{"title":"Letter From the Editors.","authors":"M Michael Sathekge, Kirsten Bouchelouche","doi":"10.1053/j.semnuclmed.2024.10.010","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2024.10.010","url":null,"abstract":"","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinical Explorations of [<sup>68</sup>Ga] Ga-FAPI-04 and [<sup>18</sup>F] FDG Dual-Tracer Total-body PET/CT and PET/MR Imaging.","authors":"Yu Lin, Huaping Gao, Jiefu Zheng, Akram Al-Ibraheem, Pengcheng Hu, Hongcheng Shi","doi":"10.1053/j.semnuclmed.2024.09.009","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2024.09.009","url":null,"abstract":"<p><p>Fibroblast activation protein inhibitor (FAPI) and [<sup>18</sup>F]fluorodeoxyglucose ([<sup>18</sup>F]FDG) provide complementary biological information, and FAPI/FDG dual-tracer imaging clinical application is increasing recently. However, optimal protocols for FAPI/FDG dual-tracer positron emission tomography/computed tomography (PET/CT) and PET/magnetic resonance (PET/MR) imaging are still under investigation. Due to its high sensitivity, total-body PET/CT allows for imaging with minimal tracer activity and supports the creation of new dual-tracer PET/CT imaging protocols. PET/MR, with its multiparametric MR imaging, provides additional biological information for diagnosis. Studies have investigated the clinical feasibility of low-activity PET/MR imaging, yielding promising results. As there are still few institutions in the world that have experience with the advances provided by the use of total-body PET/CT and equipped with a PET/MR scanner, we have discussed the clinical explorations to reduce radiation exposure and optimize workflows for [<sup>68</sup>Ga]Ga-FAPI-04 and [<sup>18</sup>F]FDG dual-tracer PET/CT and PET/MR imaging. The review also provides potential new clinical explorations of [<sup>68</sup>Ga]Ga-FAPI-04 and [<sup>18</sup>F]FDG dual-tracer total-body PET/CT and PET/MR imaging, including dual-tracer dual-low-activity imaging.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Grace A Cumbers, Edward D Harvey-Latham, Michael Kassiou, Eryn L Werry, Jonathan J Danon
{"title":"Emerging TSPO-PET Radiotracers for Imaging Neuroinflammation: A Critical Analysis.","authors":"Grace A Cumbers, Edward D Harvey-Latham, Michael Kassiou, Eryn L Werry, Jonathan J Danon","doi":"10.1053/j.semnuclmed.2024.09.007","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2024.09.007","url":null,"abstract":"<p><p>The translocator protein (TSPO) is a biomarker for imaging neuroinflammation via Positron Emission Tomography (PET) across a broad range of CNS conditions. Most clinically used PET ligands targeting TSPO have limitations, including high lipophilicity and off-target binding or poor binding to a mutated TSPO isoform present in up to 30% of the population. Research efforts over the past decade have focused on development of improved TSPO PET radiotracers that overcome these limitations. This review provides a critical analysis of the development and validation of these so-called \"third-generation\" radiotracers in clinical and preclinical settings. We also offer our perspective on the future directions of TSPO PET imaging, including recommendations for overcoming current challenges and capitalizing on emerging opportunities in molecular imaging for neuroinflammatory diseases.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Janie Duvenhage, Maryke Kahts, Beverley Summers, Jan Rijn Zeevaart, Thomas Ebenhan
{"title":"Highlighting New Research Trends on Zirconium-89 Radiopharmaceuticals Beyond Antibodies.","authors":"Janie Duvenhage, Maryke Kahts, Beverley Summers, Jan Rijn Zeevaart, Thomas Ebenhan","doi":"10.1053/j.semnuclmed.2024.10.003","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2024.10.003","url":null,"abstract":"<p><p>Zirconium-89 (<sup>89</sup>Zr) is a cyclotron-produced positron-emitting radioisotope with a half-life of 3.27 days, which makes delayed or longitudinal imaging possible. It is a superior isotope for tracking particles over several days at a high sensitivity, resolution, and specificity. <sup>89</sup>Zr-monoclonal antibodies (<sup>89</sup>Zr-mAb) have gained significant attention in the field of molecular imaging. However, the past decade has shown an avid increase in research concerning <sup>89</sup>Zr-radiopharmaceuticals apart from <sup>89</sup>Zr-mAb. In this article we highlight and discuss the status and challenges attributed to current preclinical and clinical investigations of <sup>89</sup>Zr-radiopharmaceuticals developed beyond <sup>89</sup>Zr-mAb, e.g., mAb-derived variants and macro-biomolecules, proteins, peptides, nanoparticles, and living cells.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142507114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Update on PSMA-based Prostate Cancer Imaging.","authors":"Esther Mena, Liza Lindenberg, Peter L Choyke","doi":"10.1053/j.semnuclmed.2024.10.004","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2024.10.004","url":null,"abstract":"<p><p>The increased use of prostate-specific membrane antigen (PSMA) based PET imaging for prostate cancer (Pca) detection has revolutionized the clinical management of Pca, with higher diagnostic sensitivity for extraprostatic disease and increasing clinical utility across different stages of the disease. The integration of PSMA PET imaging into clinical guidelines and consensus documents reflects its growing importance in the personalized management of Pca. This review of recent literature highlights the rapid evolution of PSMA PET into the mainstream of staging and restaging and the decreasing reliance on conventional imaging modalities. This comprehensive review serves as a resource for clinicians and researchers involved in the domains of Pca diagnosis and management.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ellen Nogueira-Lima, Thiago Alves, Elba Etchebehere
{"title":"<sup>18</sup>F-Fluoride PET/CT-Updates.","authors":"Ellen Nogueira-Lima, Thiago Alves, Elba Etchebehere","doi":"10.1053/j.semnuclmed.2024.09.005","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2024.09.005","url":null,"abstract":"<p><p>Sodium Fluoride-18 production started in the 1940s and was described clinically for the first time in 1962 as a bone-imaging agent. However, its use became dormant with the development of conventional bone scintigraphy, especially due to its low cost. Conventional bone scintigraphy has been the most utilized Nuclear Medicine technique for identifying osteoblastic bone metastases, especially in prostate and breast cancers for decades and is also employed to identify benign bone disease, especially in the orthopedic setting. While bone scintigraphy is highly sensitive, it lacks adequate specificity. With the advent of high-quality 3D Whole-Body Positron Emission Tomography combined with computed tomography (PET/CT), images, Sodium Fluoride-18 imaging with PET/CT (Fluoride PET/CT) re-emerged. This PET/CT bone-imaging agent provides higher sensitivity and specificity to detect bone lesions in both the oncological scenario as well as to identify benign bone and joint disorders. PET/CT bone-imaging provides a precise view of the bone metabolism remodeling processes at a molecular level, throughout the skeleton, and combines anatomical information, enhancing diagnostic specificity and accuracy. This article review will explore the updates on clinical applications of Fluoride PET/CT in oncology and benign conditions encompassing orthopedic, inflammatory and cardiovascular conditions and treatment response assessment.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Total Body PET/CT: A Role in Drug Development?","authors":"Xiangxi Meng, Xiangxing Kong, Runze Wu, Zhi Yang","doi":"10.1053/j.semnuclmed.2024.09.006","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2024.09.006","url":null,"abstract":"<p><p>Nowadays, total body PET has already entered the medical centers and enabled various clinical applications due to its superior imaging capabilities, especially the high sensitivity. However, the potential of the total body PET in the clinical evaluation of radiopharmaceuticals remains underexplored. The development and regulatory processes for radiopharmaceuticals present unique challenges that total body PET could address. In the safety evaluation of radiopharmaceuticals, the internal radiation dosimetry demands images with high quality and quantitative accuracy, which can be achieved using the total body PET. The current clinical pharmacokinetic study for radiopharmaceuticals still relies on invasively sampling of blood and other body fluid, causing discomfort of participant and difficulty in implementation. With the total body PET, the radioactive concentration of the drug in various blood vessels can be assessed noninvasively, facilitating the pharmacokinetic study. The parametric analysis over the total body based on compartment models also sheds light on the pharmacokinetics of the radiopharmaceutical. A special requirement for multi-center clinical research involving PET and SPECT is the harmonization of the quantitative performance among different imaging equipment, and the discrepancy between the total body PET and short axial field of view PET scanners may add to the complexity. To date, there are several successful examples of clinical trials of innovative radiopharmaceuticals using the total body PET, involving different types of tracers ranging from small molecules, peptides, nanobodies, minibodies, and aptamers. In conclusion, total body PET has the potential to revolutionize the clinical evaluation of radiopharmaceuticals and will play a crucial role in future drug development.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gilles N Stormezand, Eline de Meyer, Klaas Pieter Koopmans, Adrienne H Brouwers, G Luurtsema, Rudi A J O Dierckx
{"title":"Update on the Role of [<sup>18</sup>F]FDOPA PET/CT.","authors":"Gilles N Stormezand, Eline de Meyer, Klaas Pieter Koopmans, Adrienne H Brouwers, G Luurtsema, Rudi A J O Dierckx","doi":"10.1053/j.semnuclmed.2024.09.004","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2024.09.004","url":null,"abstract":"<p><p>[<sup>18</sup>F]-dihydroxyphenylalanine ([<sup>18</sup>F]FDOPA) is a radiopharmaceutical used in a broad spectrum of diseases, including neuroendocrine tumors (NETs), congenital hyperinsulinism, parkinsonian syndromes and neuro-oncology. Genetic analysis and disease specific biomarkers may guide the optimum selection of patients that may benefit most from [<sup>18</sup>F]FDOPA PET in different stages of several neuroendocrine neoplasms and in congenital hyperinsulinism. For clinical routine in neuro-oncology, indications for [<sup>18</sup>F]FDOPA PET include tumor delineation and distinguishing between treatment related changes and recurrent disease. New developments as the advent of large axial field of view PET/CT or integrated PET/MRI systems may provide more unique opportunities, such as those related to detection of smaller lesions in primary staging of NETs, dose reduction in children with congenital hyperinsulinism, or possibilities to obtain more extensive noninvasive quantification of cerebral uptake by using image derived input functions. Although the widespread use of [<sup>18</sup>F]FDOPA has been hampered by complex synthesis methods and high production costs in the past, significant efforts have been undertaken to provide robust GMP compliant synthesis methods with high activity yield and molar activity.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"PET/CT Assessment of Estrogen Receptor positivity for Breast Cancer using [<sup>68</sup>Ga]Ga-RM2 Bombesin Receptor Antagonist: A Systematic Review and Meta-Analysis.","authors":"Akram Al-Ibraheem, Ahmed Saad Abdlkadir, Hongcheng Shi, Hikmat Abdel-Razeq, Asem Mansour","doi":"10.1053/j.semnuclmed.2024.09.003","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2024.09.003","url":null,"abstract":"<p><p>[<sup>68</sup>Ga]Ga-RM2 is a novel gastrin-releasing peptide receptor antagonist with emerging diagnostic utility in low-grade breast cancer (BC) expressing estrogen receptors (ER). This systematic review and meta-analysis evaluates the current diagnostic utility of [<sup>68</sup>Ga]Ga-RM2 PET/CT and explores BC tumor uptake metrics in ER-positive BC lesions. A systematic search of PubMed, Scopus, and Web of Science databases was conducted using relevant keywords to extract, screen, and select eligible data for analysis. Out of 182 articles reviewed, only four studies were found eligible for inclusion. Qualitative data analysis was applied to four included papers meeting the eligibility criteria. Various promising utilities were identified, including [<sup>68</sup>Ga]Ga-RM2's ability to detect ER-positive primary BC lesions, lymph nodes, and distant metastatic lesions. Additionally, recent studies have addressed its potential for assessing therapy response following neoadjuvant chemotherapy. Importantly, [<sup>68</sup>Ga]Ga-RM2 has demonstrated clinical utility in improving and guiding proper management planning by detecting metastatic lesions that can alter overall staging and treatment strategies. The overall lesion detectability was 93% (95% CI: 87-98%) for ER-positive BC. ER-positive BC lesions showed significantly higher maximum standardized uptake values (SUVmax) compared to ER-negative lesions, with a weighted mean difference (WMD) of 10.6 (95% CI: 8.1-13.2; P < 0.00001). Furthermore, ER-positive BC lesions exhibited statistically significant higher SUVmax compared to normal background breast tissue SUVmean, with an overall WMD of 9.9 (95% CI: 7.5-12.2; P < 0.00001). Further studies utilizing this promising radiotracer should be encouraged, implementing prospective, large-scale designs in the near future.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Total-Body PET/CT: A Role of Artificial Intelligence?","authors":"Qiyang Zhang, Zhenxing Huang, Yuxi Jin, Wenbo Li, Hairong Zheng, Dong Liang, Zhanli Hu","doi":"10.1053/j.semnuclmed.2024.09.002","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2024.09.002","url":null,"abstract":"<p><p>The purpose of this paper is to provide an overview of the cutting-edge applications of artificial intelligence (AI) technology in total-body positron emission tomography/computed tomography (PET/CT) scanning technology and its profound impact on the field of medical imaging. The introduction of total-body PET/CT scanners marked a major breakthrough in medical imaging, as their superior sensitivity and ultralong axial fields of view allowed for high-quality PET images of the entire body to be obtained in a single scan, greatly enhancing the efficiency and accuracy of diagnoses. However, this advancement is accompanied by the challenges of increasing data volumes and data complexity levels, which pose severe challenges for traditional image processing and analysis methods. Given the excellent ability of AI technology to process massive and high-dimensional data, the combination of AI technology and ultrasensitive PET/CT can be considered a complementary match, opening a new path for rapidly improving the efficiency of the PET-based medical diagnosis process. Recently, AI technology has demonstrated extraordinary potential in several key areas related to total-body PET/CT, including radiation dose reductions, dynamic parametric imaging refinements, quantitative analysis accuracy improvements, and significant image quality enhancements. The accelerated adoption of AI in clinical practice is of particular interest and is directly driven by the rapid progress made by AI technologies in terms of interpretability; i.e., the decision-making processes of algorithms and models have become more transparent and understandable. In the future, we believe that AI technology will fundamentally reshape the use of PET/CT, not only playing a more critical role in clinical diagnoses but also facilitating the customization and implementation of personalized healthcare solutions, providing patients with safer, more accurate, and more efficient healthcare experiences.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}