Nuclear Medicine Communications最新文献

{"title":"Radiomics of planar Tc-99m methylene diphosphonate bone scintigraphy for pediatric osteomyelitis: a paired infected-contralateral analysis.","authors":"Jagrati Chaudhary, Rakesh Kumar, Bhoomi Gupta, Param D Sharma, Ravi Mittal, Anil Kumar Pandey","doi":"10.1097/MNM.0000000000002234","DOIUrl":"https://doi.org/10.1097/MNM.0000000000002234","url":null,"abstract":"<p><strong>Background: </strong>Pediatric osteomyelitis is a serious bone infection whose early diagnosis remains challenging because clinical and laboratory findings are often nonspecific. Although Tc-99m methylene diphosphonate (MDP) bone scintigraphy is highly sensitive for detecting osteoblastic activity and multifocal disease, image interpretation remains largely qualitative and subject to interobserver variability. This study evaluated whether radiomics analysis of planar Tc-99m MDP bone scintigraphy could quantitatively differentiate infected from contralateral normal bone in children with suspected osteomyelitis.</p><p><strong>Methods: </strong>This retrospective single-center study included 28 pediatric patients with suspected osteomyelitis who underwent anterior and posterior planar Tc-99m MDP bone scintigraphy. Paired infected and contralateral normal bone regions of interest (ROIs) of each patient were segmented. A standardized radiomics pipeline extracted 62 quantitative features per ROI, including shape, first-order intensity, and higher-order texture features. Statistical analyses included paired Wilcoxon signed-rank testing, effect size analysis, mutual information assessment, and leave-one-out cross-validated (LOOCV) logistic regression. A compact multivariable radiomics score was subsequently derived from the top-performing features.</p><p><strong>Results: </strong>Texture-based radiomic features showed the strongest discrimination between infected and contralateral bone, with gray-level co-occurrence matrix-derived correlation and information-theoretic metrics - particularly T_InformationCorrelation2Averaged2D, T_InformationCorrelation2SliceMerged2D, and T_CorrelationAveraged2D/T_CorrelationSliceMerged2D - demonstrating highly significant differences (all P < 0.001) and large paired effect sizes (Cohen's d ≈ 0.80-0.85). Single-feature logistic regression models achieved moderate discrimination (LOOCV AUC: 0.60-0.63).</p><p><strong>Conclusion: </strong>Planar Tc-99m MDP bone scintigraphy radiomics differentiated infected from normal contralateral bone in pediatric osteomyelitis, with texture-derived features outperforming intensity metrics (all P < 0.001; Cohen's d ≈ 0.80-0.85), supporting radiomics as an objective adjunct to visual interpretation.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796291","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":"Tumor spread through air spaces in non-small-cell lung cancer: 18F-fluorodeoxyglucose PET-based tumoral and peritumoral radiomics analysis with machine learning.","authors":"Nur Aydinbelge Dizdar, Ebru Tatci, Aysu Dursun, Kayacan Dizdar, Özge Kaya Korkmaz, Ozlem Ozmen","doi":"10.1097/MNM.0000000000002235","DOIUrl":"https://doi.org/10.1097/MNM.0000000000002235","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the utility of tumoral and peritumoral [18F]-fluorodeoxyglucose PET-based radiomics models for predicting tumor spread through air spaces (STAS) in non-small-cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>A total of 104 patients with NSCLC were retrospectively included and classified as STAS-positive or STAS-negative according to postoperative histopathology. Three radiomics models were developed based on tumoral and peritumoral volumes of interest (VOIs). Peritumoral models were constructed by defining VOIs with 5 and 10 mm expansions from the tumor margin (PR-5 and PR-10). Conventional PET-derived parameters were calculated. Each group was randomly divided into training (70%) and testing (30%) sets. For prediction, five machine learning algorithms were applied. Model performance was assessed by area under the receiver operating characteristic curve (AUC), accuracy, precision, recall, and F1 score.</p><p><strong>Results: </strong>Of the 104 patients, 60 (57.7%) were in the STAS-positive group, and 44 (42.3%) were in the STAS-negative group. Statistically significant differences were found in 27 tumoral, 62 PR-5, and 89 PR-10 radiomic features between the groups. Support Vector Machine achieved the best performance for the tumoral model (AUC: 0.70), whereas Logistic Regression was optimal for the PR-5 and PR-10 models, with AUCs of 0.79 and 0.74, respectively. The mean F1 score values for the tumoral, PR-5, and PR-10 models were 0.67, 0.72, and 0.68, respectively. Maximum standardized uptake value (SUVmax), SUVmean, and SUVpeak did not differ significantly between groups. Tumor size, total lesion glycolysis, and metabolic tumor volume were significantly higher in the STAS-positive group.</p><p><strong>Conclusion: </strong>Our findings suggest that peritumoral PET-based radiomics may help predict STAS status in NSCLC. The PR-5 model demonstrated the highest predictive performance, while conventional SUV-based parameters showed limited predictive value.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796379","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":"Safety profile of therapeutic radiopharmaceuticals for bone metastases pain palliation: evidence from a systematic literature review.","authors":"Sara Martins, Diana Oliveira, Cláudia Pinho, Ana Martín-Suárez, Ângelo Jesus","doi":"10.1097/MNM.0000000000002221","DOIUrl":"https://doi.org/10.1097/MNM.0000000000002221","url":null,"abstract":"<p><p>Radiopharmaceutical therapy is one of the treatment modalities used for the palliative management of pain associated with bone metastases. Given that radiopharmaceuticals may cause adverse reactions, this study aims to systematize the findings of published research on the use of strontium-89, samarium-153, rhenium-186, rhenium-188, and lutetium-177 in this clinical context. Adverse reactions were analyzed through a two-part approach. The first section presents a systematic literature review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement, using the MEDLINE and EBSCO databases, from which 29 articles were selected. Findings indicate that the four radiopharmaceuticals yielded broadly comparable results across pain relief, reduction in analgesic consumption, acute administration-related adverse reactions, hematological toxicity, and disease progression. The second section critically appraises the methodological quality of the included publications, using a structured assessment tool. Results indicate that, although therapeutic radiopharmaceuticals generally demonstrate a favorable safety profile, hematological toxicity, particularly leukopenia and thrombocytopenia, is the most frequently reported adverse reaction. The spontaneous reporting system continues to face significant challenges, including data limitations in vulnerable populations, conflicting causality assessments, and underreporting. In conclusion, the use of radiopharmaceuticals for pain palliation appears to be safe and represents a viable alternative to existing treatments. This work underscores the importance of integrating pharmacovigilance practices specific to radiopharmaceuticals, promoting structured adverse reactions reporting, and enhancing clinical awareness to safeguard patient safety.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762151","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":"Vitamin D and the accuracy of nuclear medicine imaging in patients with prosthetic hip and knee joints - a retrospective study.","authors":"Hannah E Chandler, Hassan Hirji","doi":"10.1097/MNM.0000000000002230","DOIUrl":"https://doi.org/10.1097/MNM.0000000000002230","url":null,"abstract":"<p><strong>Objective: </strong>Nuclear medicine is a well-established modality for assessing infection or loosening of prosthetic joint replacements. However, previous research suggests that loosening and low-grade periprosthetic infection can appear similar. Patients with vitamin D deficiency have been noted to have poorer outcomes postsurgery for both infection and loosening. Patients with low-grade uptake and low vitamin D levels may be mismanaged if imaging is inaccurate. This study evaluated the association between nuclear medicine imaging accuracy and vitamin D levels in patients with prosthetic joint replacements.</p><p><strong>Methods: </strong>A retrospective single-center cohort study was carried out. Data were collected anonymously with 298 cases including knee and hip prostheses. Clinical findings were split into two categories: matched, whereby scan reports agreed with clinical findings, and unmatched, whereby they did not match and therefore imaging was inaccurate. Chi-squared and Fisher's exact tests were performed to assess statistical significance.</p><p><strong>Results: </strong>Analysis shows a statistically significant association between imaging accuracy of prosthetic joint replacements and vitamin D level (P < 0.001). There was no significant difference between prosthesis types. Patients with low vitamin D were 2.61 times more likely to have inaccurate results.</p><p><strong>Conclusion: </strong>There was an association between vitamin D levels and nuclear medicine imaging accuracy, and imaging results in cases with low vitamin D levels were two times more likely to be inaccurate. Prospective research would be appropriate to further confirm this. Vitamin D levels could be used as an indicator for the accuracy of imaging results, or low vitamin D levels could be managed before imaging.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761178","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 significance of ilioinguinal nodal uptake percentages in lower limb lymphoscintigraphy.","authors":"Erkan Güler","doi":"10.1097/MNM.0000000000002233","DOIUrl":"https://doi.org/10.1097/MNM.0000000000002233","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the significance of ilioinguinal nodal uptake percentages in the evaluation of lower limb lymphoscintigraphy.</p><p><strong>Methods: </strong>Lymphoscintigraphy studies from 161 patients were retrospectively evaluated. Region-of-interest counts from the injection sites at baseline and from whole-body images at 120 min were corrected for count duration and radioactive decay; ilioinguinal nodal uptake percentages were then calculated for each lower limb. Nodal uptake percentages were compared between normal and abnormal findings in the corresponding limbs and among the study-specific lymphoscintigraphic classification groups.</p><p><strong>Results: </strong>The median ilioinguinal nodal uptake was 18.6%, with an interquartile range of 11-27, in 127 limbs with a normal lymphoscintigraphic pattern. Uptake values were higher in limbs showing features suggestive of increased lymphatic flow reserve, such as collateral lymphatic channels, but decreased with progressive lymphatic dysfunction (P < 0.001). Uptake values differed significantly among the study-specific lymphoscintigraphic classification groups (P < 0.001). Visual assessments showed a moderate correlation with semiquantitative assessments in determining asymmetry of the ilioinguinal lymph nodes on both sides (Pearson's r = 0.52, P < 0.001).</p><p><strong>Conclusion: </strong>Although ilioinguinal nodal uptake percentages are widely distributed, the observed distribution in limbs with normal lymphoscintigraphic patterns and selected threshold values may support visual interpretation.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761044","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 impact of data extraction percentage and deep learning-based reconstruction on image quality in gated PET/computed tomography.","authors":"Hiroki Nosaka, Masaya Suda, Noriaki Miyaji, Hiraku Fuse, Kenji Yasue, Norikazu Koori, Shin Miyakawa, Masato Takahashi, Koichi Hanada, Shogo Imai","doi":"10.1097/MNM.0000000000002222","DOIUrl":"https://doi.org/10.1097/MNM.0000000000002222","url":null,"abstract":"<p><strong>Background: </strong>Respiratory motion artifacts degrade PET/computed tomography (PET/CT) image quality. Data-driven gated (DDG) PET/CT addresses this issue by extracting respiratory signals directly from PET data, eliminating the need for external monitoring devices. This study investigated the effects of data extraction percentage (%count) and deep learning-based reconstruction [Advanced Intelligent Clear-IQ Engine-integrated (AiCE-i)] on image quality in DDG-PET under different respiratory conditions using a phantom model.</p><p><strong>Methods: </strong>A body phantom containing six spheres (10-37 mm) was imaged using a silicon photomultiplier-based PET/CT system. Four respiratory waveforms (no-motion, sinusoidal, representative patient, and baseline shift) and four %count levels (20, 30, 40, and 50%) were evaluated using AiCE-i reconstruction. Image quality was assessed using background variability (N10 mm), percentage contrast (QH,10 mm), contrast-to-noise ratio (QH,10 mm/N10 mm), and recovery coefficient.</p><p><strong>Results: </strong>Increasing %count consistently reduced N10 mm across all respiratory waveforms. QH,10 mm and QH,10 mm/N10 mm generally increased with increasing %count; however, at the 50% threshold, significant reductions were observed in the baseline shift and sinusoidal waveforms compared with the no-motion condition. Recovery coefficient analysis demonstrated the partial volume effect in smaller spheres and showed that quantitative performance was maintained across the evaluated gating conditions.</p><p><strong>Conclusion: </strong>The combination of DDG and AiCE-i maintained stable image quality across the respiratory conditions evaluated. Under the conditions of this phantom study, a %count range of 30-40% provided a favorable balance between image noise and the effects of respiratory motion for standard 120-s acquisitions.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702007","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":"68Ga prostate-specific membrane antigen PET/computed tomography in benign and malignant prostatic lesions: a study of maximum standardized uptake value and uptake patterns with clinicopathological correlation.","authors":"Prathamesh Mangale, Archi Agrawal, Sayak Choudhury, Gagan Prakash, Vedang Murthy, Amit Joshi, Santosh Menon, Mahendra Pal, Venkatesh Rangarajan","doi":"10.1097/MNM.0000000000002224","DOIUrl":"https://doi.org/10.1097/MNM.0000000000002224","url":null,"abstract":"<p><strong>Aim: </strong>Assessment of maximum standardized uptake value (SUVmax) values and patterns of uptake on 68Ga prostate-specific membrane antigen (PSMA) PET/computed tomography (CT) in benign and malignant prostatic lesions.</p><p><strong>Methods: </strong>Retrospective observational study of prostate cancer patients referred for 68Ga-PSMA PET/CT for initial staging. SUVmax of the prostatic lesion was correlated with risk category, International Society of Urological Pathology (ISUP) grade groups, prostate-specific antigen (PSA), and Gleason score. Uptake patterns across risk categories were also evaluated.</p><p><strong>Results: </strong>A total of 325 subjects were included (14 benign and 311 malignant). Median SUVmax of benign lesions was 8.29. Grade groups 4 and 5 showed significantly higher median SUVmax values (26.42 and 26.55) than other grade groups. SUVmax correlated positively with ISUP grade group, Gleason score, and serum PSA (all P < 0.001). SUVmax differed significantly among benign/low-, intermediate-, and high-risk groups. Receiver operating characteristic analysis identified an SUVmax cut-off of 10.91 for diagnosing prostate cancer, with 80% sensitivity, 79% specificity, 98.8% positive predictive value, and 80% diagnostic accuracy. Uptake pattern within the prostate did not differ significantly across risk categories.</p><p><strong>Conclusion: </strong>SUVmax differentiates high-risk from low- and intermediate-risk prostate cancer and may serve as a noninvasive independent prognostic marker. Intraprostatic uptake pattern has no significant role in lesion categorization.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674009","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 practice of adult whole-body nuclear medicine bone scanning in the UK: opportunities to optimise.","authors":"Samantha J Colosimo, Roger T Staff, Kathryn Adamson, Maria Burniston, Kat Dixon, Sarah McQuaid, Julie Speakman, David Towey, John C Dickson","doi":"10.1097/MNM.0000000000002218","DOIUrl":"https://doi.org/10.1097/MNM.0000000000002218","url":null,"abstract":"<p><strong>Objectives: </strong>Recent advances in bone scintigraphy, including multi-head detector systems, improved reconstruction algorithms, and novel detector technologies, offer opportunities to enhance image quality, reduce acquisition times, and lower administered activities. However, it is unclear whether these changes have led to updates in clinical practice or optimisation of local diagnostic reference levels in the UK.</p><p><strong>Methods: </strong>The UK Heads of Nuclear Medicine Physics group commissioned a national survey to determine whether these developments have led to practical advancements.</p><p><strong>Results: </strong>Fifty-four responses were received: England (36), Scotland (11), Wales (5), and Northern Ireland (2). Of these, 50 sites perform planar bone scans, using predominantly Siemens or General Electric scanners (98%), with Siemens Symbia/Intevo and General Electric 600/800 systems each representing 43% of responses. Substantial variation in protocols was observed. Optimisation of planar imaging was reported by 24% of sites, with aims including reduced scan time, lower administered activity, improved image quality, or combinations thereof. The majority of sites (88%) use fixed administered activities for planar oncology scans, either 500 MBq (11%), 550 MBq (16%), or 600 MBq (73%), rather than weight-based activities.</p><p><strong>Conclusions: </strong>This study demonstrated that the majority of sites use the Administration of Radioactive Substances Advisory Committee national diagnostic reference levels (NDRLs) for administered activity. Sites that had optimised protocols were more likely to use weight-based administered activities. The majority of respondents (49/50) supported reviewing the current NDRLs, which predate many of the technological developments. This work demonstrates the considerable variation in UK bone scintigraphy practice and suggests further optimisation is achievable.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674039","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":"An open-source framework for image-based planning and PET/computed tomography dosimetry in yttrium-90 radioembolization.","authors":"Tadeu Takao Almodovar Kubo, Lidia Vasconcellos de Sá","doi":"10.1097/MNM.0000000000002228","DOIUrl":"https://doi.org/10.1097/MNM.0000000000002228","url":null,"abstract":"<p><p>The aim of this study was to describe Yttrium Radioembolization Dosimetry Evaluation (YRDose), an investigational open-source software suite for image-based activity planning and optional post-therapy dosimetry in yttrium-90 (Y-90) radioembolization. YRDose was implemented in Python as scripted modules within 3D Slicer 5.8.1. Mandatory inputs for the complete pre-therapy workflow are anatomical computed tomography (CT) and quantitative technetium-99m macroaggregated albumin single-photon emission computed tomography/CT image. Quantitative Y-90 PET/CT is optional for delivered-dose verification. The suite integrates CT-based segmentation with expert review, geometric alignment, binary-mask export, three-dimensional lung shunt fraction (LSF) calculation, compartment-based activity allocation, and mean absorbed-dose estimation using the Medical Internal Radiation Dose local energy deposition formalism. Segmentations, intermediate measurements, and final outputs are stored in a single Medical Reality Markup Language scene. The framework enabled sequential segmentation, volumetric LSF calculation, compartment mass estimation, planned activity calculation, and post-therapy mean absorbed-dose verification within the same software environment, preserving traceability and reproducibility. This technical note presents a reproducible open-source platform for Y-90 radioembolization planning and PET/CT dosimetry. YRDose provides an accessible research framework for developing, testing, and auditing image-based personalized dosimetry workflows, particularly in institutions without proprietary platforms. Formal validation remains necessary before routine clinical adoption.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673975","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 prostate-specific antigen kinetics with gallium-68 prostate-specific membrane antigen PET/computed tomography positivity in biochemical recurrence after radical prostatectomy.","authors":"Mounish Nuthalapati, Tanmay Patravale, Nazareth Solomon, Arun Ramdas Menon, Ginil Kumar Pooleri","doi":"10.1097/MNM.0000000000002225","DOIUrl":"https://doi.org/10.1097/MNM.0000000000002225","url":null,"abstract":"<p><strong>Introduction: </strong>Biochemical recurrence (BCR) after radical prostatectomy occurs in 20-40% of patients. Prostate-specific membrane antigen (PSMA) PET/computed tomography (CT) is the preferred imaging modality for recurrence, but detection rates decline at low prostate-specific antigen (PSA) levels. The role of PSA kinetics in postradical prostatectomy BCR remains unclear. We evaluated the association between PSA kinetics and PSMA PET/CT positivity in postradical prostatectomy BCR.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed postradical prostatectomy patients (2013-2024) who developed BCR and underwent 68Ga-PSMA PET/CT. Patients with prior therapy, PSA persistence, inadequate follow-up, or non-PSMA imaging were excluded. Clinicopathological and PSA kinetic variables were compared between groups. Logistic regression assessed associations with PET positivity, and receiver operating characteristic (ROC) analysis identified exploratory cut-offs.</p><p><strong>Results: </strong>Of 973 men who underwent radical prostatectomy, 64 met the inclusion criteria. Nineteen (29.7%) had positive and 45 (70.3%) had negative scans. Baseline characteristics were comparable. Median PSA at imaging was 0.30 ng/ml. PET-positive patients had higher PSA velocity (PSAV) (0.58 vs. 0.27 ng/ml/year; P = 0.020) and shorter PSA doubling time (PSADT) (3.23 vs. 5.80 months; P = 0.009). On univariable analysis, PSAV [odds ratio (OR): 3.31, P = 0.027), PSADT (OR: 0.86, P = 0.050), and PSA at imaging (OR: 10.68, P = 0.032) were associated with PET positivity. ROC analysis showed moderate discrimination for PSADT (AUC: 0.71) and PSAV (AUC: 0.69).</p><p><strong>Conclusion: </strong>Shorter PSADT and higher PSAV predicted PSMA PET positivity in men with BCR after radical prostatectomy. Exploratory cut-offs of PSADT less than 3.9 months and PSAV more than 0.54 ng/ml/year were identified but require external validation.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679342","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}