Esther Mena MD, Liza Lindenberg MD, Peter L. Choyke MD
{"title":"Update on PSMA-based Prostate Cancer Imaging","authors":"Esther Mena MD, Liza Lindenberg MD, Peter L. Choyke MD","doi":"10.1053/j.semnuclmed.2024.10.004","DOIUrl":"10.1053/j.semnuclmed.2024.10.004","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"54 6","pages":"Pages 941-950"},"PeriodicalIF":4.6,"publicationDate":"2024-11-01","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}
{"title":"PET/CT Assessment of Estrogen Receptor positivity for Breast Cancer using [68Ga]Ga-RM2 Bombesin Receptor Antagonist: A Systematic Review and Meta-Analysis","authors":"Akram Al-Ibraheem MD, FRCP, FEBNM, FANMB , Ahmed Saad Abdlkadir MD , Hongcheng Shi PhD , Hikmat Abdel-Razeq MD, ABIM , Asem Mansour MD, FRCR","doi":"10.1053/j.semnuclmed.2024.09.003","DOIUrl":"10.1053/j.semnuclmed.2024.09.003","url":null,"abstract":"<div><div>[<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; <em>P</em> < 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; <em>P</em> < 0.00001). Further studies utilizing this promising radiotracer should be encouraged, implementing prospective, large-scale designs in the near future.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"54 6","pages":"Pages 896-903"},"PeriodicalIF":4.6,"publicationDate":"2024-11-01","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}
Kgomotso M.G Mokoala MD, PhD , Mike M. Sathekge MD, PhD
{"title":"Non-FDG hypoxia tracers","authors":"Kgomotso M.G Mokoala MD, PhD , Mike M. Sathekge MD, PhD","doi":"10.1053/j.semnuclmed.2024.10.001","DOIUrl":"10.1053/j.semnuclmed.2024.10.001","url":null,"abstract":"<div><div>Hypoxia plays a critical role in tumor biology, influencing cancer progression, treatment resistance, and patient prognosis. While 18-Fluorine fluoredeoxyglucose ([18F]F-FDG) PET imaging has been the standard for metabolic assessment, its limitations in accurately depicting hypoxic tumor regions necessitate the exploration of non-FDG hypoxia tracers. This review aims to evaluate emerging non-FDG radiotracers, such as nitroimidazole derivatives, copper-based agents, gallium-based agents and other innovative compounds, highlighting their mechanisms of action, biodistribution, and clinical applications. We will discuss the advantages and challenges associated with hypoxia imaging, as well as recent advancements in imaging techniques that enhance the assessment of tumor hypoxia. By synthesizing current research, this review seeks to provide insights into the potential of non-FDG hypoxia tracers for improving cancer diagnosis, treatment planning, and monitoring, ultimately contributing to more personalized and effective cancer care.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"54 6","pages":"Pages 827-844"},"PeriodicalIF":4.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sophia R. O'Brien MD, MSEd , Christine E. Edmonds MD , Rebecca E. Ward MD , Neil K. Taunk MD, MSCTS , Austin R. Pantel MD, MSTR , David A. Mankoff MD, PhD
{"title":"Update on 18F-Fluoroestradiol","authors":"Sophia R. O'Brien MD, MSEd , Christine E. Edmonds MD , Rebecca E. Ward MD , Neil K. Taunk MD, MSCTS , Austin R. Pantel MD, MSTR , David A. Mankoff MD, PhD","doi":"10.1053/j.semnuclmed.2024.09.001","DOIUrl":"10.1053/j.semnuclmed.2024.09.001","url":null,"abstract":"<div><div><sup>18</sup>F-16α-Fluoroestradiol (<sup>18</sup>F-FES) is a radiolabeled estrogen analogue positron emission tomography (PET) imaging agent that binds to the estrogen receptor (ER) in the nucleus of ER-expressing cells. Proof-of-concept studies of <sup>18</sup>F-FES demonstrated expected correlation between tumoral <sup>18</sup>F-FES-positivity on PET-imaging and ER+ status assessed on biopsy samples by radioligand binding and immunohistochemistry. After decades of study, <sup>18</sup>F-FES PET/CT gained clinical approval in 2016 in France and 2020 in the United States for use in patients with ER+ metastatic or recurrent breast cancer.</div><div>ER+ as assessed by <sup>18</sup>F-FES PET/CT has been shown to serve as a biomarker, identifying metastatic breast cancer patients who may respond to endocrine therapy and those who are unlikely to respond. In 2023, the Society of Nuclear Medicine and Molecular Imaging (SNMMI) published Appropriate Use Criteria for <sup>18</sup>F-FES PET/CT, identifying four indications in which use of <sup>18</sup>F-FES PET/CT was “appropriate”: (1) To assess functional ER status in metastatic lesions unfavorable to biopsy or when biopsy is nondiagnostic, (2) To detect ER status when other imaging tests are equivocal or suspicious, and at (3) initial diagnosis of metastatic disease or (4) progression of metastatic disease, for considering endocrine therapy.</div><div>This article reviews the foundations of <sup>18</sup>F-FES imaging, including normal distribution, false positives, and false negatives, and describes the most up-to-date clinical uses as well as emerging research in breast cancer and other patient populations.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"54 6","pages":"Pages 812-826"},"PeriodicalIF":4.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378233","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 PhD , Maryke Kahts PhD , Beverley Summers PhD , Jan Rijn Zeevaart PhD , Thomas Ebenhan PhD
{"title":"Highlighting New Research Trends on Zirconium-89 Radiopharmaceuticals Beyond Antibodies","authors":"Janie Duvenhage PhD , Maryke Kahts PhD , Beverley Summers PhD , Jan Rijn Zeevaart PhD , Thomas Ebenhan PhD","doi":"10.1053/j.semnuclmed.2024.10.003","DOIUrl":"10.1053/j.semnuclmed.2024.10.003","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"54 6","pages":"Pages 801-811"},"PeriodicalIF":4.6,"publicationDate":"2024-11-01","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}
Janke Kleynhans , Thomas Ebenhan , Mike Machaba Sathekge
{"title":"Expanding Role for Gallium-68 PET Imaging in Oncology","authors":"Janke Kleynhans , Thomas Ebenhan , Mike Machaba Sathekge","doi":"10.1053/j.semnuclmed.2024.06.001","DOIUrl":"10.1053/j.semnuclmed.2024.06.001","url":null,"abstract":"<div><div><span>Gallium-68 has gained substantial momentum since 2003 as a versatile radiometal that is extremely useful for application in the development of novel oncology targeting diagnostic radiopharmaceuticals. It is available through both generator produced radioactivity and via cyclotron production methods and can therefore be implemented in either small- or large-scale production facilities. It can also be implemented within different spectrum of infrastructure settings with relative ease. Whilst many of the radiopharmaceuticals are being development and investigated, which is summarized in this manuscript, [</span><sup>68</sup>Ga]Ga-SSTR2 and [<sup>68</sup>Ga]Ga-PSMA has prominence in current clinical guidelines. The novel tracer [<sup>68</sup>Ga]Ga-FAPi has also gained significant interest in the clinical context. A comparison of the labelling strategies followed to incorporate gallium-68 and fluorine-18 into the same molecular targeting constructs clearly demonstrate that gallium-68 complexation is the most convenient approach. Recently, cold kit based starting products are available to make the small-scale production of gallium-68 radiopharmaceuticals even more efficient when combined with generator produced gallium-68. The regulatory aspects is currently changing to support the implementation of gallium-68 and other diagnostic radiopharmaceuticals, simplifying the translation towards clinical use. Overall, the development of gallium-68 based radiopharmaceuticals is not only rapidly changing the landscape of diagnosis in oncology, but this growth also promotes innovation and progress in new applications of therapeutic radiometals such as lutetium-177 and actinium-225.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"54 6","pages":"Pages 778-791"},"PeriodicalIF":4.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535131","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":"Radiolabeled Somatostatin Analogs for Cancer Imaging","authors":"Aamir K. Nazar MD, PhD , Sandip Basu MD, PhD","doi":"10.1053/j.semnuclmed.2024.07.001","DOIUrl":"10.1053/j.semnuclmed.2024.07.001","url":null,"abstract":"<div><div>Somatostatin receptors (SSTR) are expressed by many tumours especially those related to neuro-endocrine origin and molecular functional imaging of SSTR expression using radiolabelled somatostatin analogs have revolutionized imaging of patients with these group of malignancies. Coming a long way from the first radiolabelled somatostatin analog <sup>123</sup>I-Tyr-3-octreotide, there has been significant developments in terms of radionuclides used, the ligands and somatostatin derivatives. <sup>111</sup>In-Pentetreotide extensively employed for imaging NETs at the beginning has now been replaced by <sup>68</sup>Ga-SSA based PET-CT. SSA-PET/CT performs superior to conventional imaging modalities and has evolved in the mainframe for NET imaging. The advantages were multiple: (i) superior spatial resolution of PET versus SPECT, (ii) quantitative capabilities of PET aiding in disease activity and treatment response monitoring with better precision, (iii) shorter scan time and (iv) less patient exposure to radiation. The modality is indicated for staging, detecting the primary in CUP-NETs, restaging, treatment planning (along with FDG: the concept of dual-tracer PET-CT) as well as treatment response evaluation and follow-up of NETs. SSA PET/CT has also been incorporated in the guidelines for imaging of Pheochromocytoma-Paraganglioma, Medullary carcinoma thyroid, Meningioma and Tumor induced osteomalacia. At present, there is rising interest on (a) <sup>18</sup>F-labelled SSA, (b) <sup>64</sup>Cu-labelled SSA, and (c) somatostatin antagonists. <sup>18</sup>F offers excellent imaging properties, <sup>64</sup>Cu makes delayed imaging feasible which has implications in dosimetry and SSTR antagonists bind with the SST receptors with high affinity and specificity, providing high contrast images with less background, which can be translated to theranostics effectively. SSTR have been demonstrated in non-neuroendocrine tumours as well in the peer-reviewed literature, with studies demonstrating the potential of SSA PET/CT in Neuroblastoma, Nasopharyngeal carcinoma, carcinoma prostate (neuroendocrine differentiation) and lymphoma. This review will focus on the currently available SSAs and their history, different SPECT/PET agents, SSTR antagonists, comparison between the various imaging tracers, and their utility in both neuroendocrine and non-neuroendocrine tumors.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"54 6","pages":"Pages 914-940"},"PeriodicalIF":4.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913799","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 MD, PhD , Eline de Meyer PhD , Klaas Pieter Koopmans PhD , Adrienne H. Brouwers PhD , G. Luurtsema PhD , Rudi A.J.O. Dierckx MD, PhD
{"title":"Update on the Role of [18F]FDOPA PET/CT","authors":"Gilles N. Stormezand MD, PhD , Eline de Meyer PhD , Klaas Pieter Koopmans PhD , Adrienne H. Brouwers PhD , G. Luurtsema PhD , Rudi A.J.O. Dierckx MD, PhD","doi":"10.1053/j.semnuclmed.2024.09.004","DOIUrl":"10.1053/j.semnuclmed.2024.09.004","url":null,"abstract":"<div><div>[<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.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"54 6","pages":"Pages 845-855"},"PeriodicalIF":4.6,"publicationDate":"2024-11-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"18F-Fluorocholine-Positron Emission Tomography/Computerized Tomography (FCH PET/CT) Imaging for Detecting Abnormal Parathyroid Glands: Indication, Practice, Interpretation and Diagnostic Performance","authors":"Lucia Noskovicova MD , Sona Balogova MD, PhD , Cyrielle Aveline MD , Marc Tassart MD , Jules Zhang-Yin MD, PhD , Khaldoun Kerrou MD , Ivan Jaksic MD , Françoise Montravers MD, PhD , Jean-Noël Talbot MD, PhD","doi":"10.1053/j.semnuclmed.2024.08.002","DOIUrl":"10.1053/j.semnuclmed.2024.08.002","url":null,"abstract":"<div><div>In patients with confirmed hyperparathyroidism (HPT) scheduled for surgical treatment, the preoperatory imaging permits to optimize the operatory protocol of parathyroidectomy (PTX), in particular by selecting those patients who can benefit from minimally invasive PTX (MIPTX). The MIPTX has the merit to shorten the operative time, incision length, and to reduce the operatory risks. With preoperative localization studies, the rate of PTX failure, in particular due to nonsuspected multiglandular or ectopic disease, has been profoundly decreased. The first cases of incidental localization of abnormal parathyroid glands (PTs) on FCH PET/CTs performed for another indication were reported more than one decade ago. Since then, significant amount of data from heterogeneous series of patients consistently confirmed better diagnostic performances of FCH PET/CT (sensitivity for detection of abnormal PT 97%, range 96%-98%) in comparison with other radiopharmaceuticals, ultrasonography or 4D-CeCT in localizing hyperfunctioning parathyroid glands (HFPTGs) in case of primary HPT. Utility of FCH PET/CT in case of renal HPT has been reported in fewer series. The article discusses and summarizes the bibliographic evidence on documented indications of FCH PET/CT in patients with HPT, its safety profile, the practice of FCH PET/CT and interpretation of FCH PET/CT findings, including potential interpretation pitfalls and tips to avoid them. Our real-world experience over 12 years reinforces published evidence supporting the use of FCH PET/CT as the first-line radionuclide imaging technique in patients with all types of HPT in whom surgery is an option.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"54 6","pages":"Pages 875-895"},"PeriodicalIF":4.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294431","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}
Yu Lin MD , Huaping Gao MM , Jiefu Zheng MD , Akram Al-Ibraheem MD , Pengcheng Hu MD , Hongcheng Shi MD, PhD
{"title":"Clinical Explorations of [68Ga] Ga-FAPI-04 and [18F] FDG Dual-Tracer Total-body PET/CT and PET/MR Imaging","authors":"Yu Lin MD , Huaping Gao MM , Jiefu Zheng MD , Akram Al-Ibraheem MD , Pengcheng Hu MD , Hongcheng Shi MD, PhD","doi":"10.1053/j.semnuclmed.2024.09.009","DOIUrl":"10.1053/j.semnuclmed.2024.09.009","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"54 6","pages":"Pages 904-913"},"PeriodicalIF":4.6,"publicationDate":"2024-11-01","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}