{"title":"Update on Molecular Imaging in Epilepsy","authors":"Kowshik Vengadesan , Ankita Phulia , Rakesh Kumar","doi":"10.1053/j.semnuclmed.2025.05.007","DOIUrl":"10.1053/j.semnuclmed.2025.05.007","url":null,"abstract":"<div><div>Epilepsy is one of the commonest neurological disorders worldwide. It is characterized by recurrent unprovoked seizures and has significant effects on one’s daily life. Though almost two thirds of patients with epilepsy respond well with one or more antiepileptic drugs, about 30% patients suffer with drug resistant epilepsy (DRE). Patients with focal variant of DRE, often have a focal pathology in brain and benefit vastly by removing or disconnecting the foci of origin of epileptiform waves from other parts of the cerebral cortex. While clinical examination, MRI and EEG are the first line investigations done in such patients before surgery, many a times they yield normal or discordant or multiple lesions of which only 1 or 2 are epileptogenic. It is in such cases; molecular imaging such as SPECT and PET helps in accurately demarcating the EZ for planning epilepsy surgery. The functional integrity of the rest of the brain can also be assessed by PET and SPECT, which may also offer valuable insights into the potential pathophysiology of the neurocognitive and behavioral impairments commonly seen in these patients. Epilepsy continues to be a common indication for perfusion SPECT as it is the only imaging method that can visualize the ictal onset zone in vivo. Interictal FDG PET/CT is a single investigation that can provide most information about EZ whereas SPECT has to be done twice—ictal and interictal. The evolution of advanced image analysis techniques like SISCOM, SISCOS, PISCOM and newer receptor-based PET tracers has further refined the localization of the seizure onset zone.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"55 4","pages":"Pages 487-502"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294917","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":"18F-FDG PET for Dementia Evaluation: Co-pathologies, New Diseases, and Its Roles in the Era of Antiamyloid Treatment","authors":"Tanyaluck Thientunyakit , Weerasak Muangpaisan , Satoshi Minoshima","doi":"10.1053/j.semnuclmed.2025.04.007","DOIUrl":"10.1053/j.semnuclmed.2025.04.007","url":null,"abstract":"<div><div>Dementia, which impairs a person's cognition and ability in daily tasks and is often caused by neurodegenerative disorders, remains one of the most challenging neuropsychiatric conditions. The prevalence of dementia has been steadily increasing in aging societies. Recently, antiamyloid treatment has been developed and approved for the treatment of Alzheimer’s disease (AD), which is known as the major cause of dementia. Such therapeutic developments have accelerated the use of in vivo biomarkers in research, clinical trials, and clinical practice. Past and recent developments of several biomarkers, including <sup>18</sup>F-fluorodeoxyglucose (FDG) positron emission tomography (PET), have played a pivotal role in understanding the underlying mechanisms of dementing disorders and accelerating progress in both research and clinical practice, leading to more accurate clinical diagnosis, recognition of co-pathologies, better understanding of new diseases, treatment planning, and response evaluation. This article reviews the roles of brain FDG PET, one of the well-established imaging biomarkers, as a valuable tool for studying brain metabolism and its applications in clinical and research settings, particularly for the treatment of dementia.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"55 4","pages":"Pages 526-537"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187870","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":"The Current Role of Tau PET Imaging in Neurodegeneration","authors":"Greet Vanderlinden , Rik Vandenberghe , Mathieu Vandenbulcke , Koen Van Laere","doi":"10.1053/j.semnuclmed.2025.03.002","DOIUrl":"10.1053/j.semnuclmed.2025.03.002","url":null,"abstract":"<div><div>Neurodegenerative tauopathies are characterized by the pathological hyperphosphorylation of tau proteins that subsequently form aggregates. Tau PET tracers with affinity to bind these pathological tau aggregates have been developed to measure disease progression and to support therapeutic drug development. In this review, we summarize the pathophysiology of tau throughout the range of neurodegenerative tauopathies. We outline the available first- and second-generation tau PET tracers, with a focus on new tau PET tracer developments, and discuss the quantification of tau PET images. Next, we summarize how tau PET relates to cerebrospinal fluid and plasma tau biomarkers. Finally, we review the current recommendations on the clinical use of tau PET versus fluid tau biomarkers in diagnosis, prognosis and treatment development.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"55 4","pages":"Pages 548-564"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006447","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}
Gabriela Capriotti , Alessia Guarnera , Andrea Romano , Giulia Moltoni , Giorgia Granese , Alessando Bozzao , Alberto Signore
{"title":"Neuroimaging of Mild Traumatic Injury","authors":"Gabriela Capriotti , Alessia Guarnera , Andrea Romano , Giulia Moltoni , Giorgia Granese , Alessando Bozzao , Alberto Signore","doi":"10.1053/j.semnuclmed.2025.06.002","DOIUrl":"10.1053/j.semnuclmed.2025.06.002","url":null,"abstract":"<div><div>Traumatic brain injury (TBI) is a global public health problem and is a leading cause of disability, morbidity and death in children and adults in USA It is characterised by alteration of neurological, behavioral and cognitive function as consequence of biomechanical insulte and possible progression to chronic encephalopathy. According to the CDC, approximately 75% of all reported TBIs are considered mild in form. Mild TBI is defined as individuals who had head trauma with subsequent mild deficit on the GCS and thu are frequently observed in military combat, athletes and motor vehicle accidents. Clinical assessment of mTBI is difficult and therefore different neuroimaging techniques have been used to characterized different stages of the disease. This article reviews the utility of imaging while focusing on the emerging applications of advanced MRI studies and PET in TBI.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"55 4","pages":"Pages 512-525"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317849","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":"Letter from the Editors","authors":"M Michael Sathekge, Kirsten Bouchelouche","doi":"10.1053/j.semnuclmed.2025.06.009","DOIUrl":"10.1053/j.semnuclmed.2025.06.009","url":null,"abstract":"","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"55 4","pages":"Pages 471-474"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144534607","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":"Toward Functional PET Imaging of the Spinal Cord","authors":"Pierre Courault , Luc Zimmer , Sophie Lancelot","doi":"10.1053/j.semnuclmed.2024.07.002","DOIUrl":"10.1053/j.semnuclmed.2024.07.002","url":null,"abstract":"<div><div>At present, spinal cord imaging primarily uses magnetic resonance imaging (MRI) or computed tomography (CT), but the greater sensitivity of positron emission tomography (PET) techniques and the development of new radiotracers are paving the way for a new approach. The substantial rise in publications on PET radiotracers for spinal cord exploration indicates a growing interest in the functional and molecular imaging of this organ. The present review aimed to provide an overview of the various radiotracers used in this indication, in preclinical and clinical settings. Firstly, we outline spinal cord anatomy and associated target pathologies. Secondly, we present the state-of-the-art of spinal cord imaging techniques used in clinical practice, with their respective strengths and limitations. Thirdly, we summarize the literature on radiotracers employed in functional PET imaging of the spinal cord. In conclusion, we propose criteria for an ideal radiotracer for molecular spinal cord imaging, emphasizing the relevance of multimodal hybrid cameras, and particularly the benefits of PET-MRI integration.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"55 4","pages":"Pages 629-643"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056460","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":"Global experience in brain amyloid imaging","authors":"Luca Filippi, Orazio Schillaci","doi":"10.1053/j.semnuclmed.2025.03.004","DOIUrl":"10.1053/j.semnuclmed.2025.03.004","url":null,"abstract":"<div><div>Brain amyloid imaging has become a crucial tool in diagnosing and understanding Alzheimer's disease (AD) and related neurodegenerative disorders. The introduction of amyloid positron emission tomography (PET) with [¹¹C]Pittsburgh Compound-B ([¹¹C]PiB) in the early 2000s marked a breakthrough in visualizing amyloid-β (Aβ) deposition in vivo. Subsequent development of ¹⁸F-labeled tracers, such as [¹⁸F]florbetapir, [¹⁸F]flutemetamol, and [¹⁸F]florbetaben, improved accessibility and extended imaging capabilities. However, global adoption remains uneven due to disparities in healthcare infrastructure, costs, and regulatory frameworks. In high-income countries, amyloid PET is increasingly used in clinical workflows, particularly for differentiating atypical dementia cases and selecting patients for anti-amyloid therapies like aducanumab and lecanemab. Despite its high sensitivity and specificity, challenges persist regarding its clinical utility, particularly in cognitively normal individuals with amyloid accumulation. Research is focusing on integrating amyloid PET with other biomarkers—tau PET, cerebrospinal fluid analysis, and plasma assays—to improve diagnostic accuracy. Geographical variations in amyloid PET research and implementation reveal North America and Europe as leaders, while access remains limited in low- and middle-income countries. Efforts such as the Worldwide Alzheimer's Disease Neuroimaging Initiative aim to enhance global standardization and accessibility. Emerging trends in artificial intelligence (AI)-assisted imaging analysis and next-generation tracers promise further improvements. Addressing ethical concerns related to preclinical screening and ensuring equitable access to amyloid PET are critical for optimizing its role in neurology and nuclear medicine worldwide.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"55 4","pages":"Pages 538-547"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018940","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}
Mia Ståhle, Cristina Popescu, Christoph Rischpler, Han Zhang, Samia Massalha, Leonor Lopes, Axel Rominger, Federico Caobelli
{"title":"New Promising Targets for Imaging in Cardiovascular Diseases.","authors":"Mia Ståhle, Cristina Popescu, Christoph Rischpler, Han Zhang, Samia Massalha, Leonor Lopes, Axel Rominger, Federico Caobelli","doi":"10.1053/j.semnuclmed.2025.05.006","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2025.05.006","url":null,"abstract":"<p><p>Cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality worldwide, driven by complex and dynamic molecular processes such as inflammation, fibrosis, metabolic dysregulation, thrombosis, and vascular remodeling. While conventional imaging techniques provide valuable anatomical and functional information, they fail to capture these underlying pathophysiological mechanisms at the molecular level. Molecular imaging, particularly with PET and SPECT, offers the potential to noninvasively visualize and quantify these processes, enabling earlier diagnosis, better risk stratification, and more precise treatment guidance. Despite substantial progress in clinical cardiology, there is a growing need for novel radiotracers that can target key disease-driving mechanisms beyond traditional perfusion or viability imaging. Emerging radiopharmaceuticals now enable the assessment of myocardial fibrosis (e.g., collagen-targeted and MMP-targeted tracers), cardiomyocyte stress responses (e.g., oxidative stress, unfolded protein response, endothelin signaling), and metabolic alterations (e.g., fatty acid, ketone, and glucose metabolism). Additionally, new tracers are being developed for thrombosis, vascular inflammation, plaque instability, and even for innovative targets such as cellular senescence and gut-derived inflammatory pathways. These developments reflect a paradigm shift towards imaging-driven phenotyping of cardiovascular disease. This review provides a comprehensive overview of the latest advances in molecular imaging tracers for cardiovascular applications, with a focus on their biological rationale, preclinical and clinical evidence, and translational challenges. We categorize tracers by their mechanistic targets and highlight their potential for integration into precision cardiology.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485772","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":"New Targets for Positron Emission Tomography Imaging in Parkinson´s Disease.","authors":"Yu-Jie Yang, Yi-Xin Zhao, Xin-Yi Li, Chuantao Zuo","doi":"10.1053/j.semnuclmed.2025.05.004","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2025.05.004","url":null,"abstract":"<p><p>In recent years, the neuroimaging biomarkers for Parkinson's disease (PD) has advanced rapidly, targeting to the key pathological mechanisms such as α-synuclein (α-syn) aggregation, neuroinflammation, mitochondrial dysfunction and brain clearance. This review summarized the novel imaging targets and their clinical practice in human studies. The presynaptic dopamine transporters and <sup>18</sup>F-Fluorodeoxyglucose positron emission tomography (PET) have been characterized as established biomarkers in PD. Furthermore, as the key pathogenic protein in PD, α-syn aggregation forming Lewy bodies could drive the neuronal degeneration, making the α-syn-targeted PET imaging a critical focus in PD research. Other co-pathologies, including amyloid-β and tau protein, were also concluded for their clinical implications in PD. Additionally, the PET imaging targets for neuroinflammatory mechanisms, including mitochondrial dysfunction, microglial and astrocyte activation, hold promise for further investigation. Finally, the radiotracers detecting disruptions of blood-brain barrier and glymphatic system would also represent as therapeutic opportunities. In conclusion, the vigorous development of novel imaging biomarkers in PD will refine the diagnostic frameworks, promoting for the future disease-modifying therapies.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249467","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}
Roberto C Delgado Bolton, Adriana K Calapaquí Terán, Ludmila Santiago Almeida, Diana Paez, Enrique Estrada Lobato, Anita Brink, Peter Knoll, Giorgio Treglia, Francesco Giammarile
{"title":"Fibroblast Activation Protein Inhibitor (FAPI) PET in Sarcoma: An Update and Future Perspective.","authors":"Roberto C Delgado Bolton, Adriana K Calapaquí Terán, Ludmila Santiago Almeida, Diana Paez, Enrique Estrada Lobato, Anita Brink, Peter Knoll, Giorgio Treglia, Francesco Giammarile","doi":"10.1053/j.semnuclmed.2025.05.003","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2025.05.003","url":null,"abstract":"<p><p>Nuclear medicine has seen significant advancements in recent years, especially in the area of Positron Emission Tomography (PET) imaging. One of these innovations is the use of Fibroblast Activation Protein Inhibitors (FAPI) as a novel radiotracer. FAPI PET imaging has shown promising results in various malignancies, including sarcomas, which are a diverse group of cancers originating from mesenchymal cells. This review aims to explore the potential of FAPI PET imaging in the diagnosis, staging, and treatment monitoring of sarcomas. Several studies have demonstrated the potential of FAPI PET in sarcomas. Furthermore, FAPI PET imaging has shown potential in assessing treatment response, with changes in FAPI uptake correlating with treatment outcomes. However, there are challenges to be addressed. The heterogeneity of sarcomas, both inter- and intra-tumoral, may affect the uniformity of Fibroblast Activation Protein (FAP) expression and thus the effectiveness of FAPI PET imaging. In conclusion, the introduction of FAPI PET imaging represents a significant advancement in the field of nuclear medicine and oncology. As we continue to deepen our understanding of this novel imaging technique, it is hoped that FAPI PET imaging will play an increasingly important role in the fight against cancer. However, as with any new technology, further research is needed to fully understand the potential and limitations of FAPI PET imaging in the clinical setting.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209346","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}
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