The Journal of Nuclear Medicine最新文献

{"title":"Evaluation of a Sensitive Visual Read Algorithm for Assessing 3R/4R Tau PET Images","authors":"Ruben Smith, Valentina Garibotto, Douglas Hägerström, Jonas Jögi, Tomas Ohlsson, Olof Strandberg, Matteo Tonietto, Shorena Janelidze, Sebastian Palmqvist, Erik Stomrud, Gregory Klein, Oskar Hansson","doi":"10.2967/jnumed.125.269685","DOIUrl":"https://doi.org/10.2967/jnumed.125.269685","url":null,"abstract":"<sec><st>Visual Abstract</st><p><fig loc=\"float\"><link locator=\"jnumed.125.269685absf1\"></fig> </p></sec>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996012","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":"Noninvasive Monitoring of Inflammatory Processes by Myeloid Cell–Directed PET Tracers in an Experimental Severe Acute Respiratory Syndrome Coronavirus 2 Infection Model","authors":"Marieke A. Stammes, Gerrit Koopman, Teresa R. Wagner, Bjoern Traenkle, Philipp D. Kaiser, Petra Mooij, Nicole van der Werff, Roja Fidel Acar, Kinga P. Böszörményi, Simone Blaess, Stefania Pezzana, Gerald Reischl, Andreas Maurer, Jan A.M. Langermans, Ulrich Rothbauer, Manfred Kneilling, Dominik Sonanini","doi":"10.2967/jnumed.125.269721","DOIUrl":"https://doi.org/10.2967/jnumed.125.269721","url":null,"abstract":"<sec><st>Visual Abstract</st><p><fig loc=\"float\"><link locator=\"jnumed.125.269721absf1\"></fig></p></sec>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916127","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 Performance of the 68Ga-Labeled Minigastrin Analog DOTA-MGS5 in Patients with Advanced Medullary Thyroid Cancer and Other Neuroendocrine Tumors","authors":"Christian Uprimny, Elisabeth von Guggenberg, Anna Sviridenko, Steffen Bayerschmidt, Lisa Maria Rossetti, Hessamoddin Roustaei, Boris Warwitz, Hanno Ulmer, Angelika Hutter, Gianpaolo di Santo, Irene J. Virgolini","doi":"10.2967/jnumed.125.269863","DOIUrl":"https://doi.org/10.2967/jnumed.125.269863","url":null,"abstract":"<p>A prospective phase 1/2a pilot study (NCT06155994) was performed at our center to compare the diagnostic performance of cholecystokinin-2 receptor (CCK2R) PET/CT imaging with the ⁶⁸Ga-labeled peptide analog DOTA-DGlu-Ala-Tyr-Gly-Trp-(N-Me)Nle-Asp-1-Nal-Phe-NH₂ (⁶⁸Ga-DOTA-MGS5) with that of the reference standard PET/CT. <strong>Methods:</strong> Six patients with advanced medullary thyroid cancer (MTC) and 6 patients with other neuroendocrine tumors (NETs)—4 with gastroenteropancreatic (GEP) NETs and 2 with bronchopulmonary (BP) NETs—were included in the study. All patients had known metastases, documented by ⁶⁸Ga-DOTATOC and ¹⁸F-DOPA PET/CT. Intensity of tracer accumulation (SUV_max/SUV_mean) of normal tissue and lesions judged malignant was compared with standard PET imaging (number of lesions, uptake per lesion). <strong>Results:</strong> When compared with standard imaging, ⁶⁸Ga-DOTA-MGS5 showed significantly increased blood-pool activity (<em>P</em> ≤ 0.009), with improved lesion contrast at 2 h after injection compared with 1 h after injection. Four of 6 patients with MTC had positive lesions on ⁶⁸Ga-DOTA-MGS5 PET/CT. Fifty-one lesions were detected with ¹⁸F-DOPA versus 48 with ⁶⁸Ga-DOTA-MGS5, with a significantly higher mean SUV_max of 7.2 at 1 h and 2 h after injection versus 4.7 with ¹⁸F-DOPA (<em>P</em> &lt; 0.001). In the 2 patients with MTC imaged with ⁶⁸Ga-DOTATOC and ⁶⁸Ga-DOTA-MGS5, the same total number of lesions (<em>n</em> = 14) was detected (mean SUV_max, 24.3 vs. 17.4 and 18.7 at 1 and 2 h after injection, respectively; <em>P</em> &gt; 0.5). In patients with non-MTC NETs, 26 CCK2R-positive lesions were confirmed for 2 patients with BP-NETs compared with 45 lesions visualized with ⁶⁸Ga-DOTATOC. In the 4 patients with GEP-NETs, only 1 of 21 lesions displaying positive uptake on ⁶⁸Ga-DOTATOC PET/CT was visualized with ⁶⁸Ga-DOTA-MGS5 (an ileal NET), whereas the lesions in the other 3 patients were negative on ⁶⁸Ga-DOTA-MGS5 PET/CT. <strong>Conclusion:</strong> CCK2R PET/CT using ⁶⁸Ga-DOTA-MGS5 showed a high tumor lesion detection rate in patients with MTC, with lesion uptake values comparable to those with ¹⁸F-DOPA and ⁶⁸Ga-DOTATOC. In patients with non-MTC NETs, ⁶⁸Ga-DOTA-MGS5 PET/CT showed possible applicability in patients with BP-NETs, which needs to be verified in a larger patient cohort. In contrast, ⁶⁸Ga-DOTA-MGS5 PET/CT seemed to be of limited value in patients with GEP-NETs.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916167","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":"Randomized Phase 2 Trial of an Extended and Flexible Dosing Schedule of 177Lu-PSMA Molecular Radiotherapy in Patients with Metastatic Castration-Resistant Prostate Cancer (FLEX-MRT): Study Protocol","authors":"Adrien Holzgreve, Astrid Delker, Zachary Ells, Julia Brosch-Lenz, Lena M. Unterrainer, John Nikitas, Shaojun Zhu, Maria M. Contreras, Hamzah Alam, Rejah M. Nabong, Stephanie Lira, Arseniy Vasilyev, Lillian Chen, Tristan Grogan, David Elashoff, Catherine A. Meyer, Magnus Dahlbom, Johannes Czernin, Jérémie Calais","doi":"10.2967/jnumed.125.269495","DOIUrl":"https://doi.org/10.2967/jnumed.125.269495","url":null,"abstract":"<p>[¹⁷⁷Lu]Lu-PSMA-617 radiopharmaceutical therapy has been approved for the treatment of men with metastatic castration-resistant prostate cancer (mCRPC) using a fixed dosing schedule of once every 6 wk for up to a total of 6 doses. We hypothesized that patients may benefit from a flexible and extended dosing schedule, up to 12 doses with potential \"treatment holiday\" periods. <b>Objective:</b> The objective of this study is to determine the 2-y survival rate of patients with mCRPC treated with an extended and flexible dosing schedule of [¹⁷⁷Lu]Lu-PSMA-617 therapy in comparison to patients treated with the standard fixed dosing schedule of a maximum of 6 treatment cycles once every 6 wk. <b>Study Design:</b> The FLEX-MRT trial is an investigator-initiated prospective phase 2, parallel group, randomized, controlled, open-label, single-center trial in men with mCRPC to determine the efficacy of a flexible and extended dosing schedule of [¹⁷⁷Lu]Lu-PSMA-617 therapy. Key inclusion criteria are patients eligible for Pluvicto (i.e., prior androgen receptor signaling inhibitors, prior chemotherapy, PSMA PET VISION criteria). Key exclusion criteria are prior [¹⁷⁷Lu]Lu-PSMA-617 therapy and less than 6 wk since last myelosuppressive therapy. The trial aims to centrally randomize 90 patients in a 1:1 ratio to 2 treatment arms. In the control arm, patients will be treated with the approved standard dosing schedule (<I>n</I> = 45). In the investigational arm, patients will be treated with up to 12 cycles and with potential treatment holidays depending on response (<I>n</I> = 45). Response assessment is based on SPECT/CT at each cycle and on PSMA PET/CT during treatment holiday periods (every 12 wk). Primary endpoint is the 2-y survival rate. Survival is calculated from the date of the first cycle of [¹⁷⁷Lu]Lu-PSMA-617 therapy. Secondary endpoints include safety by Common Terminology Criteria for Adverse Events and dosimetry and determination of overall and progression-free survival (evidence of progression as defined by radiographic, prostate-specific antigen level, or clinical progression, or death from any cause).</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"106 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916128","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":"Impact of Ultrahigh Sensitivity and Continuous Bed Motion on Performance Characteristics of Biograph Vision Quadra PET/CT","authors":"Mostafa Roya, Charalampos Tsoumpas, Johannes H. van Snick, Viet Dao, Antoon T.M. Willemsen, Riemer H.J.A. Slart, Ronald Boellaard, Andor W.J.M. Glaudemans, Joyce van Sluis","doi":"10.2967/jnumed.125.270078","DOIUrl":"https://doi.org/10.2967/jnumed.125.270078","url":null,"abstract":"<p>Continuous bed motion (CBM) for long–axial-field-of-view PET/CT enables swift total-body examination of patients. However, the sensitivity profile along the axial field of view (AFOV) varies significantly, and its effect on image quality when combined with CBM remains unexplored. This study assesses the effects of ultrahigh sensitivity (UHS) and CBM on recovery coefficients (RCs) and spatial resolution (SR). <strong>Methods:</strong> Phantom measurements, performed in static bed and CBM acquisition with different bed speeds (3.5, 7, 14, and 30 mm/s), were reconstructed for both high-sensitivity (HS) and UHS modes, and their quality was assessed using the RC and full width at half maximum of the point-spread function. In addition, 7 clinically referred oncologic patients underwent a combined CBM and UHS [¹⁸F]FDG PET/CT scan. Metrics derived from lesions and healthy tissues were compared across acquisition modes. <strong>Results:</strong> Mean RC was lower in both UHS (&lt;4.2%) and CBM (&lt;5.9%) than with HS and static acquisitions, respectively. SR in UHS was slightly deteriorated in the central plane of the AFOV (full width at half maximum difference range, 0.06–0.21 mm) but remained comparable toward the edge (full width at half maximum difference range, 0.03–0.07 mm) to SR in HS. In addition, for CBM, SR differences were negligible (full width at half maximum difference, &lt;0.13 mm). SUVs in healthy tissues (<em>r</em>² &gt; 0.94) and lesions (<em>r</em>² &gt; 0.99) showed excellent correlation. The coefficient of variation was significantly different for the liver. <strong>Conclusion:</strong> Elaborate protocols using UHS and CBM could be a step toward swift total-body PET care with only a marginal increase in noise. CBM allows a larger part of the body to be examined and helps to mitigate substantial sensitivity differences along the AFOV, albeit at the cost of slightly lower RC.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916169","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":"[44Sc]Sc-CHX-A″-DTPA-RCCB6: A PET Tracer for Imaging CD70 Expression Across Latency Types of Burkitt Lymphoma","authors":"Xiaoyan Li, Yajie Zhao, Jessica C. Hsu, Eduardo A. Sarduy, Todd E. Barnhart, Jonathan W. Engle, Weijun Wei, Shuo Hu, Weibo Cai","doi":"10.2967/jnumed.125.269991","DOIUrl":"https://doi.org/10.2967/jnumed.125.269991","url":null,"abstract":"<p>CD70 is a promising target for advancing the diagnosis and treatment of Burkitt lymphoma (BL). A ⁴⁴Sc-labeled single-domain antibody fragment tracer, [⁴⁴Sc]Sc-CHX-A″-DTPA-RCCB6, was developed and assessed for its potential in CD70-targeted immuno-PET imaging using BL models. <strong>Methods:</strong> RCCB6 single-domain antibody was conjugated with CHX-A″-DTPA and radiolabeled with ⁴⁴Sc. The final tracer, [⁴⁴Sc]Sc-CHX-A″-DTPA-RCCB6, was assessed for stability both in vitro and in vivo. Cellular uptake, binding, and internalization assays were conducted using type III and type I latency BL cell lines to confirm the tracer’s specificity for CD70. Immuno-PET and biodistribution studies were performed in type III and type I latency BL models, whereas near-infrared fluorescence imaging was used to validate tumor accumulation. Finally, immunohistochemistry analysis was conducted on tumor tissues from both latency types to correlate between tracer accumulation and CD70 expression. <strong>Results:</strong> Radiolabeling of CHX-A″-DTPA-RCCB6 with ⁴⁴Sc achieved high radiochemical yield and specific activity. The tracer was highly stable both in vitro and in vivo. In vitro cellular uptake and internalization assays confirmed the specific binding of [⁴⁴Sc]Sc-CHX-A″-DTPA-RCCB6 to CD70 in type III latency BL cells. An inhibitory concentration of 50% of 16.45 ± 2.82 nM for RCCB6 and 38.74 ± 4.66 nM for CHX-A″-RCCB6 was determined from competition binding studies. Saturation binding studies determined the maximum number of binding sites, the association constant, and receptor density values for [⁴⁴Sc]Sc-CHX-A″-DTPA-RCCB6 in type III latency BL cells to be 4.83 ± 0.52 pM, 19.75 ± 5.97 nM, and (2.36 ± 0.26) × 10⁶ receptors per cell, respectively. Immuno-PET imaging and ex vivo biodistribution revealed high tracer accumulation in type III latency BL tumors, with sustained retention up to 6 h after injection (2.85 ± 0.84 %ID/g). Tracer uptake was minimal in both the blocked group and in type I latency BL tumors, with values of 0.35 ± 0.03 %ID/g and 0.58 ± 0.16 %ID/g, respectively. Near-infrared fluorescence imaging further confirmed tracer accumulation in type III latency BL tumors. Immunohistochemistry analysis supported these results, showing more intense CD70 staining in type III latency BL tumors compared with type I latency BL tumors. <strong>Conclusion:</strong> This work highlights the robust capability of [⁴⁴Sc]Sc-CHX-A″-DTPA-RCCB6 in delineating differential CD70 expression in BL models, demonstrating promising findings that underscore the necessity for clinical studies to validate its translational potential.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916170","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":"Combining PSMA-Targeted Radiopharmaceutical Therapy with Immunotherapy","authors":"Betül Altunay, Laura Schäfer, Agnieszka Morgenroth, Quim Peña, Twan Lammers, Matthias Saar, Felix M. Mottaghy, Susanne Lütje","doi":"10.2967/jnumed.125.270317","DOIUrl":"https://doi.org/10.2967/jnumed.125.270317","url":null,"abstract":"<p>PSMA-targeted radiopharmaceutical therapy (RPT) is a standard treatment for metastatic castration-resistant prostate cancer (PCa), exploiting PSMA overexpression to deliver cytotoxic radiation. Treatment with the β-emitter [¹⁷⁷Lu]Lu-PSMA-617, approved in 2022, has been associated with prolonged progression-free and overall survival in patients with PCa. However, resistance and heterogeneous patient responses limit its efficacy. Although immunotherapy is effective in several malignancies, PCa’s immunosuppressive microenvironment often reduces its impact. Combining targeted RPT with immune checkpoint inhibitors, particularly programmed cell death protein 1 and programmed cell death ligand 1 inhibitors, may enhance antitumor responses. This review explores the rationale behind this combination, evaluates preclinical and clinical evidence, and discusses future directions for integrating immune checkpoint blockade with targeted RPT.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916173","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":"High-Resolution Positronium Lifetime Tomography at Clinical Activity Levels on the PennPET Explorer","authors":"Bangyan Huang, Bing Dai, Suzanne E. Lapi, Grace Liles, Joel S. Karp, Jinyi Qi","doi":"10.2967/jnumed.125.270130","DOIUrl":"https://doi.org/10.2967/jnumed.125.270130","url":null,"abstract":"<p>The objective of this study is to demonstrate high-resolution positronium lifetime tomography using a 3-dimensional phantom with multiple radioisotopes at activity levels relevant to human imaging. <strong>Methods:</strong> A cylinder phantom was constructed with a 6-mm thick polycarbonate slab inserted at its center. The phantom was filled with radioactive solutions and scanned in the PennPET Explorer scanner, a long–axial-field-of-view scanner with high sensitivity. Four scans were conducted with 3 different radioisotopes at varying activity levels: ⁸²Rb (240 MBq), ⁶⁸Ga (110 MBq), and ⁴⁴Sc (7.4 and 40.7 MBq). The average positron lifetime images were reconstructed with correction for random events. Radial and axial resolutions were measured from lifetime profiles across a hole on the slab and through the slab, respectively. <strong>Results:</strong> The polycarbonate slab was resolvable in all reconstructed positron lifetime images and showed a lifetime longer than that in water. The lifetime images from ⁸²Rb and ⁶⁸Ga were noisy because of their low prompt γ yields and high random fractions, whereas noise was substantially reduced in the ⁴⁴Sc images. The average lifetime estimates were consistent across the 4 scans. The estimated radial and axial resolutions were 3.7 ± 1.8 mm and 3.9 ± 0.4 mm, respectively. <strong>Conclusion:</strong> This study successfully demonstrated the feasibility of high-resolution positronium lifetime tomography using ⁸²Rb, ⁶⁸Ga, and ⁴⁴Sc on the PennPET Explorer.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"27 1","pages":"jnumed.125.270130"},"PeriodicalIF":0.0,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899160","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":"Prospective Multicenter Evaluation of [11C]Methionine PET/MRI Sensitivity Compared with MRI for Localizing Small Pituitary Neuroendocrine Tumor or Pituitary Adenoma in Cushing Disease","authors":"Anthime Flaus, Elise Levigoureux, Julie Haesebaert, Claire Briet, Frederic Castinetti, Justine Cristante, Delphine Drui, Natacha Germain, Luigi Maione, Frederic Illouz, Emmanuel Sonnet, Igor Tauveron, Ines Merida, Sophie Lancelot, Nicolas Costes, Alexandre Vasiljevic, Lucien Marchand, Sylvie Rode, Mireille Bertholon-Gregoire, Guillaume Criton, Véronique Lapras, François Cotton, Emmanuel Jouanneau, Claire Bournaud, Gerald Raverot","doi":"10.2967/jnumed.124.269392","DOIUrl":"https://doi.org/10.2967/jnumed.124.269392","url":null,"abstract":"<sec><st>Visual Abstract</st><p><fig loc=\"float\"><link locator=\"jnumed.124.269392absf1\"></fig></p></sec>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"22 1","pages":"jnumed.124.269392"},"PeriodicalIF":0.0,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899141","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":"When Age Is More Than a Number: Acceleration of Brain Aging in Neurodegenerative Diseases","authors":"Elena Doering, Merle C. Hoenig, James H. Cole, Alexander Drzezga","doi":"10.2967/jnumed.125.270325","DOIUrl":"https://doi.org/10.2967/jnumed.125.270325","url":null,"abstract":"<p>Aging of the brain is characterized by deleterious processes at various levels including cellular/molecular and structural/functional changes. Many of these processes can be assessed in&nbsp;vivo by means of modern neuroimaging procedures, allowing the quantification of brain age in different modalities. Brain age can be measured by suitable machine learning strategies. The deviation (in both directions) between a person&rsquo;s measured brain age and chronologic age is referred to as the brain age gap (BAG). Although brain age, as defined by these methods, generally is related to the chronologic age of a person, this relationship is not always parallel and can also vary significantly between individuals. Importantly, whereas neurodegenerative disorders are not equivalent to accelerated brain aging, they may induce brain changes that resemble those of older adults, which can be captured by brain age models. Inversely, healthy brain aging may involve a resistance or delay of the onset of neurodegenerative pathologies in the brain. This continuing education article elaborates how the BAG can be computed and explores how BAGs, derived from diverse neuroimaging modalities, offer unique insights into the phenotypes of age-related neurodegenerative diseases. Structural BAGs from T1-weighted MRI have shown promise as phenotypic biomarkers for monitoring neurodegenerative disease progression especially in Alzheimer disease. Additionally, metabolic and molecular BAGs from molecular imaging, functional BAGs from functional MRI, and microstructural BAGs from diffusion MRI, although researched considerably less, each may provide distinct perspectives on particular brain aging processes and their deviations from healthy aging. We suggest that BAG estimation, when based on the appropriate modality, could potentially be useful for disease monitoring and offer interesting insights concerning the impact of therapeutic interventions.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"27 1","pages":"jnumed.125.270325"},"PeriodicalIF":0.0,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899198","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}