The Journal of Nuclear Medicine最新文献

{"title":"Diagnostic Potential of 68Ga-NeoB PET/CT with Estrogen Receptor– and Progesterone Receptor–Positive Breast Cancer Undergoing Staging or Restaging for Metastatic Disease","authors":"Zahra Sabahi, Andrew Nguyen, Keith Wong, Sherrington Li, Nathan Papa, Elgene Lim, Rachel F. Dear, Alexander M. Menzies, Frances Boyle, Yoland Antill, Belinda E. Kiely, Benjamin C. Forster, Cindy Mak, Diana Adams, Lina Pugliano, Andrew Spillane, Shikha Sharma, Adam Hickey, Aron Poole, Shikha Agrawal, Sobia Khan, Narjess Ayati, Louise Emmett","doi":"10.2967/jnumed.124.268896","DOIUrl":"https://doi.org/10.2967/jnumed.124.268896","url":null,"abstract":"<p>¹⁸F-FDG PET/CT has low sensitivity for estrogen receptor and progesterone receptor (ER/PR)–positive breast cancer. By contrast, gastrin-releasing peptide receptor is overexpressed in ER/PR-positive breast cancer. This study assessed the diagnostic potential of ⁶⁸Ga-NeoB PET/CT in staging or restaging metastatic ER/PR-positive and human epidermal growth factor receptor 2 (HER2)–negative breast cancer. <strong>Methods:</strong> Patients with ER/PR-positive and HER2-negative breast cancer with clinical suspicion for metastatic disease undergoing staging or restaging were prospectively enrolled. All patients underwent ⁶⁸Ga-NeoB PET/CT, in addition to standard ¹⁸F-FDG PET/CT. ER/PR-positive and HER2-negative status was confirmed in prior biopsy samples (primary or metastatic). Conventional imaging (¹⁸F-FDG PET/CT, bone scan, and diagnostic CT) was required within 3 wk of ⁶⁸Ga-NeoB PET/CT. ¹⁸F-FDG PET/CT and ⁶⁸Ga-NeoB PET/CT were assessed visually and quantitatively. Visually, all scans were read masked by 2 readers, with a third reader if results were discordant. <strong>Results:</strong> Twenty patients were enrolled, all with ER/PR-positive and HER2-negative histopathology. Of these, 75% (15/20) had lobular-subtype cancer, 40% (8/20) had suspected metastatic disease at diagnosis, and 60% (12/20) underwent restaging after systemic therapy. Overall, 75% (15/20) of the ⁶⁸Ga-NeoB PET/CT scans and 65% (13/20) of the ¹⁸F-FDG PET/CT scans were positive on visual assessment. For 50% (10/20) of patients, both scans were positive, and for 10% (2/20) of patients, both scans were negative. In the staging group, 75% (6/8) of patients had positive ⁶⁸Ga-NeoB PET/CT and 50% (4/8) of patients had positive ¹⁸F-FDG PET/CT. At restaging, 75% (9/12) of patients had positive ⁶⁸Ga-NeoB PET/CT and 75% (9/12) of patients had positive ¹⁸F-FDG PET/CT. Sites of positive ⁶⁸Ga-NeoB PET/CT and negative ¹⁸F-FDG PET/CT disease were identified in 50% (4/8) of staging patients and 42% (5/12) of restaging patients, whereas negative ⁶⁸Ga-NeoB PET/CT and positive ¹⁸F-FDG PET/CT disease was found in none of the staging patients but 58% (7/12) of the restaging cohort. Of these, 71% (5/7) of patients had a reduction in their ER status in the most recent biopsy samples. Quantitatively, the median SUV_max was higher for ⁶⁸Ga-NeoB PET/CT (20.5; interquartile range, 5.8–31.3) than for ¹⁸F-FDG PET/CT (7.4; interquartile range, 4.9–9.8). <strong>Conclusion:</strong> ⁶⁸Ga-NeoB PET/CT has diagnostic potential in the staging of ER/PR-positive and HER2-negative breast cancer. Further evaluation is warranted.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"215 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Medium-Term Outcomes of Patients with Biopsy-Proven Intermediate- to High-Risk Prostate Adenocarcinoma with Low Intraprostatic Uptake on [68Ga]Ga-PSMA-11 PET/CT in the proPSMA Study","authors":"David C. Chen, James P. Buteau, Louise Emmett, Ramin Alipour, Felipe de Galiza Barbosa, Matthew J. Roberts, Aoife McVey, Jonathan O’Brien, Sidney Levy, Roslyn J. Francis, Nathan Lawrentschuk, Declan G. Murphy, Michael S. Hofman","doi":"10.2967/jnumed.124.268901","DOIUrl":"https://doi.org/10.2967/jnumed.124.268901","url":null,"abstract":"<p>The current prevalence of low intraprostatic uptake for staging prostate-specific membrane antigen (PSMA) PET ranges between 4.4% and 17% in retrospective studies. We aimed to define the prevalence and describe the outcomes of patients with low intraprostatic uptake on PSMA PET/CT in the prospective proPSMA study. <strong>Methods:</strong> We identified patients with an SUV_max of 4 or less on PSMA PET/CT in the proPSMA study. Patients were followed up until 42 mo after randomization. The PRIMARY score was evaluated by 3 nuclear medicine physicians, with the result determined by consensus. Treatment failure was defined as new metastatic disease, biochemical recurrence, or initiation of salvage therapy. <strong>Results:</strong> Ten of 302 (3.3%; 95% CI, 1.6%–6.0%) patients had low intraprostatic uptake on PSMA PET/CT and normal findings on conventional imaging (CT and whole-body bone scanning). The median age was 66 y (interquartile range, 60.5–70.3 y). International Society of Urological Pathologists biopsy grade group was 3 in 5 patients and 5 in 5 patients, with no atypical histology identified. The median prostate-specific antigen level was 5.1 ng/nL (interquartile range, 2.3–8.3 ng/nL). The median follow-up interval was 30 mo (interquartile range, 24–39 mo). Multiparametric MRI was performed on 5 patients, with Prostate Imaging–Reporting and Data System score 5 in 2 patients, 4 in 1 patient, and 2 in 2 patients. The PRIMARY score was positive in 5 of 10 (50%) patients. Five (50%), 4 (30%), and 2 (20%) of 10 patients received radical prostatectomy, definitive radiotherapy, and androgen deprivation therapy alone, respectively. Of the 9 (90%) patients who received definitive treatment, 1 (11%) experienced treatment failure at 18 mo after radical prostatectomy and received metastasis-directed therapy. Biochemical recurrence was nonevaluable in the single patient who received androgen deprivation therapy alone. At the 42-mo follow-up after randomization, 4 of 9 (44%) patients who received definitive therapy remained on trial—none of whom had evidence of treatment failure. No other patients had new metastatic disease or initiation of salvage therapy during follow-up. <strong>Conclusion:</strong> In the proPSMA trial, there was a low prevalence (3.3%) of low intraprostatic uptake on PSMA PET/CT in patients with biopsy-confirmed prostate cancer, and treatment failure was infrequent.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PET- and CT-Based Imaging Criteria for Response Assessment of Gastroenteropancreatic Neuroendocrine Tumors Under Radiopharmaceutical Therapy","authors":"Felix L. Herr, Christian Dascalescu, Matthias P. Fabritius, Gabriel T. Sheikh, Mathias J. Zacherl, Vera Wenter, Lena M. Unterrainer, Matthias Brendel, Adrien Holzgreve, Christoph J. Auernhammer, Christine Spitzweg, Tanja Burkard, Jens Ricke, Maurice M. Heimer, Clemens C. Cyran","doi":"10.2967/jnumed.124.268621","DOIUrl":"https://doi.org/10.2967/jnumed.124.268621","url":null,"abstract":"<p>Despite well-documented limitations, current guidelines recommend the use of size-based RECIST 1.1 for response assessment of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) under radiopharmaceutical therapy (RPT). We hypothesize that functional criteria are superior to RECIST 1.1 for response assessment and progression-free survival (PFS) prediction, and molecular scores can be used in prognosticating PFS. <strong>Methods:</strong> This single-center, retrospective study included 178 patients with GEP-NETs (G1 and G2) who were treated with at least 2 consecutive cycles of RPT with [¹⁷⁷Lu]Lu-DOTATATE and who underwent somatostatin receptor PET/CT at baseline and after 2 cycles of RPT (follow-up). PFS was defined as the time between baseline and clinical progression, as reported by a GEP-NET multidisciplinary tumor board (MDT) assessment or reported death. The differences in categorization and PFS between RECIST 1.1, Choi (functional criteria), and the MDT were evaluated, and 3-y PFS with MDT defined PFS as the reference. The predictive values of the different scores in somatostatin receptor standardized reporting and data system and Krenning (molecular scores) for PFS were analyzed. <strong>Results:</strong> Choi criteria classified a higher number of patients as having progressive disease and partial response and a lower number of patients as having stable disease compared with RECIST 1.1 (<em>P</em> &lt; 0.01). The PFS of patients with progressive disease according to RECIST 1.1 and Choi criteria was shorter than that of patients with stable disease and partial response (<em>P</em> &lt; 0.05). Choi criteria showed a nonsignificantly higher concordance with the MDT than with RECIST 1.1. There was a shift in category from a Krenning score of 4 to a score of 3 between baseline and follow-up (<em>P</em> &lt; 0.01). At baseline, a Krenning score of 3 was associated with a shorter median PFS compared with a score of 4 (<em>P</em> &lt; 0.05). <strong>Conclusion:</strong> In addition to RECIST 1.1, further PET- and CT-based imaging criteria have the potential to assess response and predict PFS in patients with GEP-NETs undergoing RPT. Our data support the assumption to use Choi criteria for prediction of PFS and agreement in response assessment. At baseline, the Krenning score can be used to predict therapy response after 2 cycles of RPT.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduced Renal Uptake of Various Radiopharmaceuticals with Sodium Paraaminohippurate Coadministration in a Rat Model","authors":"Marian Meckel, Stefanie Ehrenberg, Theresa Schmidt, Philipp Ritt, Margret I. Moré, Ralf Bergmann, Domokos Mathe, Konstantin Zhernosekov","doi":"10.2967/jnumed.124.268411","DOIUrl":"https://doi.org/10.2967/jnumed.124.268411","url":null,"abstract":"<p>The coinfusion of amino acids with targeted radiopharmaceutical therapy aims to reduce renal toxicity. Unfortunately, this requires a prolonged, large-volume infusion and often results in side effects such as nausea, vomiting, and hyperkalemia. Sodium paraaminohippurate is a nontoxic compound that has historically been used to measure renal plasma flow. It is excreted by the kidneys via glomerular filtration and tubular secretion using organic anion transporters. Paraaminohippurate has a favorable safety profile at plasma concentrations that saturate the maximum transport capacity of tubular cells. Therefore, paraaminohippurate may potentially reduce the renal accumulation of small-molecule radiopharmaceuticals. <strong>Methods:</strong> Preclinical studies, including ex vivo biodistribution, SPECT/CT, and PET analyses, were performed in Wistar rats to evaluate how coinjection of a paraaminohippurate solution affects the renal uptake of various radiopharmaceuticals compared with coinjection of a NaCl or arginine–lysine solution. <strong>Results:</strong> Paraaminohippurate was well tolerated, with no toxicity observed. Accumulated activity measured in the renal cortex was significantly lower for the small-peptide radiopharmaceuticals (0.9–2.5 kDa)—[¹⁷⁷Lu]Lu-DOTATOC, [¹⁷⁷Lu]Lu-DOTATATE, [¹⁷⁷Lu]Lu-DOTA-JR11, [¹⁷⁷Lu]Lu-DOTA-sargastrin, and [¹⁷⁷Lu]Lu-DOTARGD—when paraaminohippurate was coinjected instead of NaCl. The renal uptake of [¹⁷⁷Lu]Lu-DOTATOC, [¹⁷⁷Lu]Lu-DOTATATE, and [¹⁷⁷Lu]Lu-DOTA-JR11 was reduced by 46%, 83%, and 63%, respectively, at 1 h after injection with paraaminohippurate coinjection from the uptake after injection with NaCl. Kidney area-under-the-curve values were reduced by up to 60%, depending on the compound used. To a lesser extent, paraaminohippurate-mediated nephroprotection was observed with the prostate-specific membrane antigen (PSMA)–targeting molecules [¹⁷⁷Lu]Lu-PSMA-I&amp;T and [⁶⁸Ga]Ga-PSMA-11. The renal uptake of the larger recombinant protein [¹⁷⁷Lu]Lu-DOTA-Affiline-22 (18 kDa) and the folate derivative [^99mTc]Tc-etarfolatide was not affected. These in vivo imaging data were confirmed by ex vivo biodistribution studies. <strong>Conclusion:</strong> Coinjection of paraaminohippurate at a high concentration was found to significantly reduce the renal uptake of a select number of small-molecule radiopharmaceuticals. This indicates the importance of tubular secretion, as well as the potential role of anion transporters that may be saturated by a high paraaminohippurate plasma concentration. Therefore, paraaminohippurate comedication could serve as a fast, safe, and convenient alternative to amino acid infusion as a nephroprotective agent during targeted radiopharmaceutical therapy.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus Nomenclature for Radionuclide Therapy: Initial Recommendations from Nuclear Medicine Global Initiative","authors":"Akram Al-Ibraheem, Andrew M. Scott, Ahmed Saad Abdlkadir, Alexis Vrachimis, Francois Lamoureux, Patricia Bernal Trujillo, Dale L. Bailey, Stuart More, Francesco Giammarile, Rakesh Kumar, Julie Nonnekens, Cathy S. Cutler, Jean-Luc C. Urbain, Elizabeth H. Dibble, Mike Machaba Sathekge, Jamshed Bomanji, Juliano J. Cerci, Elizabeth Thomas, William Small, Lizette Louw, Joo Hyun O, Sze Ting Lee, Helen Nadel, Heather Jacene, Tadashi Watabe, Henry Hee-Seung Bom, Salah Eddine Bouyoucef, Charlotte Weston, Jonathan Wadsley, Andy G. Irwin, Jilly Croasdale, Pat Zanzonico, Diana Paez, Munir Ghesani","doi":"10.2967/jnumed.124.269215","DOIUrl":"https://doi.org/10.2967/jnumed.124.269215","url":null,"abstract":"<p>Since its inception in 2012, the Nuclear Medicine Global Initiative (NMGI) of the Society of Nuclear Medicine and Molecular Imaging has played an important role in addressing significant challenges in the field of nuclear medicine and molecular imaging. The first 3 projects were dedicated to standardizing pediatric nuclear medicine practices, addressing the global challenges of radionuclide access and availability, and assessing the educational and training initiatives on theranostics across the globe. These efforts aimed to advance human health, foster worldwide educational collaboration, and standardize procedural guidelines to enhance quality and safety in nuclear medicine practice. In its latest project, NMGI aimed to develop a unified nomenclature for systemic radionuclide therapy in nuclear medicine, addressing the diverse terminology currently used. An online survey was distributed to NMGI member organizations, drawing participation from various geographical locations and disciplines. The survey anonymously collected responses from physicians, physicists, scientists, radiopharmacists, radiopharmaceutical scientists, dosimetrists, technologists, and nurse managers, totaling 240 responses from 30 countries. Findings revealed a prevailing use of the term targeted radionuclide therapy for radionuclide therapy, with 52% of respondents expressing a preference for this term. In contrast, approximately 37% favored “radiopharmaceutical therapy,” whereas 11% favored “molecular radionuclide therapy.” Other key terms under the umbrella of targeted radionuclide therapy were also discussed to achieve a consensus on terminology. NMGI efforts to standardize terminology in this dynamic and fluid field should improve communication within the field, better reflect the technology used, enable comparison of results, and ultimately lead to improved patient outcomes.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"90 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of [177Lu]Lu-DOTATATE Dosimetry from High-Speed Whole-Body Recordings Provided by a 360° Cadmium–Zinc–Telluride Camera Compared with Results from a Conventional Anger-Camera Protocol","authors":"Timothée Zaragori, Elodie Chevalier, Quentin Citerne, Véronique Roch, Gabriela Hossu, Pierre-Yves Marie, Caroline Boursier, Laetitia Imbert","doi":"10.2967/jnumed.124.268910","DOIUrl":"https://doi.org/10.2967/jnumed.124.268910","url":null,"abstract":"<p>Absorbed doses (ADs) may be calculated through serial conventional SPECT imaging after therapeutic [¹⁷⁷Lu]Lu-DOTATATE injection but with recording times too long for clinical routine. The aim of this study was to determine whether activity concentrations and ADs calculated from a high-speed whole-body 360° cadmium–zinc–telluride (CZT) SPECT camera are comparable to those provided by conventional SPECT. <strong>Methods:</strong> Fifteen patients referred for [¹⁷⁷Lu]Lu-DOTATATE treatment were enrolled and underwent, at 24, 96, and 168 h after [¹⁷⁷Lu]Lu-DOTATATE injection, 32 min of thoracoabdominopelvic conventional SPECT recording and 18 min of whole-body CZT SPECT recording. The order of device procedure (conventional or CZT SPECT) was randomly selected to avoid bias. The kidneys, bone marrow, liver, and spleen were automatically segmented by an artificial intelligence–based tool on CT images, whereas the largest tumor was segmented manually on CT or MR images. Time-integrated activity curves were computed using activity concentrations from the kidneys, bone marrow, liver, spleen, and tumor and convolved by the voxel S-value kernel to calculate AD values. The partial-volume effect was corrected by fitting the recovery coefficients of 1- to 113-mL spheres. Activity concentrations (in Bq/mL) and ADs (in Gy/GBq) were expressed as median (minimum to maximum) and compared between the 2 cameras with Wilcoxon tests. <strong>Results:</strong> Activity concentrations and ADs were not significantly different between conventional and CZT SPECT, respectively, for the kidneys (337.3 [203.3–622.4] vs. 342.7 [218.2–547.8] kBq/mL at 24 h and 0.45 [0.26–0.79] vs. 0.47 [0.25–0.79] Gy/GBq), spleen (340.3 [171.8–703.1] vs. 277.7 [215.6–640.8] kBq/mL at 24 h and 0.48 [0.31–1.41] vs. 0.50 [0.35–1.15] Gy/GBq), bone marrow (32.7 [13.9–662.9] vs. 41.1 [12.4–509.6] kBq/mL at 24 h and 0.09 [0.04–1.96] vs. 0.13 [0.06–0.87] Gy/GBq), and largest tumor (826.8 [376.4–4,459.0] vs. 1,116.7 [447.0–6,043.3] kBq/mL at 24 h and 1.8 [0.9–5.7] vs. 2.0 [1.0–7.3] Gy/GBq). However, significant, albeit small, differences were observed for the liver (126.2 [42.7–335.9] vs. 113.5 [35.1–293.4] kBq/mL at 24 h and 0.23 [0.07–0.72] vs. 0.21 [0.05–0.64] Gy/GBq, both <em>P</em> &lt; 0.01). <strong>Conclusion:</strong> Activity concentrations and absorbed doses calculated from the 360° CZT SPECT/CT system after [¹⁷⁷Lu]Lu-DOTATATE injection are globally comparable to those obtained from a conventional SPECT/CT system. However, CZT SPECT/CT is more appropriate for clinical routine, with shorter recording times and actual whole-body coverage.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Additive Value of [68Ga]Ga-RM26 PET/CT to [68Ga]Ga-PSMA-617 PET/CT in Detecting Pelvic Lymph Node Metastasis in Prostate Cancer: A Prospective, Single-Center, Phase II Study","authors":"Wei Tang, Lin Qi, Minfeng Chen, Ye Zhang, Yongxiang Tang, Shuo Hu, Xiaomei Gao, Yi Cai","doi":"10.2967/jnumed.124.269189","DOIUrl":"https://doi.org/10.2967/jnumed.124.269189","url":null,"abstract":"<p>Lymph node staging in prostate cancer is crucial for treatment and prognosis, yet [⁶⁸Ga]Ga-PSMA-617 PET/CT has limited sensitivity in detecting pelvic lymph node metastasis (PLNM). [⁶⁸Ga]Ga-RM26 PET/CT, targeting the gastrin-releasing peptide receptor, complements [⁶⁸Ga]Ga-PSMA-617 PET/CT in assessing primary tumor extension and aggressiveness. However, its role in detecting PLNM and complementing [⁶⁸Ga]Ga-PSMA-617 PET/CT remains underexplored. <strong>Methods:</strong> This prospective study enrolled newly diagnosed yet untreated prostate cancer patients who underwent [⁶⁸Ga]Ga-RM26 PET/CT and [⁶⁸Ga]Ga-PSMA-617 PET/CT, followed by radical prostatectomy and extended pelvic lymph node dissection. The primary objective was to evaluate the diagnostic performance of both PET/CT modalities in detecting PLNM. <strong>Results:</strong> In total, 68 patients were enrolled, with a 30.9% (21/68) pathologic PLNM rate. In patient-based analysis, [⁶⁸Ga]Ga-RM26 PET/CT had sensitivity and specificity of 0.43 and 0.94, respectively, compared with 0.52 and 0.89 for [⁶⁸Ga]Ga-PSMA-617 PET/CT. [⁶⁸Ga]Ga-RM26 PET/CT detected additional PLNMs in 50% (5/10) of patients that were missed by [⁶⁸Ga]Ga-PSMA-617 PET/CT. The combined use of [⁶⁸Ga]Ga-RM26 PET/CT and [⁶⁸Ga]Ga-PSMA-617 PET/CT resulted in sensitivity of 0.76 and specificity of 0.85. In total, 1,049 lymph nodes were dissected, including 991 normal and 58 positive nodes. In lesion-based analysis, [⁶⁸Ga]Ga-RM26 PET/CT had sensitivity and specificity of 0.38 and 0.99, respectively, compared with 0.5 and 0.99 for [⁶⁸Ga]Ga-PSMA-617 PET/CT. [⁶⁸Ga]Ga-RM26 PET/CT identified 41.4% (12/29) of pathologic positive nodes missed by [⁶⁸Ga]Ga-PSMA-617 PET/CT. The combined [⁶⁸Ga]Ga-RM26 and [⁶⁸Ga]Ga-PSMA-617 PET/CT demonstrated sensitivity of 0.71 and specificity of 0.99. <strong>Conclusion:</strong> In dual-target imaging, [⁶⁸Ga]Ga-RM26 PET/CT identified additional PLNMs. The combination of [⁶⁸Ga]Ga-RM26 PET/CT and [⁶⁸Ga]Ga-PSMA-617 PET/CT achieved higher diagnostic sensitivity with minimal loss of specificity.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143666002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of Effective Half-Life for Instant Single-Time-Point Dosimetry Using Machine Learning","authors":"Carlos Vinícius Gomes, Yizhou Chen, Isabel Rauscher, Song Xue, Andrei Gafita, Jiaxi Hu, Robert Seifert, Lorenzo Mercolli, Julia Brosch-Lenz, Jimin Hong, Marc Ryhiner, Sibylle Ziegler, Ali Afshar-Oromieh, Axel Rominger, Matthias Eiber, Thiago Viana Miranda Lima, Kuangyu Shi","doi":"10.2967/jnumed.124.268175","DOIUrl":"https://doi.org/10.2967/jnumed.124.268175","url":null,"abstract":"<p>Single-time-point (STP) image-based dosimetry offers a more convenient approach for clinical practice in radiopharmaceutical therapy (RPT) compared with conventional multiple-time-point image-based dosimetry. Despite numerous advancements, current STP methods are limited by the need for strict and late timing in data acquisition, posing challenges in routine clinical settings. This study introduces a new concept of instant STP (iSTP) dosimetry, achieved by predicting the effective half-life (<I>T</I><SUB>eff</SUB>) of organs using machine learning applied on pretherapy patient data (PET and clinical values). <b>Methods:</b> Data from 22 patients who underwent pretherapy ⁶⁸Ga-gallium <I>N</I>,<I>N</I>-bis[2-hydroxy-5-(carboxyethyl)benzyl]ethylenediamine-<I>N</I>,<I>N</I>-diacetic acid ([⁶⁸Ga]Ga-PSMA-11) imaging and subsequently [¹⁷⁷Lu]Lu-PSMA I&amp;T RPT were analyzed. A machine learning model was developed for <I>T</I><SUB>eff</SUB> predictions for the left and right kidneys, liver, and spleen subsequently used to estimate time-integrated activity and absorbed dose. iSTP results were compared against multiple-time-point and previously proposed H&auml;nscheid methods. Our method comprised 2 different prediction scenarios, using data before each therapy cycle and from the first cycle. <b>Results:</b> The iSTP method introduced early posttherapy time points (2, 20, 43, and 69 h) for the left kidney, right kidney, liver, and spleen. Dosimetry in the first scenario, aggregating 2 and 20 h, achieved mean differences in time-integrated activity below 27% for all organs. To assess the feasibility, these time points were compared with the best results from the H&auml;nscheid method (kidneys, 69 h; liver and spleen, 20 h). At 2 h, a significant difference (<I>P</I> &lt; 0.001) was found for almost all organs except for the spleen (<I>P</I> = 0.1370). However, at 20 h, no significant differences were found for the right kidney, liver, and spleen, apart from the left kidney (<I>P</I> &lt; 0.01). In the scenario using only the initial PET/CT data to predict <I>T</I><SUB>eff</SUB> for subsequent cycles, iSTP dosimetry achieved no statistical significance (<I>P</I> &gt; 0.05) for all cycles in comparison to results using PET data before each therapy cycle. <b>Conclusion:</b> Our preliminary results prove the concept for prediction of <I>T</I><SUB>eff</SUB> with pretherapy data and achieving STP shortly and flexibly after the RPT. The proposed method may expedite the application of dosimetry in broader contexts, such as outpatient or short-duration inpatient treatment.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143666003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dansylated Amino Acid–Modified Long-Acting PSMA Derivatives 68Ga/177Lu-LNC1011 as Prostate Cancer Theranostics","authors":"Hongzhang Yang, Jiarou Wang, Xuejun Wen, Huifeng Guo, Vivianne Jakobsson, Tianzhi Zhao, Fantian Zeng, Huaxiang Shen, Heng Zhang, Xiaomin Liu, Yatong Qin, Xinyi Li, Hehe Xiong, Zijian Zhou, Jingjing Zhang, Xiaoyuan Chen","doi":"10.2967/jnumed.124.268959","DOIUrl":"https://doi.org/10.2967/jnumed.124.268959","url":null,"abstract":"&lt;p&gt;Prostate-specific membrane antigen (PSMA)–targeted radiopharmaceutical therapy has demonstrated promising potential for treating metastatic castration-resistant prostate cancer. Recently, albumin-binding motif-modified PSMA radioligands with prolonged blood circulation were developed to improve tumor uptake and therapeutic effectiveness, properties which, however, were associated with an increased risk of bone marrow toxicity. This study presents new PSMA-targeted radioligands incorporating dansylated amino acids as relatively weak and preferable albumin binders to achieve a fine balance between increased tumor accumulation, safety, and diagnostic efficacy, facilitating a unified approach to theranostics within a single molecular framework. &lt;strong&gt;Methods:&lt;/strong&gt; Three novel PSMA ligands ([&lt;sup&gt;68&lt;/sup&gt;Ga]Ga-Dan-Gly-PSMA, [&lt;sup&gt;68&lt;/sup&gt;Ga]Ga-Dan-Nva-PSMA, and [&lt;sup&gt;68&lt;/sup&gt;Ga]Ga-Dan-Phe-PSMA, denoted as [&lt;sup&gt;68&lt;/sup&gt;Ga]Ga-LNC1011) were synthesized with dansylated amino acids and measured the albumin-binding properties with human serum albumin through ultrafiltration experiments. Binding affinity and PSMA-targeting specificity were investigated using a saturation binding assay and cell uptake in the PSMA-induced prostate cancer 3 cell line (PC3-PIP). PET imaging in PC3-PIP tumor–bearing mice was performed to evaluate the preclinical pharmacokinetics and diagnostic efficiency of &lt;sup&gt;68&lt;/sup&gt;Ga-labeled PSMA ligands. Tumor uptake of [&lt;sup&gt;177&lt;/sup&gt;Lu]Lu-LNC1011 was evaluated through SPECT/CT imaging and biodistribution studies. Radiopharmaceutical therapy studies were conducted to systematically assess the therapeutic effect of the radioligand. &lt;strong&gt;Results:&lt;/strong&gt; Three novel PSMA radioligands ([&lt;sup&gt;68&lt;/sup&gt;Ga]Ga-Dan-Gly-PSMA, [&lt;sup&gt;68&lt;/sup&gt;Ga]Ga-Dan-Nva-PSMA, and [&lt;sup&gt;68&lt;/sup&gt;Ga]Ga-LNC1011) with various dansylated amino acids were successfully synthesized with a radiochemical yield greater than 97%. In the PC3-PIP xenograft tumor model, the tumor/heart, tumor/liver, tumor/kidney, and tumor/muscle ratios were 9.82 ± 2.35, 12.42 ± 3.71, 4.36 ± 0.29, and 52.88 ± 12.08 at 4 h after injection, respectively. Biodistribution studies confirmed the significantly higher tumor uptake of [&lt;sup&gt;177&lt;/sup&gt;Lu]Lu-LNC1011 (127.36 ± 16.95 %ID/g) over [&lt;sup&gt;177&lt;/sup&gt;Lu]Lu-PSMA-617 (17.44 ± 6.29 %ID/g) at 4 h after injection, and no decrease was measured for the [&lt;sup&gt;177&lt;/sup&gt;Lu]Lu-LNC1011 at up to 72 h after injection, which was corroborated with SPECT imaging. A single injection of 9.3 MBq of [&lt;sup&gt;177&lt;/sup&gt;Lu]Lu-LNC1011 achieved 89.43% inhibition of tumor growth, equivalent to 18.5 MBq of [&lt;sup&gt;177&lt;/sup&gt;Lu]Lu-PSMA-617 (90.87%). [&lt;sup&gt;68&lt;/sup&gt;Ga]Ga-LNC1011 PET/CT scans of patients with metastatic castration-resistant prostate cancer identified as many lesions as [&lt;sup&gt;68&lt;/sup&gt;Ga]Ga-PSMA-11 did, confirming its diagnostic efficacy. &lt;strong&gt;Conclusion:&lt;/strong&gt; &lt;sup&gt;68&lt;/sup&gt;Ga/&lt;sup&gt;177&lt;/sup&gt;Lu-LNC1011, characterized by high tumor uptake and retention alo","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bioanalytic Hybrid System Merging 3-Dimensional Cell Culture and Chromatographic Precision for Unprecedented Preclinical Insights in Molecular Imaging","authors":"Verena Pichler, Verena Schwingenschlögl-Maisetschläger, Irem Duman, Xavier Monforte, Stefanie Ponti, Lukas Zimmermann, Elma Joldic, Monika Dumanic, Chrysoula Vraka, Marcus Hacker, Christian Kraule, Andreas Herbert Teuschl-Woller","doi":"10.2967/jnumed.124.269133","DOIUrl":"https://doi.org/10.2967/jnumed.124.269133","url":null,"abstract":"<sec><st>Visual Abstract</st><p><fig loc=\"float\"><link locator=\"jnumed.124.269133absf1\"></fig></p></sec>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}