The Journal of Nuclear Medicine最新文献

{"title":"Feasibility of Ultra-Low-Activity 18F-FDG PET/CT Imaging Using a Long–Axial-Field-of-View PET/CT System","authors":"Charlotte L.C. Smith, Gerben J. C. Zwezerijnen, Marijke E. den Hollander, Josée M. Zijlstra, C. Willemien Menke-van der Houven van Oordt, Idris Bahce, Maqsood Yaqub, Ronald Boellaard","doi":"10.2967/jnumed.124.269272","DOIUrl":"https://doi.org/10.2967/jnumed.124.269272","url":null,"abstract":"<p>¹⁸F-FDG PET/CT imaging is widely used in oncology. Long–axial-field-of-view (LAFOV) PET/CT systems exhibit ultrahigh sensitivity and signal-to-noise ratios, enabling significant reductions in tracer activity and shorter acquisition times. This study aimed to evaluate the feasibility of using ultralow activities for semiquantitative measurements in ¹⁸F-FDG PET/CT imaging performed on an LAFOV PET/CT system through a high–low activity test–retest study. <strong>Methods:</strong> Eleven oncology patients underwent 2 ¹⁸F-FDG PET/CT scans, the first with standard activity (3.0 MBq/kg) and, within 7 d, 1 with ultralow activity (0.3 MBq/kg). List-mode data of both scans were resampled to simulate activities of 0.3 and 0.03 MBq/kg. Semiquantitative measurements (SUV_mean, SUV_peak, and SUV_max) and their repeatability in healthy organs and lesions were compared across different activities and reconstruction protocols. <strong>Results:</strong> SUV_mean remained stable across activity reductions and reconstruction protocols, whereas SUV_peak showed stability except when simulating 1% of the standard ¹⁸F-FDG activity. SUV_max significantly increased at lower ¹⁸F-FDG activities, particularly with clinically preferred scans. Repeatability analysis showed that SUV_mean and SUV_peak maintained variability within acceptable limits (&lt;15%) even at 0.03 MBq/kg, whereas SUV_max variability often exceeded these limits. Lesion detection was reliable at 0.3 MBq/kg, but several lesions could not be delineated at 0.03 MBq/kg, indicating compromised image quality. <strong>Conclusion:</strong> The use of ultralow ¹⁸F-FDG activity (0.3 MBq/kg) is feasible for PET/CT imaging on an LAFOV PET/CT system, as shown by semiquantitative measurements, repeatability analyses, lesion detectability, and semiautomated delineation methods. These findings support imaging protocols that keep radiation exposure levels as low as reasonably or practically achievable, which are particularly relevant for radiation-sensitive patients (e.g., children, pregnant women).</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872795","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":"2024 SNMMI Highlights Lecture: Cardiovascular Sciences","authors":"James T. Thackeray","doi":"10.2967/jnumed.125.269988","DOIUrl":"https://doi.org/10.2967/jnumed.125.269988","url":null,"abstract":"<p><em>The Highlights Lecture, presented at the closing session of each SNMMI Annual Meeting, was originated and presented for more than 30 y by Henry N. Wagner, Jr., MD. Beginning in 2010, the duties of summarizing selected significant presentations at the meeting were divided annually among 4 distinguished nuclear and molecular medicine subject matter experts. The 2024 Highlights Lectures were delivered on June 11 at the SNMMI Annual Meeting in Toronto, Canada. Presented here is the lecture by James T. Thackeray, PhD, Heisenberg Professor of Translational Cardiovascular Molecular Imaging, Hannover Medical School (Germany), who spoke on cardiovascular topics presented at the meeting. Note that in the following presentation summary, numerals in brackets represent abstract numbers as published in</em> The Journal of Nuclear Medicine <em>(2024;65[suppl 2])</em>.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"91 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872816","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":"Multicycle Dosimetric Behavior and Dose–Effect Relationships in [177Lu]Lu-DOTATATE Peptide Receptor Radionuclide Therapy","authors":"Gunjan Kayal, Molly E. Roseland, Chang Wang, Kellen Fitzpatrick, David Mirando, Krithika Suresh, Ka Kit Wong, Yuni K. Dewaraja","doi":"10.2967/jnumed.124.269389","DOIUrl":"https://doi.org/10.2967/jnumed.124.269389","url":null,"abstract":"&lt;p&gt;We investigated pharmacokinetics, dosimetric patterns, and absorbed dose (AD)–effect correlations in [&lt;sup&gt;177&lt;/sup&gt;Lu]Lu-DOTATATE peptide receptor radionuclide therapy (PRRT) for metastatic neuroendocrine tumors (NETs) to develop strategies for future personalized dosimetry-guided treatments. &lt;strong&gt;Methods:&lt;/strong&gt; Patients treated with standard [&lt;sup&gt;177&lt;/sup&gt;Lu]Lu-DOTATATE PRRT were recruited for serial SPECT/CT imaging. Kidneys were segmented on CT using a deep learning algorithm, and tumors were segmented at each cycle using a SPECT gradient-based tool, guided by radiologist-defined contours on baseline CT/MRI. Dosimetry was performed using an automated workflow that included contour intensity–based SPECT-SPECT registration, generation of Monte Carlo dose-rate maps, and dose-rate fitting. Lesion-level response at first follow-up was evaluated using both radiologic (RECIST and modified RECIST) and [&lt;sup&gt;68&lt;/sup&gt;Ga]Ga-DOTATATE PET-based criteria. Kidney toxicity was evaluated based on the estimated glomerular filtration rate (eGFR) at 9 mo after PRRT. &lt;strong&gt;Results:&lt;/strong&gt; Dosimetry was performed after cycle 1 in 30 patients and after all cycles in 22 of 30 patients who completed SPECT/CT imaging after each cycle. Median cumulative tumor (&lt;em&gt;n&lt;/em&gt; = 78) AD was 2.2 Gy/GBq (range, 0.1–20.8 Gy/GBq), whereas median kidney AD was 0.44 Gy/GBq (range, 0.25–0.96 Gy/GBq). The tumor-to-kidney AD ratio decreased with each cycle (median, 6.4, 5.7, 4.7, and 3.9 for cycles 1–4) because of a decrease in tumor AD, while kidney AD remained relatively constant. Higher-grade (grade 2) and pancreatic NETs showed a significantly larger drop in AD with each cycle, as well as significantly lower AD and effective half-life (T&lt;sub&gt;eff&lt;/sub&gt;), than did low-grade (grade 1) and small intestinal NETs, respectively. T&lt;sub&gt;eff&lt;/sub&gt; remained relatively constant with each cycle for both tumors and kidneys. Kidney T&lt;sub&gt;eff&lt;/sub&gt; and AD were significantly higher in patients with low eGFR than in those with high eGFR. Tumor AD was not significantly associated with response measures. There was no nephrotoxicity higher than grade 2; however, a significant negative association was found in univariate analyses between eGFR at 9 mo and AD to the kidney, which improved in a multivariable model that also adjusted for baseline eGFR (cycle 1 AD, &lt;em&gt;P&lt;/em&gt; = 0.020, adjusted &lt;em&gt;R&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.57; cumulative AD, &lt;em&gt;P&lt;/em&gt; = 0.049, adjusted &lt;em&gt;R&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.65). The association between percentage change in eGFR and AD to the kidney was also significant in univariate analysis and after adjusting for baseline eGFR (cycle 1 AD, &lt;em&gt;P&lt;/em&gt; = 0.006, adjusted &lt;em&gt;R&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.21; cumulative AD, &lt;em&gt;P&lt;/em&gt; = 0.019, adjusted &lt;em&gt;R&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.21). &lt;strong&gt;Conclusion:&lt;/strong&gt; The dosimetric behavior we report over different cycles and for different NET subgroups can be considered when optimizing PRRT to individual patients. The models we present ","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872815","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":"Initial Experience with Dual-Time-Point [18F]Flurpiridaz PET/CT for Localization of Parathyroid Adenomas in Primary Hyperparathyroidism","authors":"Thorsten Derlin, Dennis Kleine-Döpke, Lavinia Neubert, Tobias L. Ross, Bastian P. Ringe, Moritz Schmelzle, Frank M. Bengel","doi":"10.2967/jnumed.124.269387","DOIUrl":"https://doi.org/10.2967/jnumed.124.269387","url":null,"abstract":"<p>We aimed to evaluate the feasibility of [¹⁸F]flurpiridaz PET/CT for localization of parathyroid adenomas in patients with primary hyperparathyroidism (pHPT). <strong>Methods:</strong> Data for 11 patients with pHPT undergoing dual-time-point [¹⁸F]flurpiridaz PET/CT for localization of hyperfunctioning parathyroid glands were retrospectively analyzed. PET/CT findings were compared with results of other imaging tests, laboratory parameters, intraoperative findings, and final histology, serving as the reference standard. <strong>Results:</strong> [¹⁸F]flurpiridaz PET/CT identified parathyroid adenomas in 10 (91%) of the 11 patients studied. Parathyroid adenomas were exclusively visualized in early PET images. Uptake in adenomas declined over time (SUV_max, −65% ± 17%; <em>P</em> = 0.002), as did uptake in background thyroid tissue (−56% ± 16%; <em>P</em> = 0.002). <strong>Conclusion:</strong> [¹⁸F]flurpiridaz PET images after administration had high detection efficacy in pHPT. This work provides a rationale for larger prospective studies to evaluate the use of [¹⁸F]flurpiridaz PET/CT for localization of hyperfunctioning parathyroid glands in comparison with other imaging tests.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872813","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":"Evidence-Based Clinical Protocols to Monitor Efficacy of [177Lu]Lu-PSMA Radiopharmaceutical Therapy in Metastatic Castration-Resistant Prostate Cancer Using Real-World Data","authors":"Lena M. Unterrainer, Nicolas De Leiris, Marcus Unterrainer, Astrid Delker, Linus Hempel, Zachary Ells, Sophie C. Kunte, Josef Zahner, Adrien Holzgreve, Mathias J. Zacherl, Gabriel T. Sheikh, Jozefina Casuscelli, Julien Leenhardt, Kenneth J. Pienta, Emmanuelle Jacquet, Mathieu Laramas, Jerome Long, Marine Faure, Ghislaine Reboulet, Channing J. Paller, Alexis Mercier, Lilja B. Solnes, Kevin Kiraz, Harun Ilhan, Andrei Gafita, Loïc Djaileb","doi":"10.2967/jnumed.124.269431","DOIUrl":"https://doi.org/10.2967/jnumed.124.269431","url":null,"abstract":"<p>Our objectives were to assess the prognostic value of posttherapy [¹⁷⁷Lu]Lu-PSMA (LuPSMA) SPECT/CT by visual evaluation using RECIP 1.0 during LuPSMA therapy and develop an evidence-based clinical protocol to monitor the efficacy of LuPSMA. <strong>Methods:</strong> Patients with metastatic castration-resistant prostate cancer who received at least 2 LuPSMA cycles between April 2019 and November 2023 were retrospectively included in this study. Pairs of baseline and interim LuPSMA SPECT/CT (SPECT) and PSMA PET/CT (PET) images after 2 therapy cycles were analyzed per visual RECIP 1.0. Changes in prostate-specific antigen (PSA) levels at 12 wk were categorized by Prostate Cancer Working Group Criteria 3 guidelines and combined with RECIP 1.0 reads to determine disease progression using a composite classification method (PSA + RECIP). The primary outcome was the prognostic value of posttherapeutic SPECT by RECIP 1.0 for overall survival (OS). The clinical protocol was developed on the basis of the prognostic accuracy (Harrell concordance index, or C-index) of SPECT versus PET and the combination of SPECT plus PSA (SPECT + PSA) versus the combination of PET plus PSA (PET + PSA). <strong>Results:</strong> Data from 105 patients were evaluated. Progressive disease determined by SPECT was associated with shorter OS compared with stable disease (hazard ratio, 2.5; 95% CI, 1.2–5.3; <em>P</em> = 0.015) and with partial response (hazard ratio, 6.5; 95% CI, 2.7–15.7; <em>P</em> &lt; 0.001). Of the 73 patients who underwent PET after 2 cycles, 7 (10%), 30 (41%), 22 (30%), and 30 (41%) had tumor progression shown by SPECT, PET, SPECT + PSA, and PET + PSA, respectively. The C-index for SPECT was inferior compared with that for PET (0.54 vs. 0.66; <em>P</em> &lt; 0.001), whereas the C-indices for SPECT + PSA and PET + PSA did not differ significantly (0.62 vs. 0.66, respectively; <em>P</em> = 0.07). <strong>Conclusion:</strong> Posttherapeutic LuPSMA SPECT/CT per RECIP 1.0 after 2 therapy cycles was prognostic for OS. LuPSMA SPECT/CT identified significantly fewer patients with RECIP-classified progressive disease; however, SPECT + PSA achieved similar prognostic accuracy to PET + PSA for LuPSMA response evaluation.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872814","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]Florzolotau PET for the Differential Diagnosis of Parkinsonism in Patients with Suspected 4-Repeat Tauopathies","authors":"Joachim Brumberg, Nils Schröter, Ganna Blazhenets, M. Aymen Omrane, Christian Volz, Cornelius Weiller, Michel Rijntjes, Lars Frings, Sabine Hellwig, Wolfgang H. Jost, Philipp T. Meyer","doi":"10.2967/jnumed.124.268956","DOIUrl":"https://doi.org/10.2967/jnumed.124.268956","url":null,"abstract":"<sec><st>Visual Abstract</st><p><fig loc=\"float\"><link locator=\"jnumed.124.268956absf1\"></fig></p></sec>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847085","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":"Is Long–Axial-Field-of-View PET/CT Cost-Effective? An International Health–Economic Analysis","authors":"Ian Alberts, Stuart More, Karen Knapp, Riccardo Mei, Stefano Fanti, Clemens Mingels, Lorenzo Nardo, Nii Boye Hammond, Harish Nagaraj, Axel Rominger, Gary J.R. Cook, Don Wilson","doi":"10.2967/jnumed.124.269203","DOIUrl":"https://doi.org/10.2967/jnumed.124.269203","url":null,"abstract":"<p>Our aim is to assess the cost-effectiveness of long–axial-field-of-view (LAFOV) versus short–axial FOV (SAFOV) PET/CT systems using international data. <strong>Methods:</strong> Our model compares equipment and operational costs for a PET/CT center and investigates the effect of camera choice (SAFOV vs. LAFOV) and operational models. Variables include scanner, personnel, radiopharmaceuticals, and operational costs. Economic performance was measured as cost per scan per patient, the total maximum number of scans possible, and the incremental cost-effectiveness ratio. The willingness-to-pay threshold (WTPT) was taken as the cost of a PET/CT scan using the baseline scenario. Radiopharmaceutical requirements, radiation dose to staff and patients, and patient time were modeled. <strong>Results:</strong> An LAFOV system can examine as many patients per day (<em>n</em> = 36) as 2 SAFOV systems but requires fewer technologists (4.5 LAFOV vs. 6.8 SAFOV full-time equivalents) and lower activity (12.5 vs. 35.6 GBq/d), resulting in lower personnel doses (0.9 vs. 2.0 mSv/y). For all countries, LAFOV resulted in lowest per-patient scan costs. The most cost-ineffective method was the use of extended hours. Incremental cost-effectiveness ratio analysis strongly favored LAFOV for all countries, including low-income economies, with WTPT met for all jurisdictions. Net monetary benefit was highest for LAFOV. The minimum number of patients needed to meet WTPT for LAFOV was lowest in lower-income countries, suggesting that high throughput or high per-procedure income is not a prerequisite for cost-effective LAFOV usage. <strong>Conclusion:</strong> LAFOV was shown to facilitate higher patient throughput at lower per-patient and total lifetime operational costs and with lower radiopharmaceutical requirements. These data suggest that LAFOV systems are not just suited to well-resourced academic centers but also are an economically attractive solution for community and resource-limited settings.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847091","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":"Semiquantitative PET Parameters Refine Prognosis in CAR T–Treated Lymphoma After 1 and 3 Months: A Prospective Single-Center Study","authors":"Andrea Farolfi, Beatrice Casadei, Claudio Malizia, Riccardo Ussia, Veronica Rocchi, Andrea Paccagnella, Marianna Gentilini, Cristina Nanni, Lisa Argnani, Pier Luigi Zinzani, Stefano Fanti","doi":"10.2967/jnumed.125.269670","DOIUrl":"https://doi.org/10.2967/jnumed.125.269670","url":null,"abstract":"<sec><st>Visual Abstract</st><p><fig loc=\"float\"><link locator=\"jnumed.125.269670absf1\"></fig></p></sec>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847092","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":"Targeting Extra Domain A of Fibronectin to Improve Noninvasive Detection of Triple-Negative Breast Cancer","authors":"Justin S. Hachey, Tara D. Viray, Mattia Matasci, Domenico Ravazza, Dario Neri, Jason S. Lewis","doi":"10.2967/jnumed.124.268859","DOIUrl":"https://doi.org/10.2967/jnumed.124.268859","url":null,"abstract":"<p>Triple-negative breast cancer (TNBC) lags behind other breast cancer types in targeted therapeutic and diagnostic imaging agent development, largely due to high disease heterogeneity. Noninvasive imaging is essential for diagnosing and staging TNBC and predicting and measuring treatment response. This study targeted a conserved disease-specific extracellular matrix protein domain (the extra domain A of fibronectin [EDA-FN]), with a monoclonal antibody (F8) to overcome tumor cell marker heterogeneity and develop an imaging agent to detect multiple TNBC subtypes and improve diagnostic capacity. <strong>Methods:</strong> [⁸⁹Zr]Zr-desferrioxamine [DFO]-F8 was synthesized and evaluated in vitro and in vivo for EDA-FN binding capacity to detect TNBC by PET/CT in several preclinical xenograft models. <strong>Results:</strong> [⁸⁹Zr]Zr-DFO-F8 exhibited specific, blockable EDA-FN binding activity in vitro. In vivo experiments demonstrated high tumor uptake in preclinical TNBC xenograft models. [⁸⁹Zr]Zr-DFO-F8 detected EDA-FN in subcutaneous and orthotopic TNBC xenografts and accumulated in aggressive disease concordantly with EDA-FN expression. <strong>Conclusion:</strong> EDA-FN imaging with [⁸⁹Zr]Zr-DFO-F8 exhibits powerful tumor delineation in preclinical tumor delineation across TNBC molecular subtypes in vivo.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847088","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":"Prostate Cancer Recurrence Due to Isolated Testicular Metastases Detected by PSMA PET/CT","authors":"Mateus de Oliveira Taveira, Ali Aria Razmaria, Heiko Schoder, Randy Yeh","doi":"10.2967/jnumed.124.269361","DOIUrl":"https://doi.org/10.2967/jnumed.124.269361","url":null,"abstract":"<p>Prostate cancer is the most common solid malignancy to metastasize to the testicles, although testicular metastases remain rare and are often discovered only postmortem. <strong>Methods:</strong> Retrospective analysis of 95 ⁶⁸Ga-prostate-specific membrane antigen (PSMA) PET/CT reports from September 2016 to July 2024 using scrotal region search terms identified 30 patients with indeterminate findings and 6 patients with pathology-confirmed testicular metastases. Data on imaging, pathology, clinical outcomes, and prostate-specific antigen values were reviewed. <strong>Results:</strong> ⁶⁸Ga-PSMA PET/CT detected isolated testicular metastases in 6 patients with M0 castrate-sensitive prostate cancer after maximal pelvic therapy who were imaged because of rising prostate-specific antigen levels. Three of the 6 patients did not have ultrasound abnormalities. Five of the 6 patients were treated with orchiectomy and had durable responses (median follow-up, 33 mo; range, 10–58 mo). <strong>Conclusion:</strong> Including the testes in field of view of the PSMA PET scan may avoid false-negative results. ⁶⁸Ga-PSMA–avid testicular and peritesticular lesions may indicate metastasis even with a negative ultrasound. Orchiectomy can result in durable remissions for these patients.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819984","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}