{"title":"Artificial Intelligence Augmented Cerebral Nuclear Imaging.","authors":"Geoffrey M Currie, K Elizabeth Hawk","doi":"10.1053/j.semnuclmed.2025.05.005","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2025.05.005","url":null,"abstract":"<p><p>Artificial intelligence (AI), particularly machine learning (ML) and deep learning (DL), has significant potential to advance the capabilities of nuclear neuroimaging. The current and emerging applications of ML and DL in the processing, analysis, enhancement and interpretation of SPECT and PET imaging are explored for brain imaging. Key developments include automated image segmentation, disease classification, and radiomic feature extraction, including lower dimensionality first and second order radiomics, higher dimensionality third order radiomics and more abstract fourth order deep radiomics. DL-based reconstruction, attenuation correction using pseudo-CT generation, and denoising of low-count studies have a role in enhancing image quality. AI has a role in sustainability through applications in radioligand design and preclinical imaging while federated learning addresses data security challenges to improve research and development in nuclear cerebral imaging. There is also potential for generative AI to transform the nuclear cerebral imaging space through solutions to data limitations, image enhancement, patient-centered care, workflow efficiencies and trainee education. Innovations in ML and DL are re-engineering the nuclear neuroimaging ecosystem and reimagining tomorrow's precision medicine landscape.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182019","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 Radiopharmaceutical Tools in Imaging.","authors":"Dirk Bender","doi":"10.1053/j.semnuclmed.2025.05.002","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2025.05.002","url":null,"abstract":"<p><p>The strength of Nuclear Medicine imaging are the compounds to be used as radioactive probes. Unfortunately there are many constraints both in relation to physiological parameters such as metabolism as well to compound related properties like lipophilicity or chemical stability. Due these constraints, many, otherwise promising, compounds could not be used in Nuclear Medicine imaging. Within this review a brief summary is given regarding possible limitations for imaging probes and approaches or techniques to overcome the constraints. Even so the review focuses on imaging with central active compounds, many of these problems appear likewise when targeting peripheral organs. Besides the established approaches to overcome limitations some new, so far not explored, directions are discussed. Finally, a potential new tool in imaging will be presented, a trojan horse approach for transportation of radioligands. Here, like in conventional drug development, lipid nanoparticles may have potential to be used as carrier systems in Nuclear Medicine as well. This, so far not explored, concept is briefly presented.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161566","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}
Katarzyna Barańska, Katarzyna Niemas, Kacper Pełka, Jolanta Kunikowska
{"title":"PET/CT in the Imaging of CNS Tumors.","authors":"Katarzyna Barańska, Katarzyna Niemas, Kacper Pełka, Jolanta Kunikowska","doi":"10.1053/j.semnuclmed.2025.04.002","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2025.04.002","url":null,"abstract":"<p><p>Central nervous system (CNS) tumors are quite rare but cause significant morbidity and mortality. Positron Emission Tomography (PET) is a widely utilized imaging modality within the field of nuclear medicine. CNS tumor diagnostics are an essential tool in the diagnosis and treatment of patients with glioma, offering valuable insights into tumor characteristics, treatment response and outcomes. A variety of different tracers are used in PET imaging of brain tumors including <sup>18</sup>F-labeled fluorodeoxyglucose ([<sup>18</sup>F]FDG), markers showing amino acid metabolism, angiogenesis or inflammatory processes. In this article we describe possibility of use different tracers in different clinical scenario of CNS tumors.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128568","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}
Zhaoguo Lin, Pawel Rasinski, Ted Nilsson, Maria Holstensson, Yangmeihui Song, August Blomgren, Warissara Jutidamrongphan, Kalyani Pandya, Jimin Hong, Axel Rominger, Kuangyu Shi, Rimma Axelsson, Xiaoli Lan, Robert Seifert
{"title":"FAPI PET Versus FDG PET/CT in Gastrointestinal Cancers: An Overview.","authors":"Zhaoguo Lin, Pawel Rasinski, Ted Nilsson, Maria Holstensson, Yangmeihui Song, August Blomgren, Warissara Jutidamrongphan, Kalyani Pandya, Jimin Hong, Axel Rominger, Kuangyu Shi, Rimma Axelsson, Xiaoli Lan, Robert Seifert","doi":"10.1053/j.semnuclmed.2025.04.006","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2025.04.006","url":null,"abstract":"<p><p>Fibroblast activation protein (FAP) is a type II transmembrane serine protease that is highly expressed in cancer-associated fibroblasts (CAFs) but absent in quiescent fibroblasts. Its overexpression is associated with poor prognosis in various cancers and contributes to treatment resistance. In recent years, radiolabeled FAP inhibitors (FAPI) for PET imaging have shown promising clinical value across a range of cancers. Gastrointestinal (GI) malignancies, which often exhibit a desmoplastic reaction with a high density of FAP-expressing CAFs, are particularly well-suited for FAPI PET. Given the limitations of [<sup>18</sup>F]FDG PET in GI cancers, such as low sensitivity in certain histological subtypes and high physiological background uptake, FAPI PET is expected to serve as a complementary method, potentially enhancing both diagnostic accuracy and treatment guidance. This review provides a comprehensive comparison of the clinical applications of FAPI PET and [<sup>18</sup>F]FDG PET in various GI cancers, including their value in diagnosis, staging, and treatment guidance. Additionally, this review summarizes studies on the expanding role of FAPI PET, including its use in assessing treatment response and predicting prognosis, aiming to provide insights into its potential contribution to the improved management of GI malignancies.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120739","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}
Weiyuan Lin, Chongyi Huang, Zhiqiang Tan, Hao Xu, Weijun Wei, Lu Wang
{"title":"Cu<sup>II</sup>-bis(thioureido) Complex: A Potential Radiotracer for Detecting Oxidative Stress and Neuroinflammation in Neurodegenerative Diseases.","authors":"Weiyuan Lin, Chongyi Huang, Zhiqiang Tan, Hao Xu, Weijun Wei, Lu Wang","doi":"10.1053/j.semnuclmed.2025.03.008","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2025.03.008","url":null,"abstract":"<p><p>Neurodegenerative diseases, characterized by progressive neuronal degeneration and associated with neuroinflammation and oxidative stress, present significant challenges in diagnosis and treatment. This review explores the potential of copper(II)-bis(thiosemicarbazone) complexes, particularly Cu-ATSM, as a dual-purpose radiopharmaceutical for imaging and therapeutic interventions. Cu-ATSM exhibits unique redox-dependent retention in pathological microenvironments, driven by mitochondrial dysfunction and hyper-reductive states, which enables the noninvasive detection of oxidative stress via positron emission tomography (PET). Preclinical studies demonstrate its efficacy in mitigating neuroinflammation by suppressing glial activation, reducing the secretion of pro-inflammatory cytokines (e.g., TNF-α, MCP-1), and increasing the expression of neuroprotective metallothionein-1 (MT1). Some Clinical research reveals elevated ⁶⁴Cu-ATSM uptake in Parkinson's disease (PD), Alzheimer's disease (AD), and amyotrophic lateral sclerosis (ALS) patients, correlating with disease severity and regional oxidative stress markers. Furthermore, Cu-ATSM derivatives show promise in modulating blood-brain barrier (BBB) permeability, enhancing amyloid-β clearance, and restoring copper homeostasis in ALS models. Despite these advances, limitations such as small cohort sizes and heterogeneity in clinical studies underscore the need for larger-scale validation. Multimodal imaging integrating PET and MRI, alongside novel structural analogs targeting Aβ plaques and redox imbalances, emerges as a strategic direction for future research. Collectively, Cu-ATSM represents a transformative tool for elucidating neuropathological mechanisms and advancing therapeutic strategies in neurodegenerative disorders.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044493","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}
Martina Di Franco, Giuseppe Lamberti, Davide Campana, Valentina Ambrosini
{"title":"Molecular Imaging for Response Assessment of Neuroendocrine Tumors (NET).","authors":"Martina Di Franco, Giuseppe Lamberti, Davide Campana, Valentina Ambrosini","doi":"10.1053/j.semnuclmed.2025.04.005","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2025.04.005","url":null,"abstract":"<p><p>Assessing treatment response in neuroendocrine tumors (NET) remains a significant challenge due to their typically indolent growth and heterogenity, the frequent occurrence of disease stabilization rather than tumor shrinkage after therapy, and the inherent limitations of conventional imaging criteria. While molecular imaging-primarily somatostatin receptor (SST) PET/CT-has improved lesion detection, the absence of standardized response criteria limits its clinical utility and prevents its use as full replacement of conventional imaging. Emerging strategies, including revised thresholds for dimensional changes, criteria evaluating different features, such as lesions' density and functional tumor volumes, offer potential improvements in response evaluation but require further validation for routine clinical implementation. This review examines the current challenges in assessing NET treatment response, evaluates the strengths and limitations of available imaging modalities, and discusses emerging approaches and future directions for optimizing therapeutic monitoring in the heterogeneous panorama of NET.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051835","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}
Anita Brink, Diana Paez, Enrique Estrada Lobato, Roberto C Delgado Bolton, Peter Knoll, Aruna Korde, Adriana K Calapaquí Terán, Mohamad Haidar, Francesco Giammarile
{"title":"New Targets for Imaging in Nuclear Medicine.","authors":"Anita Brink, Diana Paez, Enrique Estrada Lobato, Roberto C Delgado Bolton, Peter Knoll, Aruna Korde, Adriana K Calapaquí Terán, Mohamad Haidar, Francesco Giammarile","doi":"10.1053/j.semnuclmed.2025.04.004","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2025.04.004","url":null,"abstract":"<p><p>Nuclear medicine is rapidly evolving with new molecular imaging targets and advanced computational tools that promise to enhance diagnostic precision and personalized therapy. Recent years have seen a surge in novel PET and SPECT tracers, such as those targeting prostate-specific membrane antigen (PSMA) in prostate cancer, fibroblast activation protein (FAP) in tumor stroma, and tau protein in neurodegenerative disease. These tracers enable more specific visualization of disease processes compared to traditional agents, fitting into a broader shift toward precision imaging in oncology and neurology. In parallel, artificial intelligence (AI) and machine learning techniques are being integrated into tracer development and image analysis. AI-driven methods can accelerate radiopharmaceutical discovery, optimize pharmacokinetic properties, and assist in interpreting complex imaging datasets. This editorial provides an expanded overview of emerging imaging targets and techniques, including theranostic applications that pair diagnosis with radionuclide therapy, and examines how AI is augmenting nuclear medicine. We discuss the implications of these advancements within the field's historical trajectory and address the regulatory, manufacturing, and clinical challenges that must be navigated. Innovations in molecular targeting and AI are poised to transform nuclear medicine practice, enabling more personalized diagnostics and radiotheranostic strategies in the era of precision healthcare.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013197","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}
Matilde Nerattini, Elisabetta Maria Abenavoli, Valentina Berti
{"title":"PET/CT in Movement Disorders: Update.","authors":"Matilde Nerattini, Elisabetta Maria Abenavoli, Valentina Berti","doi":"10.1053/j.semnuclmed.2025.03.007","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2025.03.007","url":null,"abstract":"<p><p>This review synthesizes recent literature, primarily from the last 5 years, to highlight the impact of innovative technologies and analytical approaches on the application of positron emission tomography (PET) in movement disorders. PET remains a cornerstone for investigating these conditions, with recent advancements enhancing our understanding of disease pathophysiology and progression. Established findings, such as the ability of [<sup>18</sup>F]-fluorodeoxyglucose PET (18F-FDG PET) to differentiate Parkinson's disease (PD) from atypical parkinsonian syndromes based on characteristic metabolic patterns, have been consistently validated. PD typically presents with relative hypermetabolism in the basal ganglia, thalamus and cerebellum, while atypical parkinsonisms exhibit more widespread subcortical hypometabolism. Technological innovations, particularly in quantification methods and metabolic connectivity analysis, have improved diagnostic precision and provided deeper insights into disease mechanisms. Dopaminergic PET imaging, crucial for assessing presynaptic and postsynaptic dysfunction, has also benefited from these advances. The field is further evolving with the development of novel tracers targeting pathological hallmarks, such as alpha-synuclein in PD and multiple system atrophy (MSA), tau in progressive supranuclear palsy (PSP) and cortico-basal degeneration (CBD), and tracers for neuroinflammation, microglial activation, and neurotransmitter systems like serotonin and acetylcholine. While PET is not yet routinely used for the clinical assessment of Huntington's disease or ataxia, research applications are expanding, driven by the potential of these new tracers and analytical techniques. These advancements not only reinforce existing knowledge but also open new avenues for enhancing the understanding and management of movement disorders.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029797","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":"Impact of PSMA PET on Radiation Oncology Planning.","authors":"Simon K B Spohn, Anca-L Grosu","doi":"10.1053/j.semnuclmed.2025.03.006","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2025.03.006","url":null,"abstract":"<p><p>Radiation therapy (RT) plays a critical role in managing prostate cancer (PCa) in various stages, from localized disease to metastatic settings. Recent advancements in molecular imaging using prostate-specific membrane antigen positron emission tomography (PSMA-PET) have revolutionized PCa diagnosis, significantly enhancing local, lymph node and distant stagingto conventional imaging methods. This narrative review explores the impact of PSMA-PET on RT planning, highlighting its diagnostic performance and implications for RT treatment management. PSMA-PET has shown superior sensitivity in detecting metastatic lesions and intraprostatic tumor volumes, leading to more accurate disease staging and treatment planning. The HypoFocal trials investigate the safety and efficacy of implementing PSMA-PET into definitive RT regimens. Additionalongoing clinical trials are investigating the potential of PSMA-PET-based RT recurrent and oligometastatic PCa. Despite these advancements, further research is necessary to optimize patient selection and define the best management strategies for PSMA-PET-guided RT.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022482","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}
Greet Vanderlinden, Rik Vandenberghe, Mathieu Vandenbulcke, Koen Van Laere
{"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":"https://doi.org/10.1053/j.semnuclmed.2025.03.002","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-04-21","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}