The Journal of Nuclear Medicine最新文献

{"title":"Evaluation of Mitochondrial Complex 1 Density with [18F]BCPP-EF in a Murine Model and Individuals with Friedreich Ataxia","authors":"Laigao Chen, Gaia Rizzo, Christine Bulawa, Koene R.A. Van Dijk, Erica C. Henning, Alain Martelli, Jeffrey Palmer, Avery McIntosh, Marko Pregel, Pengling Sun, Emmanuel Adewunmi, Mark Aldridge, Jackson Chan, Roger N. Gunn, Mickael Huiban, Allan Listanco, Peter T. Loudon, Sara Moz, Jan Passchier, Lauren Sauvage, Rachel Stewart, Lisa Wells, Eugenii A. Rabiner, Lawrence R. Charnas, Richard J. Festenstein","doi":"10.2967/jnumed.124.268698","DOIUrl":"https://doi.org/10.2967/jnumed.124.268698","url":null,"abstract":"<sec><st>Visual Abstract</st><p><fig loc=\"float\"><link locator=\"jnumed.124.268698absf1\"></fig></p></sec>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756377","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":"Assessing Interlesional Tumor Response and Patient Outcomes with Sequential PSMA PET/CT in Metastatic Castration-Resistant Prostate Cancer","authors":"Chloé S. Denis, François Cousin, Bram De Laere, Jan Vanwelkenhuyzen, Roland Hustinx, Brieuc R. Sautois, Nadia Withofs","doi":"10.2967/jnumed.125.269729","DOIUrl":"https://doi.org/10.2967/jnumed.125.269729","url":null,"abstract":"<p>The impact of heterogeneous interlesional tumor response on outcomes in patients with metastatic castration-resistant prostate cancer (mCRPC) remains unclear. We aimed to evaluate the role of prostate-specific membrane antigen (PSMA) PET/CT in assessing patient outcomes on the basis of global tumor response and interlesional tumor response. <strong>Methods:</strong> We retrospectively analyzed data for 24 patients with mCRPC treated with androgen receptor pathway inhibitors who underwent [⁶⁸Ga]Ga-PSMA-11 PET/CT at baseline and at weeks 4 and 12 of therapy as well as conventional imaging at baseline and week 12 of therapy. Global PET/CT response was evaluated in accordance with the European Association of Urology/European Association of Nuclear Medicine criteria, classifying patients as having progressive disease (PD) or nonprogressive disease (non-PD) (i.e., complete response, partial response, or stable disease) and was correlated with overall survival (OS), prostate-specific antigen–progression-free survival (PSA-PFS) (i.e., time from diagnosis to PSA progression or death from any cause), radiologic progression-free survival, and time to no longer clinically benefiting from treatment. For interlesional assessment, a subset of PSMA-positive lesions was extracted from each patient and compared longitudinally. Patients classified as having either interlesional progression or interlesional homogeneous response were included in the OS and PSA-PFS analyses. <strong>Results:</strong> The median OS was 22 mo for patients with PD (<em>n</em> = 8) and 51 mo for those with non-PD (<em>n</em> = 16) (hazard ratio [HR], 28.2; <em>P</em> &lt; 0.0001). PSMA PET/CT–based response was significantly associated with median PSA-PFS (6.5 mo vs. not reached [NR]; HR, 20.5; <em>P</em> = 0.0001), radiologic progression-free survival (9 mo vs. NR; HR, 12.2; <em>P</em> = 0.002), and time to no longer clinically benefiting from treatment (12 mo vs. NR; HR, 18.6; <em>P</em> = 0.0002) for patients with PD versus non-PD, respectively. The results were similar at week 12 and remained statistically significant. Interlesional assessment was performed for 125 PSMA-positive lesions in 20 (83%) patients. At week 12, 9 (45%) of 20 patients had interlesional progression, which was significantly associated with worse outcomes compared with patients who had an interlesional homogeneous response (median PSA-PFS, 7 mo vs. NR; HR, 19.2; <em>P</em> &lt; 0.0001; median OS, 16 mo vs. 52 mo; HR, 31.2; <em>P</em> &lt; 0.0001, respectively). <strong>Conclusion:</strong> Assessment of interlesional tumor response at week 12 by sequential PSMA PET/CT enabled the identification of patients with mCRPC who had worse outcomes after treatment with an androgen receptor pathway inhibitor.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756572","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":"CD24 as a Novel Radiopharmaceutical Target for Hepatocellular Carcinoma","authors":"Hima Makala, Julia Sheehan-Klenk, Woonghee Lee, Joon-Yong Chung, Kwamena E. Baidoo, Divya Nambiar, Peter L. Choyke, Freddy E. Escorcia","doi":"10.2967/jnumed.125.270167","DOIUrl":"https://doi.org/10.2967/jnumed.125.270167","url":null,"abstract":"<p>Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide. After the use of liver-directed therapies, it is challenging to differentiate between nonviable tumor and viable residual or recurrent disease using conventional imaging techniques. Targeted radiopharmaceutical imaging agents with specificity for HCC-selective molecules may address this unmet need. CD24, a glycosylated plasma membrane protein, is overexpressed in HCC. Here, we describe a CD24-targeted antibody-based PET (immuno-PET) tracer for the noninvasive detection of CD24-positive (CD24+) tumors. <strong>Methods:</strong> CD24 expression was assessed at the messenger RNA, total protein, and cell membrane levels across 4 HCC cell lines (Huh7, Hep3B, SNU182, SNU449), 1 hepatoblastoma line (HepG2), and a CD24+ colorectal cancer–positive control line (HT29) using quantitative reverse transcription polymerase chain reaction, Western blot testing, and flow cytometry. Clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9–mediated <em>CD24</em> gene knockout was performed in SNU449, Hep3B, and HT29 cells to yield otherwise isogenic cell lines as CD24-negative (CD24−) controls. The binding affinity of a humanized monoclonal anti-CD24 antibody (α-hCD24) for recombinant CD24 protein was confirmed by biolayer interferometry and enzyme-linked immunosorbent assay. We then synthesized the immuno-PET tracer ([⁸⁹Zr]Zr-desferrioxamine [DFO]-α-hCD24) and assessed target engagement in vivo using PET/CT imaging and ex vivo by evaluating the biodistribution of xenograft models using paired CD24+ and CD24− HCC and HT29 isogenic cell lines in athymic nude mice. <strong>Results:</strong> Huh7, Hep3B, SNU449, and HT29 cell lines demonstrated high total and plasma membrane expression of CD24. The α-hCD24 antibody exhibited good binding affinity to recombinant human CD24 (dissociation constant, 2.4 nM) and was unaffected by DFO conjugation of α-hCD24 (dissociation constant, 2.7 nM). [⁸⁹Zr]Zr-DFO-α-hCD24 was efficiently produced at high radiochemical yield (75% ± 5%) and radiopurity (99% ± 1%). PET/CT imaging and biodistribution studies confirmed specific uptake of [⁸⁹Zr]Zr-DFO-α-hCD24 in Hep3B CD24+ tumors (8.7 ± 1.2 %IA/g) and much lower accumulation in Hep3B CD24− tumors (2.3 ± 0.6 %IA/g) at 144 h after injection. <strong>Conclusion:</strong> Our findings establish CD24 as a promising radiotheranostic target for HCC. Future work will optimize [⁸⁹Zr]Zr-DFO-α-hCD24 to improve tumor-to-liver signal and facilitate CD24-targeted radiopharmaceutical therapy.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756376","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":"Advancing In Vivo Detection of T-Cell Function: Development and Preclinical Evaluation of 89Zr-Ivuxolimab, a Human OX40 PET Tracer","authors":"Mausam Kalita, Renesmee C. Kuo, Samantha T. Reyes, Deana Rae Crystal Colburg, Irene N. Falk, David Anders, Ophir Vermesh, Samira Hayee, E. Carmen Azevedo, Sydney C. Nagy, Emily M. Deal, Anthony An-Fa Dahm Chen, Christina S. Kong, Federico Simonetta, Anand Giddabasappa, Edmund J. Keliher, Derek W. Bartlett, Kevin P. Maresca, Michelle L. James, Israt S. Alam","doi":"10.2967/jnumed.125.269799","DOIUrl":"https://doi.org/10.2967/jnumed.125.269799","url":null,"abstract":"<sec><st>Visual Abstract</st><p><fig loc=\"float\"><link locator=\"jnumed.125.269799absf1\"></fig></p></sec>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"214 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144701887","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":"Proceedings: PET Drugs—A 2023 Workshop on Product Quality, Regulatory Submissions, Facility Inspections, and Benefit–Risk Considerations","authors":"Sue Bunning, Danae Christodoulou, Jonathan E. Cohen, Cathy S. Cutler, David W. Dick, Krishnakali Ghosh, Christopher Ignace, Ravindra K. Kasliwal, Hsiaoju Lee, Libero Marzella, Tim Pohlhaus, Peter J.H. Scott, Sally W. Schwarz, Irum A. Syed, Henry F. VanBrocklin, Laura R. Wasil, Steven S. Zigler","doi":"10.2967/jnumed.125.270011","DOIUrl":"https://doi.org/10.2967/jnumed.125.270011","url":null,"abstract":"<p>Advances in PET radiopharmaceutical technologies necessitate continued dialogue between members of the PET drug manufacturing community and the U.S. Food and Drug Administration (FDA) to ensure that these drugs continue to be safe and effective and are sustainably supplied in accordance with regulatory commitments and current good manufacturing practice (cGMP) regulations. After the success of the 2020 PET drugs workshop, the FDA hosted a follow-up public workshop entitled “PET: Product Quality, Regulatory Submissions, Facility Inspections, and Benefit–Risk Considerations.” The 2023 workshop addressed knowledge gaps that emerged during the 2020 workshop and themes from responses to a survey of PET drug manufacturers. The goal of this workshop was to support continued communication between the FDA and PET stakeholders to drive clarity toward PET cGMP regulations described in the <em>Code of Federal Regulations</em> (title 21, part 212) and PET Drug cGMP guidance documents, with the objective to improve compliance with PET drug manufacturing guidelines. In addition, investigational PET drugs (<em>Code of Federal Regulations</em>, title 21, part 312) were discussed, as they are intimately connected with the approval process and eventual cGMP manufacturing regulations once they matriculate to clinical use. The workshop was held on November 13–14, 2023, on the FDA campus in Silver Spring, MD. The Society of Nuclear Medicine and Molecular Imaging, the Medical Imaging and Technology Alliance, and the Coalition of PET Drug Manufacturers cosponsored the workshop with the FDA. This article summarizes the discussions that were conveyed at this workshop.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"93 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144701905","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":"90Y-FAPI-46 Theranostics Leads to Near-Complete Metabolic Response in 3 Patients with Solitary Fibrous Tumors","authors":"Helena Lanzafame, Christoph E. Heilig, Eva Wardelmann, Mélanie Desaulniers, Kim Magaly Pabst, Ilektra Antonia Mavroeidi, Ina Pretzell, Pedro Fragoso Costa, Micheal Nader, Stephan Leyser, Martin Schuler, Sebastian Bauer, Jens Thomas Siveke, Leila Kamkar, Simon Kreutzfeldt, Stefan Fröhling, Sebastian Mühl, Ken Herrmann, Wolfgang Peter Fendler, Rainer Hamacher","doi":"10.2967/jnumed.125.269572","DOIUrl":"https://doi.org/10.2967/jnumed.125.269572","url":null,"abstract":"<p>Solitary fibrous tumor (SFT) is a rare soft-tissue sarcoma with limited treatment options, especially in advanced or metastatic cases. Fibroblast activation protein α (FAPα) is overexpressed in certain sarcomas, including SFTs, making it a promising target for diagnostics and radiopharmaceutical therapy (RPT). We present the cases of 3 patients with metastatic SFTs who, after exhausting standard treatments, underwent molecular profiling and showed elevated FAPα expression. <strong>Methods:</strong> Messenger RNA and protein expression of FAPα were examined in biopsy samples from 3 patients participating in the Molecularly Aided Stratification for Tumor Eradication Research program, a multicenter observational study focused on biology-driven stratification of adults with advanced cancer. Messenger RNA expression levels were quantified as transcripts per million, with RNA extraction, sequencing, and data processing performed using established protocols. Protein expression was assessed and stained with FAPα immunohistochemistry using a recombinant anti-FAPα antibody. Following the recommendation of the molecular tumor board, these patients received ⁹⁰Y-labeled fibroblast activation protein inhibitor (FAPI)-46 RPT because of the high uptake observed in ⁶⁸Ga-FAPI-46 PET/CT scans. <strong>Results:</strong> ⁹⁰Y-FAPI-46 RPT led to substantial clinical benefits, including metabolic resolution and symptom relief, with disease control confirmed using RECIST and PERCIST. Treatment was well-tolerated, with only minor adverse events observed. <strong>Conclusion:</strong> Our findings underscore the utility of FAPα screening as a predictive biomarker and the potential of FAP-targeted RPT as a viable treatment for advanced SFT.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144701904","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 Left Ventricular Assist Device–Specific Infection by Whole-Body Parametric PET Imaging","authors":"Thorsten Derlin, Jasmin S. Hanke, Rudolf A. Werner, Sibylle I. Ziegler, Günes Dogan, Bastian Schmack, Desiree Weiberg, Christoph Czerner, Tobias L. Ross, Jan D. Schmitto, Arjang Ruhparwar, Frank M. Bengel","doi":"10.2967/jnumed.125.270252","DOIUrl":"https://doi.org/10.2967/jnumed.125.270252","url":null,"abstract":"<p>Clinical molecular imaging with PET has an evolving role in the diagnosis and treatment of left ventricular assist device (LVAD)–specific infection. We analyzed the added value of parametric whole-body [¹⁸F]FDG PET images for the multifaceted assessment of local inflammatory response to infection and characterization of systemic organ networks and explored the prognostic significance of systems-based parameters. <strong>Methods:</strong> Twenty-three patients with suspected device-specific infection were prospectively enrolled and underwent multipass [¹⁸F]FDG PET/CT with direct Patlak reconstruction between January 2020 and March 2023. Three sets of images were generated: SUV-equivalent images, parametric images of the maximum metabolic rate of [¹⁸F]FDG (MR_FDG), and parametric images of the distribution volume of [¹⁸F]FDG. Images were analyzed for the presence and extent of infection, differential spatial distribution of signal in parametric images, and signal contrast. We then aimed to characterize the association between PET signal and inflammatory markers from peripheral blood, results of microbial cultures, and systemic organ networks identified in whole-body PET. <strong>Results:</strong> Visually increased uptake at the driveline exit site, subcutaneous driveline, outflow graft, and pump pocket was found in 74%, 30%, 26%, and 17% of patients, respectively, and findings were concordant between SUV images and MR_FDG images. Quantitative MR_FDG analysis provided accurate identification of driveline exit site infection. Improved contrast was found in MR_FDG images (<em>P</em> ≤ 0.0003). Analysis of parametric images revealed spatial heterogeneity caused by differential contribution of MR_FDG, blood volume, and distribution volume of [¹⁸F]FDG in infectious lesions. Blood-based inflammatory markers (e.g., monocyte count) (<em>P</em> = 0.0217) were associated with MR_FDG but not SUVs. Finally, there was an association between the internal LVAD components signal and hematopoietic organ signal in MR_FDG images (e.g., bone marrow signal; <em>P</em> = 0.0353), highlighting systemic interactions. <strong>Conclusion:</strong> [¹⁸F]FDG PET/CT allows for the diagnosis and characterization of the extent of LVAD-specific infections. Parametric MR_FDGimages provide improved contrast, refined biologic understanding of the relative contribution of signal components to the measured PET signal in infection, correlation with circulating immune biomarkers in peripheral blood, and characterization of systemic interactions.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652151","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":"[18F]SynVesT-1 PET Detects SV2A Changes in the Spinal Cord and Brain of Rats with Spinal Cord Injury","authors":"Baosheng Chen, Chao Zheng, Tutukhanim Balayeva, Takuya Toyonaga, Xingxing Wang, Jie Tong, William Mennie, Jelena Mihailovic, Daniel Coman, Fahmeed Hyder, Stephen M. Strittmatter, Richard E. Carson, Yiyun Huang, Zhengxin Cai","doi":"10.2967/jnumed.124.269291","DOIUrl":"https://doi.org/10.2967/jnumed.124.269291","url":null,"abstract":"<sec><st>Visual Abstract</st><p><fig loc=\"float\"><link locator=\"jnumed.124.269291absf1\"></fig></p></sec>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"153 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652219","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":"Interspecies Variability in Biodistribution and PET Imaging Performance of [18F]Di-PyL: A Dimeric, PSMA-Targeted PET Agent for Prostate Cancer","authors":"Yimin Chen, Xiaojun Zhang, Xinlin Wang, Yachao Liu, Jinming Zhang, Mengchao Cui","doi":"10.2967/jnumed.125.270069","DOIUrl":"https://doi.org/10.2967/jnumed.125.270069","url":null,"abstract":"<p>Prostate cancer (PCa) is a leading cause of cancer deaths, making effective early detection, precise staging, and monitoring of biochemical recurrence crucial. Next-generation prostate-specific membrane antigen (PSMA) PET tracers could detect small or early metastatic lesion, especially in patients with low prostate-specific antigen. However, species differences in PSMA expression affect tracer biodistribution and imaging performance, highlighting the need for cross-species studies to optimize design and ensure clinical accuracy. <strong>Methods:</strong> We developed [¹⁸F]Di-PyL, a dimeric, PSMA-targeted radiotracer based on the structure of [¹⁸F]DCFPyL, and systematically evaluated the biodistribution of [¹⁸F]Di-PyL in mice, pigs, dogs, and cynomolgus monkeys before conducting a preliminary imaging study in humans. The aim of these comparative analyses was to provide critical insights into the interspecies biodistribution and imaging performance of this dimeric agent, while highlighting its potential to improve the detection of PCa, particularly in patients with low prostate-specific antigen levels and biochemical recurrence. <strong>Results:</strong> [¹⁸F]Di-PyL showed a 23-fold higher PSMA-binding affinity than did [¹⁸F]DCFPyL. In vitro assays showed increased cellular uptake of [¹⁸F]Di-PyL in PSMA-positive cells. Biodistribution studies revealed significant interspecies differences, with the kidneys showing the highest uptake across all species. Distinct uptake patterns were observed in the lungs and hearts of beagles and pigs, whereas cynomolgus monkeys exhibited high uptake in salivary glands and vertebrae. In humans, significant uptake was noted in the liver and spleen. PET/CT imaging in patients with PCa revealed strong tumor localization and excellent contrast in bone metastases. <strong>Conclusion:</strong> [¹⁸F]Di-PyL is a promising PSMA PET tracer with enhanced binding affinity and excellent performance in vitro and in vivo. [¹⁸F]Di-PyL PET studies across species revealed significant biodistribution variability but consistently highlighted the tracer’s superior PSMA-targeting capability. These findings provide critical data to support further preclinical animal studies and lay a solid foundation for subsequent clinical trials.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652152","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":"Quantitative Deauville Scoring to Uncover Prognostic Information from 18F-FDG PET–Based Response Assessment: Data from the EuroNet-PHL-C1 Trial","authors":"Lars Kurch, Judith Landman-Parker, Thomas W. Georgi, Andishe Attarbaschi, Walentyna Balwierz, Auke Beishuizen, Matthias Braun, Michaela Cepelova, Francesco Ceppi, Alexander Claviez, Stephen Daw, Karin Dieckmann, Ana Fernández-Teijeiro, Jamie E. Flerlage, Alexander Fosså, Lisa L. Hjalgrim, Andrea Hraskova, Jonas Karlén, Tomaz Klekawka, Thierry Leblanc, Francoise Montravers, Egesta Lopci, Maurizio Mascarin, Jean Pears, Tanja Pelz, Tomaž Prelog, Marius Rohde, Osama Sabri, Jonas Steglich, Dietrich Stoevesandt, Anne Uytterbroeck, Dirk Vordermark, William Hamish Wallace, Dieter Körholz, Christine Mauz-Körholz, Regine Kluge, Dirk Hasenclever","doi":"10.2967/jnumed.125.269603","DOIUrl":"https://doi.org/10.2967/jnumed.125.269603","url":null,"abstract":"<p>Cure rates are excellent in classical Hodgkin lymphoma. The challenge is tailoring the treatment to the individual patient to avoid not only overtreatment and treatment-related sequelae but also undertreatment. ¹⁸F-FDG PET is a major tool for guiding response-adapted treatment. Metabolic response is by default assessed using the visual 5-point Deauville scale (vDS), which is, however, limited by its ordinal nature. In this methodologic paper, we investigate whether a quantitative extension of the vDS, namely qPET, allows for better prognostic discrimination. <strong>Methods:</strong> In total, 1,447 patients with newly diagnosed pediatric Hodgkin lymphoma of all stages from the multicentric EuroNet-PHL-C1 trial received 2 vincristine, etoposide, prednisone, and doxorubicin cycles before they underwent ¹⁸F-FDG PET for early response assessment. The qPET value (quotient of SUV_peak of the lymphoma residual and SUV_mean of the liver) corresponding to the lesion with the highest determined vDS was retrospectively measured. Logistic regression used qPET as a continuous biomarker for 60 mo of event-free survival (EFS). <strong>Results:</strong> The individual qPET value strongly relates to the EFS: EFS is high at about 89% for qPET values of less than 1.3, corresponding to the currently applied threshold for complete metabolic remission (vDS, ≤3). Among patients with a vDS of 4 or 5, qPET further discriminates a larger group with still high EFS, that is, 84.3% (1.3 &lt; qPET ≤ 2; refers to vDS4) and 83.1% (2 &lt; qPET ≤ 3; refers to vDS5), from a smaller, high-risk group with unacceptably low EFS at 47.6% (qPET &gt; 3; refers to vDS5). Thus, using metric measures enabled splitting up the vDS5 category into 5A and 5B, showing totally different EFS rates. <strong>Conclusion:</strong> qPET extends the ordinal vDS and discriminates prognosis continuously over its whole range. The group of vDS5 patients (qPET &gt; 2.0) has a particularly wide prognostic range (EFS, 47.6%–83.1%). Additional information provided by qPET may justify new treatment strategies for patients with high qPET values greater than 3, reveal that standard treatment (chemotherapy plus radiotherapy) is sufficient for patients with qPET values between 1.3 and 3, and confirm favorable outcome when radiotherapy is omitted if qPET is below 1.3.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603132","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}