Seminars in nuclear medicine最新文献

{"title":"Letter from the Editors","authors":"M. Michael Sathekge MD, PhD, Kirsten Bouchelouche MD, DMSc","doi":"10.1053/j.semnuclmed.2026.08.004","DOIUrl":"10.1053/j.semnuclmed.2026.08.004","url":null,"abstract":"","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"56 5","pages":"Pages 777-779"},"PeriodicalIF":6.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888572","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":"Pediatric gastrointestinal transit scintigraphy: From esophageal transit to whole-gut transit","authors":"Reza Vali,&nbsp;Amer Shammas,&nbsp;Neha Kwatra,&nbsp;Elnaz Jenabihaghparast,&nbsp;Zvi Bar-Sever","doi":"10.1053/j.semnuclmed.2026.07.009","DOIUrl":"10.1053/j.semnuclmed.2026.07.009","url":null,"abstract":"<div><div>Pediatric gastrointestinal scintigraphy provides physiologic, quantitative, and clinically useful information for children with suspected motility disorders, feeding intolerance, reflux or aspiration, refractory constipation, and complex postsurgical anatomy. This review summarizes the role of esophageal transit scintigraphy, gastric emptying and gastroesophageal reflux scintigraphy, and small-bowel and colonic transit scintigraphy in children. These studies complement anatomic imaging, endoscopy, pH-impedance testing, and manometry by directly evaluating the movement of radiolabeled meals or boluses under relatively physiologic conditions.</div><div>For each application, the review emphasizes practical patient preparation, meal and radiopharmaceutical selection, acquisition methods, quantitative analysis, interpretation patterns, reporting elements, and common pitfalls. Suggested pediatric protocols are provided in three tables, and representative examples are illustrated as figures. Because pediatric normative data are limited for several gastrointestinal transit applications, results should be interpreted in the context of patient age, symptoms, meal type, position, medication status, prior surgery, and institutional methodology. A structured and clinically oriented approach can improve the diagnostic value of pediatric gastrointestinal scintigraphy and help guide multidisciplinary management.</div></div><div>Pediatric gastrointestinal scintigraphy provides physiologic, quantitative, and clinically useful information for children with suspected motility disorders, feeding intolerance, reflux or aspiration, refractory constipation, and complex postsurgical anatomy. This review summarizes the role of esophageal transit scintigraphy, gastric emptying and gastroesophageal reflux scintigraphy, and small-bowel and colonic transit scintigraphy in children. These studies complement anatomic imaging, endoscopy, pH-impedance testing, and manometry by directly evaluating the movement of radiolabeled meals or boluses under relatively physiologic conditions.</div><div>For each application, the review emphasizes practical patient preparation, meal and radiopharmaceutical selection, acquisition methods, quantitative analysis, interpretation patterns, reporting elements, and common pitfalls. Suggested pediatric protocols are provided in three tables, and representative examples are illustrated as figures. Because pediatric normative data are limited for several gastrointestinal transit applications, results should be interpreted in the context of patient age, symptoms, meal type, position, medication status, prior surgery, and institutional methodology. A structured and clinically oriented approach can improve the diagnostic value of pediatric gastrointestinal scintigraphy and help guide multidisciplinary management.</div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"56 5","pages":"Pages 860-875"},"PeriodicalIF":6.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654043","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":"Neuroblastoma imaging: From MIBG to advanced PET tracers","authors":"Ameya D. Puranik DNB, FEBNM","doi":"10.1053/j.semnuclmed.2026.07.008","DOIUrl":"10.1053/j.semnuclmed.2026.07.008","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Neuroblastoma is the most common extracranial solid malignancy of childhood and accounts for approximately 15% of pediatric cancer–related mortality. Originating from neural crest–derived sympathetic nervous system cells, neuroblastoma demonstrates remarkable biological heterogeneity, ranging from spontaneous regression to highly aggressive metastatic disease. Accurate imaging is fundamental to diagnosis, staging, risk stratification, treatment planning, response assessment, and surveillance. Over the past four decades, molecular imaging of neuroblastoma has evolved substantially, progressing from conventional metaiodobenzylguanidine (MIBG) scintigraphy to advanced positron emission tomography/computed tomography (PET/CT) tracers that provide complementary biological and molecular information. This review explores the evolution of neuroblastoma imaging, highlighting the strengths, limitations, and emerging roles of established and novel radiopharmaceuticals. 131/123I–MIBG scintigraphy remains the cornerstone of functional imaging in neuroblastoma because of its high specificity for tumors expressing the norepinephrine transporter. MIBG imaging has become integral to the International Neuroblastoma Risk Group (INRG) staging system and is widely utilized for evaluating primary tumors, metastatic disease, and therapeutic response. Furthermore, MIBG serves as a theranostic agent, enabling targeted radionuclide therapy with 131I–MIBG in patients with relapsed or refractory disease. However, approximately 5–10% of neuroblastomas demonstrate absent or low MIBG avidity, limiting its diagnostic utility. Additionally, MIBG imaging is constrained by lower spatial resolution, prolonged imaging protocols, and reduced sensitivity for small lesions compared with modern PET techniques. The increasing availability of PET/CT has led to the development of several promising tracers that address these limitations. 18F–fluorodeoxyglucose (18F–FDG) PET/CT has emerged as an important alternative, particularly in MIBG–negative tumors, dedifferentiated disease, and high–risk neuroblastoma. FDG uptake often correlates with tumor aggressiveness and adverse biological features, providing valuable prognostic information. Beyond FDG, tracers targeting specific aspects of neuroblastoma biology have demonstrated significant potential. 18F–fluorodihydroxyphenylalanine (18F FDOPA) PET/CT exploits catecholamine biosynthesis pathways and has shown superior sensitivity for detecting both primary and metastatic lesions. Somatostatin receptor imaging with 68Ga–DOTA–peptides offers opportunities for patient selection for peptide receptor radionuclide therapy.As novel theranostic paradigms emerge, molecular imaging is increasingly serving not only as a diagnostic tool but also as a means of guiding targeted therapies and monitoring treatment efficacy. This review provides a comprehensive overview of contemporary neuroblastoma imaging, tracing the transition from MIBG–based scin","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"56 5","pages":"Pages 905-915"},"PeriodicalIF":6.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689921","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":"Can AI Make Paediatric PET/CT Lower Dose? Opportunities, Evidence and Cautions","authors":"Geoffrey M. Currie,&nbsp;Eric M. Rohren","doi":"10.1053/j.semnuclmed.2026.07.002","DOIUrl":"10.1053/j.semnuclmed.2026.07.002","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Artificial intelligence (AI) has emerged as a potential enabling technology for lower-dose paediatric PET/CT, but its value depends on whether dose reduction can be achieved without compromising diagnostic accuracy, lesion detectability, quantitative reliability or clinical confidence. This review examines AI-enabled pathways for paediatric PET/CT dose optimisation, including low-count PET denoising, image enhancement, full-count synthesis, reconstruction-integrated AI, low-dose CT reconstruction, synthetic CT, CT-free attenuation/scatter correction, motion correction, automated quality control, patient-specific protocol selection and reduction of unnecessary or repeat imaging. The strongest direct opportunities are low-count PET enhancement and AI-supported CT dose reduction, while synthetic CT and CT-free correction may reduce or eliminate attenuation-correction CT in selected settings where diagnostic CT is not required. Indirect AI approaches, including motion-risk reduction, quality-control systems and agentic workflow support, may reduce dose by improving first-time-right imaging, avoiding repeat acquisition and matching protocols to the clinical question. It is important to differentiate between visually aesthetic images and diagnostic images, in other words, visual image improvement is an inadequate endpoint. AI-enhanced lower-dose PET/CT must be validated for small-lesion detection, quantitative accuracy, response-classification stability, scanner and tracer generalisability, failure modes and prospective clinical safety. Social, ethical and legal considerations are also central, because AI tools have the potential to widen disparities. AI may make paediatric PET/CT lower dose, but only when it preserves clinical value within a governed, paediatric-specific optimisation framework.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Artificial intelligence (AI) has emerged as a potential enabling technology for lower-dose paediatric PET/CT, but its value depends on whether dose reduction can be achieved without compromising diagnostic accuracy, lesion detectability, quantitative reliability or clinical confidence. This review examines AI-enabled pathways for paediatric PET/CT dose optimisation, including low-count PET denoising, image enhancement, full-count synthesis, reconstruction-integrated AI, low-dose CT reconstruction, synthetic CT, CT-free attenuation/scatter correction, motion correction, automated quality control, patient-specific protocol selection and reduction of unnecessary or repeat imaging. The strongest direct opportunities are low-count PET enhancement and AI-supported CT dose reduction, while synthetic CT and CT-free correction may reduce or eliminate attenuation-correction CT in selected settings where diagnostic CT is not required. Indirect AI approaches, including motion-risk reduction, quality-control systems and agentic workflow support, may reduce dose by improving first-time-right imaging, avoiding repeat acquisition and matching protocol","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"56 5","pages":"Pages 780-792"},"PeriodicalIF":6.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550335","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":"Equine nuclear medicine: Current state of play","authors":"Peter Tually,&nbsp;Shiphrah Becker,&nbsp;Geoffrey M. Currie","doi":"10.1053/j.semnuclmed.2026.07.004","DOIUrl":"10.1053/j.semnuclmed.2026.07.004","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Background: Equine nuclear medicine provides functional information on bone turnover, perfusion, inflammation and tracer biodistribution. Its role has evolved from planar scintigraphy toward SPECT, PET and quantitative imaging. This review synthesised the historical foundations and contemporary state of equine nuclear medicine, with emphasis on racehorse and performance-horse applications.&lt;/div&gt;&lt;div&gt;Methods: A PRISMA-aligned systematic narrative review and evidence map were undertaken. MEDLINE via PubMed, Web of Science Core Collection and SciQuest were searched, supplemented by reference-list screening, forward citation searching and snowballing. Eligible records addressed nuclear medicine imaging, radiopharmaceutical use, technical methods, diagnostic or therapeutic applications, dosimetry, radiation safety or facility/workflow considerations in horses. Heterogeneity in populations, indications, modalities and outcomes precluded meta-analysis; records were therefore mapped descriptively and synthesised narratively.&lt;/div&gt;&lt;div&gt;Results: After consolidation and deduplication, 181 records were retained. Historical and foundational approaches accounted for 138 records, spanning non-skeletal applications, technical factors, musculoskeletal interpretation, lameness localisation and stress injury in performance / racehorses. This literature established scintigraphy as a tool for detecting altered skeletal turnover, localising occult or complex lameness and identifying stress remodelling or prodromal injury, while emphasising clinical correlation, normal-pattern recognition and technical standardisation. Contemporary approaches accounted for 43 records and included scintigraphic optimisation, quantitation, AI/radiomics, contemporary scintigraphy, SPECT and PET. These studies demonstrated refinement of planar scintigraphy, emerging standing SPECT for complex axial regions, and growth of standing 18F-NaF and 18F-FDG PET for distal-limb imaging, lesion monitoring and multimodality assessment.&lt;/div&gt;&lt;div&gt;Conclusions: Equine nuclear medicine has progressed from planar localisation toward a complementary functional imaging discipline. Scintigraphy remains useful for broad screening, SPECT is under-developed but promising for pelvis, vertebral column and head applications, and PET is the leading contemporary advance for high-resolution distal-limb imaging, quantitation and performance-horse injury prevention.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Background: Equine nuclear medicine provides functional information on bone turnover, perfusion, inflammation and tracer biodistribution. Its role has evolved from planar scintigraphy toward SPECT, PET and quantitative imaging. This review synthesised the historical foundations and contemporary state of equine nuclear medicine, with emphasis on racehorse and performance-horse applications.&lt;/div&gt;&lt;div&gt;Methods: A PRISMA-aligned systematic narrative review and evidence map were undertaken. MEDLINE via PubMed, Web of Science Core Collec","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"56 5","pages":"Pages 1012-1026"},"PeriodicalIF":6.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621396","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":"FAPI PET in musculoskeletal oncology: An update and future directions.","authors":"Anja Dietze, Daniel M Aebersold, Axel Rominger, Constantin Lapa, Robert Seifert","doi":"10.1053/j.semnuclmed.2026.08.006","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2026.08.006","url":null,"abstract":"<p><p>Fibroblast activation protein inhibitor (FAPI) imaging has become a promising approach in musculoskeletal oncology, with growing evidence supporting its application in both primary sarcomas and skeletal metastatic disease. Fibroblast activation protein (FAP) is expressed by cancer-associated fibroblasts and by tumor cells themselves in several sarcoma subtypes, while demonstrating limited expression in normal adult tissues. This biological profile has supported the development of radiolabeled FAP inhibitors, which provide high tumor-to-background contrast on PET imaging and enable theranostic applications with FAP-targeting radioligands. In sarcoma, available studies demonstrate higher FAPI uptake and improved lesion detection compared with [¹⁸F]FDG PET across most histological subtypes, with particularly notable advantages in low- and intermediate-grade tumors. However, FAPI uptake varies according to histological subtype. In metastatic bone disease, FAPI PET detects more lesions than [¹⁸F]FDG PET, particularly osteolytic and marrow-based metastases. The benefit is greatest in tumor entities with low [¹⁸F]FDG uptake, though at the cost of reduced specificity, as benign skeletal and fibroinflammatory processes also take up the tracer. As FAPI and [¹⁸F]FDG reflect different tumor biology with distinct strengths, their roles are increasingly regarded as complementary rather than competing. Beyond imaging, FAPI PET facilitates patient selection for FAP-targeted radioligand therapy, with early clinical experience demonstrating feasibility and encouraging preliminary evidence of disease control. Prospective studies are needed to define its clinical impact, establish standardized interpretation and response criteria, and determine the role of FAPI-based imaging and therapy in the management of musculoskeletal malignancies.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841108","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 innovation logic cycle of nuclear medicine: Translation, adoption, and reinvention across 130 years.","authors":"Geoffrey M Currie, Dale L Bailey","doi":"10.1053/j.semnuclmed.2026.08.001","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2026.08.001","url":null,"abstract":"<p><p>Nuclear medicine is often narrated as a chronology of discoveries, but its development is better understood as a recurring process through which scientific possibility becomes durable clinical practice. This narrative review examines 130 years of nuclear medicine innovation using a conceptual framework in which transformation occurs when scientific possibility, clinical unmet need, an operational platform and a legitimising ecosystem converge. Fourteen innovation clusters are examined as translational episodes rather than isolated inventions. Across these cases, innovations became clinically transformative only when infrastructure, workflow, workforce capability, evidence, regulation, reimbursement and professional legitimacy evolved together. The analysis also shows that major technologies reorganised practice, redistributed professional roles and created new platforms from which later innovations emerge. Nuclear medicine's history reveals an innovation logic that is cumulative rather than episodic; science becomes service when discovery, infrastructure, workforce, evidence and legitimacy converge. This framework provides a basis for understanding both past transformation and the conditions under which future innovations are most likely to reshape nuclear medicine.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797788","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":"Post-therapy radioiodine imaging characterizes occult metastatic differentiated thyroid carcinoma years after thyroidectomy for presumed benign multinodular goiter.","authors":"Chanchan Shan, Shichen Xu, Aisheng Zhong, Jian Zhang","doi":"10.1053/j.semnuclmed.2026.07.012","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2026.07.012","url":null,"abstract":"<p><p>Occult differentiated thyroid carcinoma may become clinically evident years after thyroidectomy performed for presumed benign multinodular goiter, presenting an important diagnostic challenge. Following CT-guided biopsy confirmation of metastatic differentiated thyroid carcinoma of thyroid follicular-cell origin, post-therapy ¹³¹I scintigraphy and SPECT/CT demonstrated multifocal iodine-avid pulmonary metastases and defined the functional extent of disease. These images illustrate the complementary value of post-therapy radioiodine imaging in characterizing iodine avidity and metastatic disease distribution.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763025","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":"FAPI PET-guided tumor volume delineation for radiotherapy planning: A comprehensive review across solid tumors.","authors":"Sajjad Sadeghpour, Atena Aghaee, Armin Doostparast, Nikoo Rezaei, Ghasemali Divband, Nasrin Raeisi, Falk Roeder, Theresa Jung, Christian Pirich, Salman Soltani, Ramin Sadeghi, Mohsen Beheshti","doi":"10.1053/j.semnuclmed.2026.06.002","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2026.06.002","url":null,"abstract":"<p><p>Accurate gross tumor volume (GTV) delineation remains a critical yet error-prone step in radiotherapy (RT) planning. Conventional imaging and [¹⁸F]FDG PET/CT are limited by poor tumor-to-background contrast and non-specific inflammatory uptake. ¹⁸F/⁶⁸Ga-labeled fibroblast activation protein inhibitor (FAPI) PET, which targets cancer-associated fibroblasts (CAFs) within the tumor microenvironment, offers a biologically distinct and potentially superior alternative. This review summarizes the current evidence across multiple solid tumors, highlighting its potential to improve gross tumor volume delineation, refine staging, and reduce interobserver variability compared with conventional imaging and [¹⁸F]FDG PET. Although FAPI PET frequently altered target volumes and RT planning, the available evidence is limited by small, predominantly retrospective studies and the absence of histopathological validation or long-term clinical outcomes. At present, FAPI PET should be considered a complementary imaging tool with particular value in selected clinical settings. Prospective multicenter studies are needed to establish standardized segmentation methods and determine whether improved target delineation translates into better patient outcomes.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456873","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 diagnostic performance and clinical value of [18F]FDG PET/CT in pleural mesothelioma - A systematic review and meta-analysis.","authors":"Anne H Thostrup, Natasja U Stubbe, Mathias P Schreiner, Morten Bentestuen, Anne V Olesen, Helle D Zacho","doi":"10.1053/j.semnuclmed.2026.05.010","DOIUrl":"https://doi.org/10.1053/j.semnuclmed.2026.05.010","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review and meta-analysis aims to evaluate the diagnostic accuracy of FDG PET/CT for diagnosing pleural mesothelioma in treatment-naïve patients using histopathology as reference standard. Secondary aims include evaluation of FDG PET/CT or FDG PET/MRI's diagnostic accuracy of lymph node and distant metastases, their impact on TNM-staging, and PET uptake and volumetric parameters in pleural mesothelioma.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis adhering to 'Preferred Reporting Guidelines for Systematic reviews and Meta-Analyses' (PRISMA) with a predefined literature search. It consisted of the terms: \"pleura\" or \"pleural\" or \"mesothelioma\", \"PET\" or \"positron emission tomography\", and \"FDG\" or \"fluorodeoxyglucose\". Two independent reviewers systematically screened the literature based on eligibility criteria, extracted data, and evaluated quality of evidence. The meta-analysis was performed using a hierarchical model to estimate pooled diagnostic accuracy parameters. Publication bias was assessed with Deeks' regression test.</p><p><strong>Results: </strong>Forty-one studies were included; the primary aim was evaluated by a meta-analysis which included 10 studies. Thirty-eight studies were included for evaluating secondary aims. The estimated pooled sensitivity and specificity for FDG PET/CT in differentiating pleural mesothelioma from benign pleural lesions were 0.94 (95%CI: 0.87-0.97) and 0.84 (95%CI: 0.73-0.91), respectively. There was substantial study heterogeneity, but no publication bias was detected.</p><p><strong>Conclusion: </strong>This study shows high sensitivity and specificity of FDG PET/CT for diagnosing pleural mesothelioma. The results are compatible with previous findings and give an updated evidence base to compare diagnostic performance of FDG PET/CT to other imaging modalities e.g. contrast-enhanced CT or PET with novel tracers.</p>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219569","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}