The Journal of Nuclear Medicine最新文献

{"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}

{"title":"Feasibility of an Ultra-Low-Dose PET Scan Protocol with CT-Based and LSO-TX–Based Attenuation Correction Using a Long–Axial-Field-of-View PET/CT Scanner","authors":"Hasan Sari, Mohammadreza Teimoorisichani, Marco Viscione, Clemens Mingels, Robert Seifert, Kuangyu Shi, Michael Morris, Eliot Siegel, Babak Saboury, Thomas Pyka, Axel Rominger","doi":"10.2967/jnumed.124.268380","DOIUrl":"https://doi.org/10.2967/jnumed.124.268380","url":null,"abstract":"<p>Long–axial-field-of-view (LAFOV) PET scanners enable substantial reduction in injected radiotracer activity while maintaining clinically feasible scan times. Whole-body CT scans performed for PET attenuation correction can significantly add to total radiation exposure. We investigated the feasibility of an ultra-low-dose PET protocol and the application of a CT-less PET attenuation correction method (lutetium oxyorthosilicate background transmission [LSO-TX]) that uses ¹⁷⁶Lu background radiation from detector scintillators with low-count PET data. <strong>Methods:</strong> Each of the 4 study subjects was scanned for 90 min using an ultra-low-dose ¹⁸F-FDG protocol (injected activity, 6.7–9.0 MBq) with an LAFOV PET scanner. PET images were reconstructed with different frame durations using low-dose CT-based and LSO-TX–based attenuation maps (μ-maps). The image quality of PET images was assessed by the signal-to-noise ratio (SNR) in the liver and the contrast-to-noise ratio in the brain. Absolute errors in SUVs between PET images reconstructed with LSO-TX–based and CT-based μ-maps were assessed at each scan duration. <strong>Results:</strong> Visual assessment showed that 20–30 min of PET data obtained using ¹⁸F-FDG activities below 10 MBq (i.e., 0.1 MBq/kg) can yield high-quality images. PET images reconstructed with CT-based and LSO-TX–based μ-maps had comparable SNRs and contrast-to-noise ratios at all scan durations. The mean ± SD SNRs of PET images reconstructed with the CT-based and the LSO-TX–based μ-maps were 9.2 ± 1.9 dB and 9.8 ± 2.0 dB at 90-min scan duration, 6.8 ± 1.7 dB and 6.9 ± 1.8 dB at 30-min scan duration, and 5.5 ± 1.2 dB and 5.6 ± 1.2 dB at 20-min scan duration, respectively. The relative absolute SUV errors between PET images reconstructed with LSO-TX–based and CT-based μ-maps ranged from 3.1% to 6.4% across different volumes of interest with a 20-min scan duration. <strong>Conclusion:</strong> PET scans with an LAFOV scanner maintained good visual image quality with ¹⁸F-FDG activities below 10 MBq for scan durations of 20–30 min. The LSO-TX–based attenuation correction method yielded images comparable to those obtained with the CT-based attenuation correction method in such protocols.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"218 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819982","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":"An External, Independent Validation of an O-(2-[18F]Fluoroethyl)-l-Tyrosine PET Automatic Segmentation Network on a Single-Center, Prospective Dataset of Patients with Glioblastoma","authors":"Nathaniel Barry, Jake Kendrick, Pejman Rowshanfarzad, Ghulam Mubashar Hassan, Roslyn J. Francis, Nicholas Bucknell, Eng-Siew Koh, Andrew M. Scott, Martin A. Ebert, Robin Gutsche, Keith George Ciantar, Norbert Galldiks, Karl-Josef Langen, Philipp Lohmann","doi":"10.2967/jnumed.124.268925","DOIUrl":"https://doi.org/10.2967/jnumed.124.268925","url":null,"abstract":"<p>The goal of this study was to conduct an external, independent validation of an <em>O</em>-(2-[¹⁸F]fluoroethyl)-<span>l</span>-tyrosine ([¹⁸F]FET) PET automatic segmentation network on a cohort of patients with glioblastoma. <strong>Methods:</strong> Twenty-four patients with glioblastoma were included in this study who underwent a total of 52 [¹⁸F]FET PET scans (preradiotherapy, <em>n</em> = 23; preradiotherapy retest, <em>n</em> = 9; follow-up, <em>n</em> = 20). Biologic tumor volume (BTV) delineation was performed by an expert nuclear medicine physician and an automatic segmentation network. Physician and automated quantitative metrics (BTV, mean tumor-to-background ratio [TBR_mean], lesion SUV_mean, and background SUV_mean) were assessed with Pearson correlation and Bland–Altman analysis (bias, limits of agreement [LoA]). Automated and physician segmentation overlap was assessed with spatial and distance-based metrics. <strong>Results:</strong> BTV and TBR_mean Pearson correlation was excellent for all time points (range, 0.92–0.98). In 2 patients with frontal lobe lesions, the network segmented the transverse sinus. Bland–Altman analysis showed network underestimation of physician-derived BTVs (absolute bias, 2.7 cm³, LoA, −13.1–18.5 cm³; relative bias, 27.9%, LoA, −95.3%–151.2%) and deviations for TBR_mean were small (absolute bias, 0.03, LoA, −0.25–0.30; relative bias, 0.83%, LoA −14.27%–15.93%). Median Dice similarity coefficient, surface Dice similarity coefficient, Hausdorff distance, 95th percentile Hausdorff distance, and mean absolute surface distance were 0.83, 0.95, 10.94 mm, 3.62 mm, and 0.88 mm, respectively. <strong>Conclusion:</strong> Automated quantitative analysis was highly correlated with physician assessment; however, volume underestimation and erroneous segmentations may impact radiotherapy treatment planning and response assessment. Further training on a representative local dataset would likely be required for multicenter implementation.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775622","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":"212Bi-Macroaggregated Albumin Inhibited Mouse Melanoma Growth by Regulating Cell Cycle Checkpoint Markers Without Promoting Living Cell Repopulation","authors":"Satyendra Kumar Singh, Nathan Kauffman, Isabelle Maria Lynch, Zeynep Meral Kunt, Kurt R. Zinn, Dalen Agnew, Jinda Fan","doi":"10.2967/jnumed.124.269190","DOIUrl":"https://doi.org/10.2967/jnumed.124.269190","url":null,"abstract":"<p>Radiotherapy using an α-particle emitting radionuclide has emerged as a promising candidate for cancer treatment; however, the efficacy of ²¹²Bi for mouse melanoma treatment has not yet been studied. Here, we evaluated the efficacy of ²¹²Bi-labeled macroaggregated albumin (MAA) in delivering radiation to mouse melanoma cells in vitro and in vivo. <strong>Methods:</strong> The efficacy of ²¹²Bi efficacy in killing melanoma cells was assessed by in vitro clonogenic and cell survival assays. Immunoblot assays were used to investigate downstream pathways, radioresistance, and epithelial-to-mesenchymal markers. We assessed melanoma cells’ repopulation using a conditioned medium (CM; 50%) from ²¹²Bi-MAA–irradiated B16F10 cells. ²¹²Bi-MAA was intratumorally injected in B16F10 melanoma–bearing C57BL/6 mice to study the efficacy, stability, and internal organ toxicity of ²¹²Bi-MAA. <strong>Results:</strong> ²¹²Bi-MAA effectively killed and inhibited the clonogenic capacity of B16F10 cells. Furthermore, ²¹²Bi-MAA induced the expression of DNA damage (γH2AX) and cell death (cleaved caspase-3) markers, which was at maximum at a dose of 3.7 MBq. Cell cycle checkpoint markers (ATR, Chk1, and Wee1) were also elevated after ²¹²Bi treatment; however, these were reduced at 3.7 MBq compared with 0.93- and 1.85-MBq doses. Minimal to no upregulation of radioresistance (Trex1 and STAT1), cancer stemness (Nanog), and epithelial–mesenchymal transition (E-cadherin, N-cadherin, and Vimentin) markers was found after ²¹²Bi-MAA treatment. CM from ²¹²Bi-MAA–irradiated B16F10 cells did not alter the cell proliferation, colony-forming, and migration capacity of living B16F10 cells. CM did not change epithelial–mesenchymal transition and cell proliferation marker expression. Studies in mice showed that ²¹²Bi-MAA was retained in B16F10 tumors and effectively reduced tumor growth in vivo without causing toxicity. <strong>Conclusion:</strong> These findings suggested that ²¹²Bi-MAA was an effective therapy for mouse melanoma and did not induce factors that aid melanoma repopulation.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775623","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":"Validating the Utility of Supervised Clustering Algorithm for Precise [11C]DPA-713 PET Brain Image Quantification","authors":"Youjin Lee, Thanh D. Nguyen, Yong Du, Jennifer M. Coughlin, Sara A. Zein, Nicolas A. Karakatsanis, Sadek Nehmeh, Martin G. Pomper, Susan A. Gauthier, Yeona Kang","doi":"10.2967/jnumed.124.268519","DOIUrl":"https://doi.org/10.2967/jnumed.124.268519","url":null,"abstract":"<sec><st>Visual Abstract</st><p><fig loc=\"float\"><link locator=\"jnumed.124.268519absf1\"></fig></p></sec>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"216 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775620","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":"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}