The Journal of Nuclear Medicine最新文献

{"title":"Theranostics in Perspective: White Paper","authors":"Marcel P.M. Stokkel, Martin Gotthardt, Ken Herrmann, Gopinath Gnanasegaran","doi":"10.2967/jnumed.125.269776","DOIUrl":"https://doi.org/10.2967/jnumed.125.269776","url":null,"abstract":"<p>Nuclear medicine has evolved from a diagnostic-oriented speciality toward theranostics. Radionuclide therapy has become a booming business with newer radiopharmaceuticals and indications. Although the specialty of nuclear medicine seems scintillating, several challenges might limit sustained and long-term success. Some of the challenges and issues requiring clarification include radiopharmaceutical cost and supply, cost–benefit analysis, reimbursement, training, workforce, collaboration with the radiopharmaceutical industry, national and international nuclear medicine, and applied specialities. This review discusses these challenges and possible solutions to avoid speed breakers in theranostics.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144066510","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":"Designed Ankyrin Repeat Protein–Mediated Peptide Nucleic Acid–Based Pretargeting: A Proof-of-Principle Study","authors":"Maryam Oroujeni, Kristina Westerlund, Eleftherios Papalanis, Alexander van Deventer, Yongsheng Liu, Jacob Clinton, Zhengyue Wang, Ivan Zelepukin, Anna Orlova, Vladimir Tolmachev, Amelie Eriksson Karlström","doi":"10.2967/jnumed.125.269533","DOIUrl":"https://doi.org/10.2967/jnumed.125.269533","url":null,"abstract":"<p>Designed ankyrin repeat proteins (DARPins) are a class of engineered scaffold proteins (ESPs) with a molecular weight of approximately 15 kDa and a picomolar affinity for tumor antigen targets. Proof-of-concept studies have demonstrated the potential of DARPin radioimmunodiagnostics in humans. However, a high accumulation of activity in the kidneys limits their use in conventional radionuclide therapy. A peptide nucleic acid (PNA)–based pretargeted approach was successfully applied to Affibody molecules, another class of ESP. We hypothesized that this method could also enable the controlled conversion of DARPins into pretargeting probes. In this proof-of-principle study, we tested this hypothesis using the human epidermal growth factor receptor type 2 (HER2)–targeting DARPin G3 as a model. <strong>Methods:</strong> We performed site-specific coupling of PNA to the DARPin using sortase A–mediated ligation. The DARPin G3 was modified at the C-terminus with a sortase A recognition sequence. A GGG–modified hybridization probe (HP1) containing a 15-base PNA sequence was attached to G3 using sortase A, creating the primary agent G3-HP1. To evaluate cell binding specificity and biodistribution, G3-HP1 was labeled with ¹²⁵I. The complementary PNA-based secondary probe HP2 containing the DOTA chelator was labeled with ¹⁷⁷Lu. In vitro studies were performed in HER2-expressing cell lines. Biodistribution and in vivo targeting and pretargeting specificity were evaluated in mice with HER2-positive SKOV-3 and HER2-negative Ramos xenografts. In vivo pretargeting of [¹⁷⁷Lu]Lu-HP2 using G3-HP1 was head-to-head compared with Affibody molecule–mediated pretargeting using Z_HER2:342-HP1 and with direct targeting using [¹⁷⁷Lu]Lu-DOTA-G3. <strong>Results:</strong> [¹²⁵I]I-G3-HP1 demonstrated specific binding to HER2-expressing cells with picomolar affinity. [¹⁷⁷Lu]Lu-HP2 showed HER2-specific and PNA-dependent binding to G3-HP1–pretreated cells with subnanomolar affinity. Biodistribution studies confirmed HER2-specific tumor uptake of [¹²⁵I]I-G3-HP1. The uptake of [¹⁷⁷Lu]Lu-HP2 in xenografts was HER2-dependent and PNA-mediated in the case of G3-HP1 preinjection. The pretargeting approach increased the tumor uptake 8-fold compared with direct targeting using [¹⁷⁷Lu]Lu-DOTA-G3. Pretargeting substantially decreased the uptake in the kidneys (∼9-fold), liver (∼370-fold), and spleen (6.5-fold). The biodistribution and the tumor uptake of [¹⁷⁷Lu]Lu-HP2 were strikingly similar in the cases of Affibody- and DARPin-based pretargeting. <strong>Conclusion:</strong> Sortase A–mediated coupling enables the development of a PNA-based pretargeting system for DARPin G3, expanding the application of this approach to another class of ESPs.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144066498","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":"First-in-Human Study of 18F-Labeled PET Tracer for Glutamate AMPA Receptor [18F]K-40: A Derivative of [11C]K-2","authors":"Sadamitsu Ichijo, Tetsu Arisawa, Mai Hatano, Waki Nakajima, Tomoyuki Miyazaki, Tsuyoshi Eiro, Yuuki Takada, Ryunosuke Iai, Akane Sano, Masaki Sonoda, Yutaro Takayama, Yuichi Kimura, Takuya Takahashi","doi":"10.2967/jnumed.124.269405","DOIUrl":"https://doi.org/10.2967/jnumed.124.269405","url":null,"abstract":"<sec><st>Visual Abstract</st><p><fig loc=\"float\"><link locator=\"jnumed.124.269405absf1\"></fig></p></sec>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927253","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":"A Vision for Gastrin-Releasing Peptide Receptor Targeting for Imaging and Therapy: Perspective from Academia and Industry","authors":"Clément Morgat, Heying Duan, Simone Dalm, Elif Hindié, Thomas Günther, Bernd J. Krause, Vasko Kramer, Florine Cavelier, Andrew W. Stephens, Stephen Moran, Laura Lamb, Andrei Iagaru","doi":"10.2967/jnumed.124.269444","DOIUrl":"https://doi.org/10.2967/jnumed.124.269444","url":null,"abstract":"<p>The gastrin-releasing peptide receptor (GRPR) is overexpressed in various cancers, including prostate cancer, breast cancer, small cell and non–small cell lung cancer, uterine and ovarian cancer, colon cancer, and gastrointestinal stromal tumors. This makes GRPR a multicancer target for theranostics, that is, molecular imaging and therapy. Here, we explore the current state of GRPR-targeted theranostics from bench to bedside, highlighting the preclinical development of various GRPR-targeting compounds and clinical applications. We review the role of GRPR-targeted molecular imaging for all stages of prostate cancer, breast cancer, and other tumors and provide a quo vadis GRPR. We aimed to offer a comprehensive overview of GRPR-targeted theranostics to inform researchers, clinicians, pharma, and regulators of the potential benefits and emerging opportunities in the pursuit of personalized precision cancer care.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927251","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":"Detection of HER2-Low Lesions Using HER2-Targeted PET Imaging in Patients with Metastatic Breast Cancer: A Paired HER2 PET and Tumor Biopsy Analysis","authors":"Randy Yeh, Fresia Pareja, Parnian Shobeiri, Dara Ross, Vetri S. Jayaprakasam, Ali Aria Razmaria, Joshua Z. Drago, Audrey Mauguen, Serge K. Lyashchenko, Brian M. Zeglis, Jason S. Lewis, Gary A. Ulaner","doi":"10.2967/jnumed.124.269227","DOIUrl":"https://doi.org/10.2967/jnumed.124.269227","url":null,"abstract":"<p>Trastuzumab deruxtecan (T-DXd), a human epidermal growth factor receptor 2 (HER2)–targeted antibody–drug conjugate, demonstrated remarkable efficacy in previously treated patients with HER2-low metastatic breast cancer (mBC), marking a new therapeutic option for this patient population. Prior studies with HER2 PET using ⁸⁹Zr-radiolabeled antibodies were limited by high rates of imaging false positives for HER2-positive malignancy. In this retrospective study, we investigate whether these false positives (HER2-negative on pathology) could be explained by HER2-low lesions. <strong>Methods:</strong> A retrospective study was conducted of mBC patients who previously enrolled in 2 prospective HER2 PET imaging trials: NCT02286843 using ⁸⁹Zr-trastuzumab and ⁸⁹Zr-pertuzumab and NCT04692831 using ⁸⁹Zr-ss-pertuzumab. Patients were included if paired HER2 PET scan and biopsy were performed within a 2-mo period. Of 56 total patients, 23 patients met the inclusion criteria. Pathology results for biopsied lesions were collected, without repeat interpretation, and lesions were classified as HER2-positive, HER2-low, or HER2-0. SUV_max of biopsied lesions were compared between pathologic classifications to determine whether lesion uptake intensity could differentiate between HER2-positive and HER2-low lesions. <strong>Results:</strong> All prior false-positive lesions on HER2 PET scans from NCT02286843 were reclassified as HER2-low (instead of HER2-negative). In the ⁸⁹Zr-trastuzumab cohort, 3 lesions were HER2-positive (33%) and 6 were HER2-low (67%); in the ⁸⁹Zr-pertuzumab cohort, 2 were HER2-positive (29%) and 5 were HER2-low (71%). In the ⁸⁹Zr-ss-pertuzumab cohort (NCT04692831), 7 patients underwent recent biopsies of 8 total lesions demonstrating 1 HER2-positive (12%), 5 HER2-low (62%), and 2 HER2-0 lesions (25%). HER2 PET SUV_max of biopsied lesions were compared between HER2-positive and HER2-low lesions for the combination of all 3 radiotracer cohorts. HER2-low lesions had a significantly higher SUV_max (median, 12.7; interquartile range, 8.05) than did HER2-positive lesions (median, 6.4; interquartile range, 1.98; <em>P</em> = 0.01). <strong>Conclusion:</strong> HER2 PET imaging with ⁸⁹Zr-radiolabeled antibodies detects HER2-low lesions in addition to HER2-positive lesions in patients with mBC, suggesting its ability to visualize the entire spectrum of HER2 expression. All prior false positives on ⁸⁹Zr-trastuzumab and ⁸⁹Zr-pertuzumab PET scans were reclassified as HER2-low. Lesion SUV_max is not reliable in differentiating HER2-positive from HER2-low lesions; however, it may be useful in distinguishing lesions expressing HER2 from HER2-0 lesions.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927252","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":"From Genome to Phenome: Opportunities and Challenges of Molecular Imaging","authors":"Mei Tian, Leroy Hood, Arturo Chiti, Markus Schwaiger, Satoshi Minoshima, Yasuyoshi Watanabe, Keon Wook Kang, Hong Zhang","doi":"10.2967/jnumed.124.267660","DOIUrl":"https://doi.org/10.2967/jnumed.124.267660","url":null,"abstract":"<p>The study of the human phenome is essential for understanding the complexities of wellness and disease and their transitions, with molecular imaging being a vital tool in this exploration. Molecular imaging embodies the 4 principles of human phenomics: precise measurement, accurate calculation or analysis, well-controlled manipulation or intervention, and innovative invention or creation. Its application has significantly enhanced the precision, individualization, and effectiveness of medical interventions. This article provides an overview of molecular imaging’s technologic advancements and presents the potential use of molecular imaging in human phenomics and precision medicine. The integration of molecular imaging with multiomics data and artificial intelligence has the potential to transform health care, promoting proactive and preventive strategies. This evolving approach promises to deepen our understanding of the human phenome, lead to preclinical diagnostics and treatments, and establish quantitative frameworks for precision health management.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927249","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":"[11C]ZTP-1: An Effective Short-Lived Radioligand for PET of Rat and Monkey Brain Phosphodiesterase Type 4 Subtype B","authors":"Qunchao Zhao, Jeih-San Liow, Joo Eun Jee, Jose Montero Santamaria, Matilah Pamie-George, Cheryl Morse, Shawn Wu, Sami S. Zoghbi, Sung Won Kim, Robert B. Innis, Victor W. Pike, Sanjay Telu","doi":"10.2967/jnumed.124.269159","DOIUrl":"https://doi.org/10.2967/jnumed.124.269159","url":null,"abstract":"<p>Phosphodiesterase type 4 subtype B (PDE4B) selectively hydrolyzes cyclic adenosine monophosphate to enact numerous downstream signaling events. PDE4B is widely expressed in the brain and is implicated in several neuropsychiatric disorders. Moreover, PDE4B inhibition shows antiinflammatory and antidepressant-like effects in animal studies. [¹⁸F]PF-06445974 has been developed to image human brain PDE4B using PET, thereby providing a tool for pathophysiologic studies and drug development. However, a radioligand labeled with shorter-lived ¹¹C would be an alternative for studies that require more than 1 administration into the same imaging subject on a single day. <strong>Methods:</strong> 8-Cyclopropyl-10-(3,5-difluoro-4-(methoxy)phenyl)-7,8-dihydropyrido[2′,3′:4,5]pyrrolo[1,2-<em>a</em>]pyrazin-9(6<em>H</em>)-1 (ZTP-1) was identified as possessing many favorable properties for development as a ¹¹C-labeled PET radioligand, including high PDE4B inhibitory potency, moderate computed lipophilicity, and a methoxy group as a potential labeling site. Here, [¹¹C]ZTP-1 was readily obtained by ¹¹C methylation of a synthesized <em>O</em>-desmethyl precursor. PET imaging of rat and rhesus monkey brains was performed with [¹¹C]ZTP-1 at baseline and after administration of PDE4B- and PDE4D-selective inhibitors. Radiometabolite profiles for [¹¹C]ZTP-1 were also determined ex vivo in rat plasma and brains. <strong>Results:</strong> [¹¹C]ZTP-1 was obtained in a high activity yield and with high molar activity. Rat and monkey PET imaging showed high whole-brain radioactivity uptake with subsequent gradual washout. Challenge experiments verified a high and PDE4B-selective PET signal in rat and monkey brains. Ex vivo rat brain uptake of [¹¹C]ZTP-1 showed less than 1% radiometabolite contamination at 30 min. Total distribution volume measures in monkey brains quickly reached stability. <strong>Conclusion:</strong> [¹¹C]ZTP-1 is a promising, shorter-lived alternative to [¹⁸F]PF-06445974 for quantifying brain PDE4B in rodents and nonhuman primates with PET and warrants further investigation in humans.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927254","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":"[11C]Carfentanil PET Whole-Body Imaging of μ-Opioid Receptors: A First in-Human Study","authors":"Jacob G. Dubroff, Chia-Ju Hsieh, Corinde E. Wiers, Hsiaoju Lee, Alexander Schmitz, Elizabeth J. Li, Erin K. Schubert, Robert H. Mach, Henry R. Kranzler","doi":"10.2967/jnumed.124.269413","DOIUrl":"https://doi.org/10.2967/jnumed.124.269413","url":null,"abstract":"<p>μ-opioid receptors (MORs) are G-coupled receptors widely expressed in the brain and body. MORs have a high affinity for both endogenous opioids such as β-endorphins and exogenous opioids such as fentanyl. They mediate pain and reward and have been implicated in the pathophysiology of opioid, cocaine, and other substance use disorders. Using an instrument with a long axial field of view and the MOR-selective radioligand [¹¹C]carfentanil, we measured the whole-body distribution of MORs in 13 healthy humans. We also examined sex differences in MOR distribution at baseline and after pretreatment with the MOR antagonist naloxone. <strong>Methods:</strong> Six female and 7 male healthy subjects underwent 2 [¹¹C]carfentanil PET imaging sessions—one at baseline and one immediately after pretreatment with the MOR antagonist naloxone (13 μg/kg). Whole-body PET imaging was performed on an instrument with a 142-cm axial bore. [¹¹C]carfentanil brain distribution volume ratios were determined using the occipital cortex and the visual cortex within it as reference regions. For peripheral organ distribution volume ratios, the descending aorta and proximal-extremity muscle (biceps/triceps) were used as reference regions. <strong>Results:</strong> Naloxone blockade reduced MOR availability by 40%–50% in the caudate, putamen, thalamus, amygdala, and ventral tegmentum, brain regions known to express high levels of MORs. Women showed greater receptor occupancy in the thalamus, amygdala, hippocampus, and frontal and temporal lobes and a greater naloxone-induced reduction in thalamic MOR availability than men (<em>P</em> &lt; 0.05). For determining brain MOR availability, there was less variance in the visual cortex than in the occipital cortex reference region. For peripheral MOR determination, the descending aorta reference region showed less variance than the extremity muscle, but both showed blocking effects of naloxone. <strong>Conclusion:</strong> [¹¹C]carfentanil whole-body PET scans are useful for understanding MOR physiology under both baseline and blocking conditions. Extra–central nervous system reference regions may be useful for quantifying radiotracers when a region devoid of binding in the central nervous system is unavailable. The long axial field of view was useful for measuring changes in the short-lived radiotracer [¹¹C]carfentanil, with and without naloxone blocking. Further research is needed to evaluate the behavioral and clinical relevance of sex differences in naloxone–MOR interactions.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"108 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927348","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":"First-in-Human Serum Stability Studies of [177Lu]Lu-AMTG: A Step Toward Improved GRPR-Targeted Radiopharmaceutical Therapy","authors":"Veronika Felber, Nadine Holzleitner, Markus Joksch, Tim Suhrbier, Gunhild von Amsberg, Sarah Schwarzenböck, Jens Kurth, Martin Heuschkel, Thomas Günther, Bernd J. Krause","doi":"10.2967/jnumed.124.269132","DOIUrl":"https://doi.org/10.2967/jnumed.124.269132","url":null,"abstract":"<sec><st>Visual Abstract</st><p><fig loc=\"float\"><link locator=\"jnumed.124.269132absf1\"></fig></p></sec>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"114 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893890","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 of Persistent Cardiovascular and Pulmonary Abnormalities on PET/MRI and DECT Imaging in Long COVID Patients","authors":"Maria Giovanna Trivieri, Ana Devesa, Philip M. Robson, Sonali Bose, Busra Cangut, Steve Liao, Audrey Kaufman, Renata Pyzik, Valentin Fauveau, Jamie Wood, Aaron Shpiner, Edwin Yoo, Sarayu Huang, Claudia Calcagno, Venkatesh Mani, Sahityasri Thapi, Johanna Contreras, Kai Nie, Seunghee Kim-Schulze, Sacha Gnjatic, Miriam Merad, Munir Ghesani, David Putrino, Adam Jacobi, Donna Mancini, Charles Powell, Zahi A. Fayad","doi":"10.2967/jnumed.124.268980","DOIUrl":"https://doi.org/10.2967/jnumed.124.268980","url":null,"abstract":"<p>The objective of this study is to describe the prevalence of inflammatory cardiopulmonary findings in a prospective cohort of long coronavirus disease (LC) patients. <strong>Methods:</strong> Subjects with a history of coronavirus disease 2019 infection, persistent cardiopulmonary symptoms 9–12 mo after initial infection, and a clinical assessment compatible with LC underwent cardiopulmonary ¹⁸F-FDG PET/MRI, dual-energy CT (DECT) of the lungs, and plasma protein analysis (subgroup). A control group that included subjects with a history of acute severe acute respiratory syndrome coronavirus 2 infection but without cardiopulmonary symptoms at recruitment was also characterized. <strong>Results:</strong> Ninety-eight patients (median age, 48.5 y; 47% men) were enrolled. The most common LC symptom was shortness of breath (80%), and 27% of participants were hospitalized. Of the subjects, 90% presented abnormalities in DECT, with 67% and 59% of participants demonstrating pulmonary infiltrates and abnormal perfusion, respectively. PET/MRI was abnormal for 57% of subjects: 24% showed cardiac involvement suggestive of myocarditis, 22% presented uptake reminiscent of pericarditis, 11% showed periannular uptake, and 30% showed vascular uptake (aortic or pulmonary). There was no myocardial, pericardial, periannular, or pulmonary uptake on the PET/MRI scans of the control group (<em>n</em> = 9). Analysis of plasma protein concentrations showed significant differences between the LC and the control groups. Lastly, the plasma protein profile was significantly different among LC patients with abnormal and normal PET/MRI. <strong>Conclusion:</strong> In LC subjects evaluated up to a year after coronavirus disease 2019 infection, our results indicate a high prevalence of abnormalities on PET/MRI and DECT, as well as significant differences in the peripheral biomarker profile, which might warrant further monitoring to exclude the development of complications such as pulmonary hypertension and valvular disease.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893889","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}