Nuclear Medicine Communications最新文献

{"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":"Significance of 18 F-fluorodeoxyglucose PET/computed tomography in the initial staging of malignant peritoneal mesothelioma.","authors":"Hui Zhang, Lifang Pang, Jun Hou, Beilei Li, Yiqiu Zhang","doi":"10.1097/MNM.0000000000001990","DOIUrl":"10.1097/MNM.0000000000001990","url":null,"abstract":"<p><strong>Objective: </strong>This study was aimed at evaluating the significance of 18 F-fluorodeoxyglucose PET/computed tomography (FDG PET/CT) in the staging and differentiation of malignant peritoneal mesothelioma (MPeM).</p><p><strong>Materials and methods: </strong>We retrospectively analyzed clinical and imaging data of 21 women and 21 men with MPeM who underwent 18 F-FDG PET/CT, and reviewed and analyzed 18 F-FDG PET/CT characteristics of the patients. Standardized uptake values (SUV max ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG = MTV × SUV mean ) were determined for peritoneal lesions at the highest glycolysis point. Two experienced readers assessed tumor-node-metastasis (TNM) staging and peritoneal cancer index according to Peritoneal Surface Oncology Group International diagnostic requirements.</p><p><strong>Results: </strong>The SUV max and MTV values were significantly lower for the epithelial cases than for the nonepithelioid cases, with the difference being significant ( P  < 0.05). The mean TLG value was significantly lower for the epithelial cases than for the nonepithelioid cases; however, the difference was NS ( P  > 0.05). Exploratory laparotomy was performed in 18 patients, the 18 F-FDG PET/CT diagnostic accuracy for the T stage was 72.2%, and the TNM stage diagnostic accuracy was 94.4%. However, lymph node metastasis was more common in the biphasic type group, and metastasis was more often seen in the sarcomatoid type group.</p><p><strong>Conclusion: </strong>Using a previously suggested novel approach for TNM staging in 18 F-FDG PET/CT assessment of MPeM may improve the accuracy of staging; however, SUV max values showed slight variations depending on the pathology type. 18 F-FDG PET/CT can improve the accuracy of TNM staging, and SUV max values vary slightly depending on the pathology type. Furthermore, 18 F-FDG PET/CT can afford simultaneous visualization of lesions throughout the body, which can help develop a treatment strategy.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"746-752"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993400","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}

{"title":"Outcomes of I-131 therapy in pediatric and adolescent differentiated thyroid cancer: a long-term follow-up of a single-center Indian cohort.","authors":"Ajit Nimmagadda, Zakir Ali Abubacker, Prathyusha Bikkina, Virupakshappa C B, Lakshmi Pratyusha Paladugula","doi":"10.1097/MNM.0000000000001981","DOIUrl":"10.1097/MNM.0000000000001981","url":null,"abstract":"<p><strong>Background: </strong>Pediatric differentiated thyroid cancer (DTC), particularly papillary thyroid carcinoma, is the most common endocrine malignancy in children and adolescents. Despite its aggressive presentation, including lymph nodes and distant metastases, pediatric DTC generally has an excellent prognosis. The 2015 American Thyroid Association (ATA) guidelines emphasize a risk-stratified approach, but dynamic risk stratification (DRS) has been less studied in this population. This study aimed to evaluate DRS in predicting persistent and recurrent disease in pediatric DTC over a mean follow-up of nearly 10 years.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on 88 pediatric patients with DTC who underwent surgery and radioactive iodine therapy (RAIT) between March 2009 and September 2017. Inclusion criteria were patients aged less than or equal to 18 years with postsurgical RAIT and at least 5 years of follow-up. DRS was applied based on clinical, biochemical, and imaging findings.</p><p><strong>Results: </strong>The cohort had a mean age of 15 years, predominantly female (72.7%). At diagnosis, 70.5% had lymph node metastases, and 15.9% had distant metastases. DRS categorized patients into excellent response, biochemical incomplete response, and structural incomplete response. At the final follow-up, 86.4% of patients had complete or stable disease. High-risk patients required additional treatments, including repeat RAIT.</p><p><strong>Conclusion: </strong>DRS is a valuable tool for predicting persistent and recurrent disease in pediatric DTC, refining risk categories beyond ATA stratification. It provides a more personalized approach, potentially improving outcomes by identifying high-risk individuals for tailored treatment and follow-up. Further prospective studies are needed to standardize DRS in pediatric DTC.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"613-619"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753925","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":"Correlation between PD-L1 expression and FDG-PET/CT visual assessments in non-small cell lung cancer resected specimens.","authors":"Miki Nishimori, Hitomi Iwasa, Kana Miyatake, Noriko Nitta, Kosuke Nakaji, Takayasu Izumi, Tomohiro Matsumoto, Rika Yoshimatsu, Tomoaki Yamanishi, Rikako Imai, Mahiru Kato, Hironobu Okada, Takuji Yamagami","doi":"10.1097/MNM.0000000000001984","DOIUrl":"10.1097/MNM.0000000000001984","url":null,"abstract":"<p><strong>Purpose: </strong>This retrospective study aimed to investigate the validity of fluorodeoxyglucose PET (FDG-PET) visual assessments to predict programmed death-ligand 1 (PD-L1) expression levels in patients with non-small cell lung cancer (NSCLC).</p><p><strong>Materials and methods: </strong>One hundred and seven NSCLC patients who underwent FDG-PET/computed tomography (CT) scans and PD-L1 expression tests were retrospectively identified. Patients were divided into two groups according to PD-L1 expression: PD-L1 high group (PD-L1 tumor proportion score ≥50%) and PD-L1 low group (<50%). We compared clinicopathological characteristics and PET assessments [maximum standardized uptake value (SUVmax) and Deauville score] between the two groups based on PD-L1 expression.</p><p><strong>Results: </strong>High expression of PD-L1 was detected in 25 of 107 cases. In both univariable and multivariable analysis, there were significant differences in PET visual assessments in NSCLC ( P  < 0.05). Receiver operating characteristics for the PET visual assessments [area under the curve (AUC) = 0.712, 95% confidence interval (CI) 0.628-0.793] and SUVmax (AUC = 0.753, 95% CI 0.647-0.861) showed equivalent accuracy ( P  = 0.227). Based on histopathology, in adenocarcinoma patients, there were significant differences between PET visual assessments and PD-L1 expression ( P  < 0.05), while no significant differences were observed in squamous cell carcinoma patients. Based on epidermal growth factor receptor (EGFR) mutation analysis, in patients with EGFR wild type, there were significant differences between PET visual assessments and PD-L1 expression ( P  = 0.006), while in patients with EGFR mutations, there were no significant differences between PET visual assessments and PD-L1 expression.</p><p><strong>Conclusion: </strong>Results of PET visual assessments correlated with PD-L1 expression in NSCLC.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"636-642"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034387","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 neural network approach to glomerular filtration rate estimation: a single-centre retrospective audit.","authors":"Jack A Johnson, Richard Meades, Nathan J Dickinson","doi":"10.1097/MNM.0000000000001982","DOIUrl":"10.1097/MNM.0000000000001982","url":null,"abstract":"<p><strong>Objectives: </strong>The 2009 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation without race correction factor is frequently used for an estimate of glomerular filtration rate (eGFR) and to support a single-sample GFR regime. This study examines whether neural networks offer a potential means to improve the accuracy of GFR estimates using the same initial inputs as eGFR.</p><p><strong>Methods: </strong>An audit of 865 adult GFR examinations and serum creatinine measurements between January 2010 and 2024 was undertaken. Patient sex, age, creatinine, and measured GFR were used to train a neural network (NN) model with an 80 : 20 train-test split, with test set root mean square error (RMSE), accuracy, median bias, and sensitivity calculated and compared against the 2009 CKD-EPI equation eGFR.</p><p><strong>Results: </strong>NN GFR showed an improved performance against the 2009 CKD-EPI equation in RMSE: 12.0 vs. 16.6 mL/min/1.73 m 2 ( P  < 0.001), median bias: -2.50 vs. 7.86 mL/min/1.73 m 2 ( P  < 0.001) and accuracy: 94.2 vs. 83.2% ( P  < 0.001). Both NN GFR and the eGFR equation had poor sensitivity across the British Nuclear Medicine Society single-sample ranges of 25-50, 50-70, 70-100, and >100 mL/min/1.73 m 2 : 57.9 vs. 57.9%, 50.0 vs. 26.9%, 84.4 vs. 54.2%, 10.0 vs. 70.0%.</p><p><strong>Conclusion: </strong>This study has suggested that locally trained NNs can offer a potential avenue to improve GFR predictions, even on small and diverse datasets.</p><p><strong>Advances in knowledge: </strong>Although the model is not sufficiently sensitive to predict the optimum time-sample point for a single-sample regime, this work can serve as a proof of concept for UK-specific NN GFR models.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"620-628"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036143","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":"The role of 68 Ga-FAPI PET/CT imaging in gynecological cancers: an integrative review.","authors":"Sharjeel Usmani, Khulood Al Riyami, Nisar Ahmad, Ikram A Burney","doi":"10.1097/MNM.0000000000001977","DOIUrl":"10.1097/MNM.0000000000001977","url":null,"abstract":"<p><p>Clinical staging of gynecological cancers traditionally employs computed tomography (CT) scan or 18 fluorine-deoxyglucose PET/CT ( 18 F-FDG PET/CT), which have limited sensitivity, especially for early-stage ovarian cancer, borderline tumors, tumors with cystic/mucinous components, and those with low metabolic activity. Fibroblast activation protein inhibitor (FAPI) targets cancer-associated fibroblasts in tumor stroma independent of metabolic activity, providing favorable tumor-to-background contrast when used with PET imaging. We conducted an integrative review of FAPI PET/CT use in gynecological cancers for staging, treatment response assessment, and recurrence detection. Database searches yielded 205 documents, with 23 studies meeting inclusion criteria (12 original research articles, 7 case reports, 4 reviews). 68 Ga-FAPI PET/CT image was reported to be superior to 18 F-FDG PET/CT in differentiating high-grade from lower-grade ovarian cancer, detection of nodal, peritoneal, and pleural disease, as well as early relapses. 68 Ga-FAPI PET/CT showed enhanced detection of lymph node metastasis in newly diagnosed cervical cancer. However, its utility in endometrial cancer is limited by physiological uptake in normal uterine tissue. 68 Ga-FAPI PET/CT shows promising results for diagnosis and staging of ovarian and cervical cancers. Further research is warranted as this modality has potential to modify treatment approaches by improving detection capabilities beyond conventional imaging techniques, particularly for tumors with challenging characteristics that limit current diagnostic methods. Nucl Med Commun.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"585-591"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701108","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":"Leg-muscle perfusion reserve on 99mTc-MIBI stress-rest scintigraphy: the novel use of radionuclide imaging in assessing lower extremity functional capacity.","authors":"Tejasvini Singhal, Parneet Singh, Girish Kumar Parida, Kanhaiyalal Agrawal","doi":"10.1097/MNM.0000000000001978","DOIUrl":"10.1097/MNM.0000000000001978","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the utility of lower extremity 99mTc-MIBI imaging as a noninvasive correlate to lower extremity functional capacity.</p><p><strong>Materials and methods: </strong>Patients referred for stress myocardial perfusion imaging with no known history of peripheral artery disease (PAD) were included in the study. 99mTc-MIBI perfusion scintigraphy was performed for calf muscles at stress and rest. Perfusion reserve (PR) for bilateral calves was calculated as: (average stress counts-average rest counts)/average rest counts × 100. Correlation of PR was assessed for functional/exercise capacity [metabolic equivalents (METs) and exercise duration].</p><p><strong>Results: </strong>Eighty-six patients (70 male and 16 female) with a median age of 53.5 (range 28-77) years were included in the study. The mean PR for calf muscles was 62.9 ± 37.9%. There was a significant correlation between the functional capacity of the patients (METs achieved and exercise duration) and PR of bilateral calf muscles.</p><p><strong>Conclusion: </strong>Radionuclide imaging with 99 m-Tc MIBI allows noninvasive assessment of changes in both macrovascular and microvascular perfusion under dynamic exercise. Thus, it may serve as an ideal noninvasive imaging to provide insight into physiological adaptations as well as to detect the macrovascular and microvascular perfusion disturbances in PAD and skeletal muscle adaptation in response to exercise therapy commonly prescribed for PAD or other novel therapies.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"599-604"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753899","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":"Effect of body composition parameters, including sarcopenia, myosteatosis, and adipose tissue, on overall survival of patients with mCRPC receiving 177 Lu-PSMA PRRT.","authors":"İhsan Kaplan, Halil Kömek, Canan Can, Fulya Kaya İpek, Ferat Kepenek, Hüseyin Karaoğlan, Ayhan Şenol, Fatih Güzel, Veysi Şenses, Ridvan Kiliç, Ömer Yeprem, Mehmet Serdar Yildirim, Bilgin Bahadir Başgöz, Yunus Güzel","doi":"10.1097/MNM.0000000000001985","DOIUrl":"10.1097/MNM.0000000000001985","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to examine the role of computed tomography (CT)-derived myosteatosis, sarcopenia, and other body composition parameters on overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC) scheduled to receive lutetium (Lu)-177 treatment.</p><p><strong>Material and method: </strong>Patients with mCRPC who underwent 68 Ga-prostate-specific membrane antigen (PSMA) PET/CT imaging before [ 177 Lu]Lu-PSMA-617 treatment and received at least two cycles of Lu-177 PSMA treatment between March 2017 and March 2023 were retrospectively reviewed in this study. Body composition including psoas muscle, skeletal muscle, subcutaneous adipose tissue, and visceral adipose tissue were evaluated at the third lumbar spine vertebra on CT axial sections.</p><p><strong>Results: </strong>Median age of the 76 patients enrolled in this study was 75 years (59-91 years), and the median Gleason score was 8 (6-10). All patients received two to six (median 4) cycles of 7.4 GBq Lu-177 PSMA treatment at 6-8 week intervals. Upon univariant Cox regression analysis, subcutaneous adipose tissue index, right psoas myosteatosis, left psoas myosteatosis, and skeletal muscle index were determined to be prognostic factors for OS ( P  = 0.03, P  = 0.02, P  < 0.001, and P  = 0.04, respectively). However, the left psoas myosteatosis value was an independent prognostic factor for OS as determined by multivariant Cox regression analysis ( P  < 0.001).</p><p><strong>Conclusion: </strong>Sarcopenia and myosteatosis before treatment were associated with shorter survival in mCRPC patients who were scheduled for Lu-177 PSMA treatment. Patients with left psoas myosteatosis value ≤26.85 HU had shorter OS, and we showed that OS is an independent prognostic factor.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"592-598"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027589","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 new therapeutic paradigm: radioiodine combined with lenvatinib for radioiodine-avid metastatic well-differentiated thyroid cancer.","authors":"Siddharth Sharma, Aftab Hasan Nazar, Prabhakar Mishra, Manish Ora, Amitabh Arya, Sukanta Barai, Prasanta Kumar Pradhan, Sanjay Gambhir","doi":"10.1097/MNM.0000000000001980","DOIUrl":"10.1097/MNM.0000000000001980","url":null,"abstract":"<p><strong>Purpose: </strong>Metastatic well-differentiated thyroid cancer (WDTC) has significant morbidity and mortality. Multidisciplinary treatment, including high-dose radioiodine therapy (HDRI), has seldom complete response. Concerns are side effects, radioiodine refractoriness, and systemic metastasis. This study investigates the impact of lenvatinib with HDRI for disease control in radioiodine-avid metastatic WDTC.</p><p><strong>Material and methods: </strong>Fifteen patients were enrolled with or without prior HDRI. The disease burden was evaluated with imaging and thyroglobulin measurement. Lenvatinib was given for three months, along with thyroxine suppression. Lenvatinib was discontinued with Thyroxin withdrawal, followed by HDRI. Treatment response was evaluated based on imaging (Whole body iodine scan, PERSIST, and RECIST criteria) and tumor markers.</p><p><strong>Results: </strong>The mean age was 52.0 ± 14.2 years. Lung and bone metastases were noted in (12, 80%) and 10 (66%) patients. Nine (60%) patients already had HDRI (242.5 ±140.3 mCi). Ten patients had grade I toxicities with Lenvatinib. During follow-up (14.79 ± 5.93 months), Tg level fell from 45800.8±69283.9 to 10672.5±18490.5 ng/mL. Tg fall was not associated (p>0.05) with age, sex, histopathology, and previous HDRI. Partial response and stable disease were noted in 10 and 4 patients. One patient had disease progression on Tg and imaging.</p><p><strong>Conclusion: </strong>HDRI, with Lenvatinib, was well-tolerated and demonstrated potential benefits in radioiodine-avid metastatic WDTC. Unprecedented fall in thyroglobulin and partial imaging response noted with single therapy cycle. Despite small sample size, preliminary data suggests synergistic treatment effect. Further investigation with a larger cohort is warranted to confirm findings and explore potential response predictors.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"605-612"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753895","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}