"<p><strong>Objectives: </strong>Administration of sublingual glyceryl trinitrate (GTN) prior to resting radiotracer injection during myocardial perfusion imaging (MPI) has been advocated to aid detection of viable myocardium and increase the extent of reversible perfusion defects. However, GTN is also known to reduce resting left ventricular volume and could thus increase the transient ischaemic dilation (TID) ratio, independently of severe or extensive coronary artery disease. We aimed to determine if GTN administration causes an increase in the TID ratio.</p><p><strong>Methods: </strong>Causal inference using propensity score matched analysis was used to assess the effect of GTN on TID ratios in subjects undergoing adenosine sestamibi MPI.</p><p><strong>Results: </strong>From 597 consecutive patients undergoing MPI, we selected a treatment group of 51 who received 400 μg of sublingual GTN before resting sestamibi injection and 51 propensity score matched controls. Mean TID ratios were 1.24 in treated subjects and 1.10 in controls (mean difference 0.15; 95% CI, 0.05-0.25; P  = 0.0018). The mean difference in TID ratio fell progressively in each quartile of time elapsed between GTN administration and image acquisition. The proportion with TID ratios equal and greater than an abnormal threshold of 1.39 was 17.6% among the treated and 0% in controls ( P  = 0.0010). The effect on TID ratio was not restricted to those with moderate-to-severe stress perfusion defects or accompanied by greater reversible perfusion defects.</p><p><strong>Conclusions: </strong>There is evidence of a cause-and-effect relationship between administering GTN before resting sestamibi injection and increased TID ratio on MPI. This may be a source of misleading false positive TID findings.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"128-137"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709676","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":"Local and systemic biodistribution of a small-molecule radiopharmaceutical probe after transcatheter embolization and intra-arterial delivery in a porcine orthotopic renal tumor model.","authors":"Samuel L Rice, Fernando Gómez Muñoz, Jamaal L Benjamin, Mhd Wisam Alnablsi, Joseph R Osborne, Regina Beets-Tan","doi":"10.1097/MNM.0000000000001928","DOIUrl":"https://doi.org/10.1097/MNM.0000000000001928","url":null,"abstract":"<p><strong>Background: </strong>Small-molecule biomacromolecules target tumor-specific antigens. They are employed as theranostic agents for imaging and treatment. Intravenous small-molecule radioligands exhibit rapid tumor uptake and excretion. However, systemic administration for peptide receptor radionuclide therapy still lacks the therapeutic index to completely treat solid tumors beyond palliation. We study intra-arterial delivery with tumor embolization of a small molecule as a means to deliver local intertumoral brachytherapy for curative internal ablation.</p><p><strong>Results: </strong>18F-fluorodeoxyglucose (FDG) was used as a surrogate for a small-molecule theranostic agent in a porcine renal tumor model, this tumor model is not known to specifically express human tumor antigens, but the model demonstrates similar vascularity. Angiography and micron particle embolization of the tumor arterioles were performed in a renal tumor model. Significantly more tumor uptake (2-4×), was observed for intra-arterial administration (IA) compared to intravenous (IV) (%ID/g = 44.41 ± 2.48 vs. 23.19 ± 4.65; P = 0.0342 at 1 min and 40.8 ± 2.43 vs. 10.94 ± 0.42; P = 0.018 at 10 min). At later time points, up to 120 min after injection, washout of the tracer from the tumor was observed, but the percent injected dose per gram remained elevated, with three times higher concentration of FDG with IA administration compared with IV, but the difference was not statistically significant. A trend towards diminished systemic percent injected dose per gram measured in the blood, liver, kidney, spleen, muscle, and urine for study IA compared to IV administration is observed.</p><p><strong>Conclusion: </strong>Combining IA administration of a small-molecule radioprobe surrogate with embolization of the tumor's arterioles extending the time for interaction of the drug within the tumor by diminishing flow out of the tumor via the efferent capillaries significantly increases the first-pass uptake of the small-molecule drug within a tumor and decreases the radiation to normal nontumor tissues when compared with IV injection of the same drug. The minimally invasive drug delivery allows tumor-specific theranostic treatment of renal tumors with a brachytherapy-absorbed dose of radiation that is potentially curative.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":"46 2","pages":"138-145"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952674","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":"Predicting higher-risk growth patterns in invasive lung adenocarcinoma with multiphase multidetector computed tomography and 18 F-fluorodeoxyglucose PET radiomics.","authors":"Yi Luo, Xiaoguang Li, Jinju Sun, Suihan Liu, Peng Zhong, Huan Liu, Xiao Chen, Jingqin Fang","doi":"10.1097/MNM.0000000000001931","DOIUrl":"10.1097/MNM.0000000000001931","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a predictive model for identifying the higher-risk growth pattern of invasive lung adenocarcinoma using multiphase multidetector computed tomography (MDCT) and 18 F-fluorodeoxyglucose (FDG) PET radiomics.</p><p><strong>Methods: </strong>A total of 203 patients with confirmed invasive lung adenocarcinoma between January 2018 and December 2021 were enrolled and randomly divided into training ( n  = 143) and testing sets ( n  = 60). Patients were classified into two groups according to the predominant growth pattern (lower-risk group: lepidic/acinar; higher-risk group: papillary/solid/micropapillary). Preoperative multiphase MDCT and 18 F-FDG PET images were evaluated. The Artificial Intelligence Kit software was used to extract radiomic features. Five predictive models [arterial phase, venous phase, and plain scan (AVP), PET, AVP-PET, clinical, and radiomic-clinical (Rad-Clin) combined model] were developed. The models' performance was assessed using receiver-operating characteristic (ROC) curves and compared using the DeLong test.</p><p><strong>Results: </strong>Among the radiomics models (AVP, PET, and AVP-PET), the AVP-PET model [area under ROC curve (AUC) = 0.888] outperformed the PET model (AUC = 0.814; P  = 0.015) in predicting the higher-risk growth patterns. The combined Rad-Clin model (AUC = 0.923), which integrates AVP-PET radiomics and five independent clinical predictors (gender, spiculation, long-axis diameter, maximum standardized uptake value, and average standardized uptake value), exhibited superior performance in predicting the higher-risk growth pattern compared with radiomic models ( P  = 0.043, vs. AVP-PET; P  = 0.016, vs. AVP; P  = 0.002, vs. PET) or the clinical model alone (constructing based on five clinical predictors; AUC = 0.793; P < 0.001).</p><p><strong>Conclusion: </strong>The combined Rad-Clin model can predict the higher-risk growth patterns of invasive adenocarcinoma (IAC). This approach could help determine individual therapeutic strategies for IAC patients by distinguishing predominant growth patterns with high risk.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"171-179"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688387","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 application of extraocular muscle maximum standardized uptake value of 99mTc-diethylenetriamine pentaacetic acid orbital single photon emission computed tomography/computed tomography in the assessment of Graves' orbitopathy.","authors":"Chao Lu, Yang Yu, Shen Wang, Xue Yin, Hongyuan Zheng, Xiangxiang Li, Qiang Jia, Wei Zheng","doi":"10.1097/MNM.0000000000001927","DOIUrl":"https://doi.org/10.1097/MNM.0000000000001927","url":null,"abstract":"<p><strong>Purpose: </strong>To study the feasibility and value of assessing patients with Graves' orbitopathy (GO) in 99mTc-diethylenetriamine pentaacetic acid (DTPA) orbital single photon emission computed tomography/computed tomography (SPECT/CT) with extraocular muscle maximum standardized uptake value (SUVmax).</p><p><strong>Methods: </strong>A total of 235 patients underwent 99mTc-DTPA orbital SPECT/CT, including 176 patients with GO and 59 patients with Graves' disease (GD) as controls. The SUVmax of extraocular muscles, including right medial rectus muscle (RMR), right lateral rectus muscle (RLR), left medial rectus muscle (LMR), left lateral rectus muscle (LLR), was compared between groups, correlation analyses with clinical activity scores (CAS) and serological indices was performed, and the diagnostic efficacy was evaluated using receiver operating characteristic curves. The consistency of SPECT/CT and MRI in assessing extraocular muscle activity was compared.</p><p><strong>Results: </strong>SUVmax in the extraocular muscles of active GO patients was significantly higher than in inactive GO patients and controls. In GO patients, SUVmax of the medial rectus (LMR most prominent) was higher than that of the lateral rectus. SUVmax correlated with CAS, thyroid-stimulating hormone, total cholesterol, low-density lipoprotein (positively) and free triiodothyronine and free thyroxine (negatively), but not with GO duration. The optimal cutoff values for distinguishing between active and inactive SUVmax were identified. RLR had high sensitivity and RMR had high specificity. SPECT/CT and MRI showed moderate agreement in assessing extraocular muscle activity in 87 GO patients, with high concordance.</p><p><strong>Conclusions: </strong>The extraocular muscle SUVmax of 99mTc-DTPA orbital SPECT/CT may be used as an adjunct method in combination with CAS to more accurately assess GO activity, which can help in clinical diagnosis and individualized treatment.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":"46 2","pages":"120-127"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952678","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":"Evaluation of brain metabolism using F18-FDG PET/CT imaging in patients diagnosed with lung cancer.","authors":"Ahmet E Şen, Buğra Kaya, Hakan Ş Bozcuk, Özlem Şahin, Mehmet Uyar, Mehmet Artaç, Mustafa Erol","doi":"10.1097/MNM.0000000000001911","DOIUrl":"10.1097/MNM.0000000000001911","url":null,"abstract":"<p><strong>Objectives: </strong>Brain imaging of regional metabolic changes in cancer patients can provide insights into cancer biology. We aimed to detect regional metabolic changes in the brains of untreated lung cancer patients without brain metastases using 2-deoxy-2-[18F]fluoroglucose PET/computed tomography.</p><p><strong>Methods: </strong>The study included 44 lung cancer patients and 17 non-cancer patients as controls. Standardized uptake value (SUV) mean values of 68 different brain regions were recorded, and their ratios to whole brain and brainstem SUVmean were calculated.</p><p><strong>Results: </strong>Comparisons between the groups showed significant reductions in the frontal lobe, inferior temporal gyrus, and right cingulate and paracingulate gyrus ratios in the patient group. Conversely, the right nucleus caudatus and right pallidum ratios were elevated. Correlation analysis with total lesion glycolysis (TLG) revealed positive correlations in the basal ganglia, right insula, amygdala, and right hippocampus ratios. Negative correlations were observed in the left frontal lobe and some temporal and parietal regions.</p><p><strong>Conclusions: </strong>While most brain regions showed reduced metabolism, potentially due to tumor-brain glucose competition, others were preserved or positively correlated with TLG, suggesting a link to poor prognosis. The reduced metabolism in the frontal lobe might be associated with depression and cognitive decline in cancer patients.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"76-82"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361889","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":"Different degrees of summed difference perfusion score in women: influence on the prognostic variables associated with cardiac events.","authors":"Guillermo Romero-Farina, Santiago Aguadé-Bruix, Ignacio Ferreira-González","doi":"10.1097/MNM.0000000000001921","DOIUrl":"10.1097/MNM.0000000000001921","url":null,"abstract":"<p><strong>Objective: </strong>Evaluating the predictive models (PM) for a major adverse cardiac event (MACE) only in women with abnormal summed difference score (SDS ≥ 1), borderline myocardial ischemia (borderline-MIsch: SDS = 1), MIsch (SDS ≥ 2), mild-MIsch (SDS = 2-4), and moderate-severe MIsch (ms-MIsch: SDS ≥ 5).</p><p><strong>Methods: </strong>Between January 2000 and January 2018, of 25 943 consecutive patients who underwent gated single-photon emission computed tomography myocardial perfusion imaging (gSPECT-MPI) for coronary risk stratification; 717 women (age 68.37 ± 3.4 years) with an abnormal SDS ≥ 1 were included. During the follow-up (mean 4 ± 2.9 years) post-gSPECT-MPI, MACE (unstable angina, nonfatal myocardial infarction, coronary revascularization, cardiac death) was assessed.</p><p><strong>Results: </strong>In the global women cohort with abnormal SDS ( n  = 717), the PM was angina [hazard ratio (HR): 1.65, P  = 0.016], diabetes (HR: 1.72, P  = 0.004), beta-blockers (HR: 1.61, P  = 0.009), pharmacological stress (HR: 1.74, P  = 0.007), ↓ segment (ST) mm ≥ 1 (HR: 1.54, P  = 0.039), and moderate-to-severe abnormal summed stress score (ms-SSS) (HR: 2.92, P  = 0.001). In borderline-MIsch group ( n  = 208), the PM was previous myocardial infarction (HR: 3.8, P  = 0.001), nitrates (HR: 2.13, P  = 0.047), pharmacological stress (HR: 4.81, P  < 0.001), and ↓ST mm ≥ 1 (HR: 3.07, P  = 0.014). In MIsch group ( n  = 509), the PM model was ms-SSS (HR: 2.25, P  = 0.001), diabetes (HR: 1.73, P  = 0.011), angina (HR: 1.68, P  = 0.029), beta-blockers (HR: 1.59, P  = 0.026), and ms-MIsch (HR: 1.62, P  = 0.044). In mild-MIsch group ( n  = 399), the PM was ms-SSS (HR: 2.55, P  = 0.003), diabetes (HR: 2.17, P  = 0.004), angina (HR: 1.89, P  = 0.037), and beta-blockers (HR: 2.01, P  = 0.011). In ms-MIsch group ( n  = 110), the predictive variable for MACE was ms-SSS (HR: 2.27, P  = 0.016). The ms-SSS significantly increases the prognostic value of the ms-MIsch ( P  = 0.001).</p><p><strong>Conclusion: </strong>Women with different degrees of abnormal SDS have different PMs of MACE. The ms-SSS stands out as the most significant predictive variable.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"28-37"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546656","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":"Prognosis and ablation success in thyroid cancer: overcoming the challenges of incomplete clinical profiles.","authors":"Manish Ora, Aftab Hasan Nazar, Prabhakar Mishra, Sukanta Barai, Amitabh Arya, Prasanta Kumar Pradhan, Sanjay Gambhir","doi":"10.1097/MNM.0000000000001923","DOIUrl":"10.1097/MNM.0000000000001923","url":null,"abstract":"<p><strong>Background: </strong>Differentiated thyroid carcinoma (DTC) is managed by surgery followed by radioiodine (RAI) therapy in most intermediate and high-risk patients. Most nonmetastatic patients have excellent treatment responses and have long-term disease-free status. A lack of comprehensive medical services in resource-limited nation leads to attrition of critical clinical prognostication information. This study aimed to identify readily available clinical, biochemical, and histopathological parameters to predict remnant ablation success and long-term outcomes.</p><p><strong>Methods: </strong>The study included DTC patients who underwent RAI after surgery. Ablation success was determined by thyroglobulin (Tg) and whole-body radioiodine scan. Patients were followed for at least 5 years to assess biochemical incomplete response (BIR) and structural recurrence.</p><p><strong>Results: </strong>The study included 383 patients (a mean age of 37.8 ± 12.9 years). Successful ablation was noted in 251 (65.5%). High preablative stimulated serum Tg (presTg), papillary variants, and central and lateral compartment lymph nodal metastases were associated with ablation failure. PresTg ( P  < 0.001) was the most significant predictor. After a 102.9 ± 34.5 months follow-up, 280 (73.1%) patients were disease-free. BIR and structural recurrence were noted in 103 and 32 patients. PresTg (8.1 ± 27.7 vs. 92.3 ± 99.9 ng/ml), ATg (112.9 ± 389.8 vs. 43.2 ± 89.8 IU/ml), papillary variant, central [109 (66.1%) vs. 56 (33.9%)], and lateral compartment [65 (63.7%) vs. 37 (36.3%) lymph nodal metastases were associated ( P  < 0.05) with BIR. PresTg >10.5 ng/ml has a sensitivity and specificity of 86.6 and 86.0% for predicting BIR. Patients with successful remnant ablation and a presTg level <10.5 ng/ml had a low risk of long-term disease recurrence (less than 5%).</p><p><strong>Conclusion: </strong>This ambispective study found that successful ablation and long-term disease-free survival were achievable in a significant proportion of DTC patients. BIR (26.9%) and structural recurrence (8.4%) were not uncommon. PresTg levels emerged as a crucial predictor of ablation success and subsequent outcomes. In resource-limited regions, presTg levels and ablation failure can aid in optimizing treatment strategies and improving patient care.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"21-27"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590563","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}