World Journal of Nuclear Medicine最新文献

{"title":"Uneven Global Distribution of Theranostics.","authors":"Kalevi Kairemo, Akram Al-Ibraheem","doi":"10.1055/s-0046-1824537","DOIUrl":"10.1055/s-0046-1824537","url":null,"abstract":"","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"25 2","pages":"101-102"},"PeriodicalIF":1.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limited Added Prognostic Value of Choline PET/CT in Treatment-Naïve Hepatocellular Carcinoma.","authors":"Irina Vierasu, Hugo Levillain, Martina Pezzullo, Jennifer Dhont, Hugues Azema, Hugo Couvert, Clémentine Marin, Nicola Trotta, Simon Lacroix, Ana-Maria Bucalau, Gontran Verset, Anne Demols, Marianne Paesmans, Desislava Germanova, Valerio Lucidi, Eric Trépo, Thierry Gustot, Christophe Moreno, Jean-Luc Van Laethem, Patrick Flamen","doi":"10.1055/s-0046-1824460","DOIUrl":"10.1055/s-0046-1824460","url":null,"abstract":"<p><strong>Background: </strong>This retrospective study aimed to assess whether choline PET/CT provides additional independent prognostic value compared with magnetic resonance imaging (MRI) and [ ¹⁸ F]FDG PET/CT in treatment-naïve patients with hepatocellular carcinoma (HCC). A total of 78 treatment-naïve patients with predominantly single-lesion and early-stage HCC who underwent MRI, [ ¹⁸ F]FDG PET/CT, and choline PET/CT were retrospectively included.</p><p><strong>Results: </strong>Higher than median MRI-, choline and [ ¹⁸ F]FDG PET/CT-derived tumor volumes were associated with poorer overall survival (OS) in univariate analyses. An MRI-derived tumor volume > 17.81 mL was associated with worse OS ( <i>p</i>  = 0.005; hazard ratio [HR], 3.15; 95% confidence interval [CI], 1.41-7.03), as were choline PET/CT tumor volume > 8.4 mL ( <i>p</i>  = 0.04; HR, 2.27; 95% CI, 1.03-5.01) and [ ¹⁸ F]FDG positivity ( <i>p</i>  = 0.02; HR, 2.74; 95% CI, 1.11-6.81). After multivariate analysis with correction for multiple testing, only MRI-derived tumor volume remained an independent predictor of OS. Although associated with OS in univariate analyses, choline PET-derived metrics did not retain statistical significance after adjustment, suggesting limited incremental prognostic information beyond MRI-derived tumor burden. Liver transplantation and hepatectomy were associated with superior survival compared with locoregional therapies ( <i>p</i>  = 0.006). No significant correlations were observed between imaging parameters and α-fetoprotein (AFP) levels or ALBI score (all <i>p</i>  > 0.05). Interaction analyses did not detect any significant modification of the prognostic effect of choline PET imaging biomarkers by AFP levels, ALBI score, or Child-Pugh class. Treatment modality emerged as the strongest prognostic factor in the penalized model using least absolute shrinkage and selection operator regularization, while choline PET-derived parameters did not show independent prognostic value.</p><p><strong>Conclusion: </strong>Choline PET/CT did not demonstrate additional independent prognostic value beyond MRI or [ ¹⁸ F]FDG PET/CT in this cohort of treatment-naïve patients with predominantly early-stage and single-lesion HCC.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"25 3","pages":"208-218"},"PeriodicalIF":1.0,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Side Effects of rhTSH-Aided Radioiodine Ablation and Treatment of Differentiated Thyroid Cancer: A Real-World Experience.","authors":"Ismaheel O Lawal, Priya D John, Margaret Lim, Ashley Bridges, Gbenga O Popoola, Saima Muzahir","doi":"10.1055/s-0046-1823122","DOIUrl":"10.1055/s-0046-1823122","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to investigate the early side effects of recombinant human thyroid-stimulating hormone (rhTSH)-aided radioactive iodine (RAI) administration in an unselected cohort of patients with differentiated thyroid cancer (DTC) in the real-world setting.</p><p><strong>Methods: </strong>During follow-up (at 6 weeks, 6 months, and 12 months post-RAI) of patients with DTC who received rhTSH-aided RAI, we used a standardized questionnaire to collect patient-reported side effects of RAI. We investigated the factors that impact the occurrence of RAI-associated side effects.</p><p><strong>Results: </strong>A total of 111 patients with a female predominance (66.7%) and a mean age of 51.1 ± 16.0 years were included, including 13 patients (11.7%) who had previously received RAI. The predominant tumor histology was papillary thyroid cancer, with 91.0% of patients having stage I/II disease. At 6-week follow-up, loss of taste/smell, nausea, salivary gland pain or swelling, dry mouth, and neck pain were reported by 45.9, 37.8, 30.6, 36.9, and 20.7% of patients, respectively. In most patients, these side effects lasted for less than 1 week. At 6-month post-RAI, 13 patients reported lingering RAI-associated side effects, including 4 and 3 patients who reported dry mouth and dry eyes, respectively. A 12-month post-RAI, one patient each reported dry eyes, watery eyes, and fatigue as RAI side effects. Women were at higher risk of neck pain, while young patients were more likely to experience nausea ( <i>p</i>  < 0.05).</p><p><strong>Conclusion: </strong>rhTSH-aided RAI administration in DTC patients is associated with tolerable side effects, most of which resolved within weeks of treatment.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"25 2","pages":"128-135"},"PeriodicalIF":1.0,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival Insights in Locally Advanced Gallbladder Cancer: The Role of ¹⁸ F-FDG PET/CT.","authors":"Shantanu Pande, Zaeba Nayeem, Nihit Mhatre, Abhishek Gawande, Jyoti Ranjan Swain","doi":"10.1055/s-0046-1824336","DOIUrl":"10.1055/s-0046-1824336","url":null,"abstract":"<p><strong>Background: </strong>Gallbladder carcinoma (GBC) is an aggressive malignancy with a poor prognosis, often diagnosed at a locally advanced stage. Accurate risk stratification is crucial for optimizing treatment, yet conventional imaging and staging systems have limitations. This study aimed to evaluate the prognostic value of metabolic and volumetric parameters from ¹⁸ F-fluorodeoxyglucose positron emission tomography/computed tomography ( ¹⁸ F-FDG PET/CT) in patients with locally advanced GBC.</p><p><strong>Methods: </strong>This retrospective study included 32 patients with biopsy-confirmed, locally advanced GBC who underwent baseline ¹⁸ F-FDG PET/CT. The standard uptake values (SUVmax, SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured for both primary tumors and nodal metastases. A univariate Cox proportional hazards model was used to assess the association between these volumetric metabolic PET parameters and progression-free survival (PFS) and overall survival (OS). The multivariate Cox model was used to test the independence of significant univariate prognostic factors.</p><p><strong>Results: </strong>In the univariate analysis of volumetric metabolic PET parameters of primary tumors, higher pSUVmean (hazard ratio [HR]: 1.39, <i>p</i>  = 0.04), pTLG2.5 (per 100 units; HR: 1.01, <i>p</i>  = 0.02), pMTV40 (HR: 1.00, <i>p</i>  = 0.02), and pTLG40 (per 100 units; HR: 1.09, <i>p</i>  = 0.01) were all significantly associated with worse OS. Similar significant associations were found for PFS. Notably, the conventional metric of pSUVmax was not a significant predictor of either PFS ( <i>p</i>  = 0.11) or OS ( <i>p</i>  = 0.25). On multivariate analysis, pTLG40 remained an independent predictor of survival. Furthermore, none of the volumetric metabolic PET parameters derived from nodal metastases showed a significant association with survival outcomes.</p><p><strong>Conclusion: </strong>Volumetric metabolic PET parameters, particularly TLG and MTV, which reflect the total metabolic burden of the primary tumor, may offer greater prognostic utility in locally advanced GBC compared with the conventional SUVmax. These parameters should be considered for integration into prognostic models to enhance patient risk stratification and guide personalized therapeutic strategies.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"25 2","pages":"121-127"},"PeriodicalIF":1.0,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Status of Nuclear Medicine in Nepal: Current Infrastructure, Challenges, and Future Perspectives.","authors":"Ajay Kumar Yadav, Om Prakash Yadav, Birendra Yadav, Amardeep Chaudhary, Ganga D Adhikari, Bibekanand Aarya, Manish Tiwari","doi":"10.1055/s-0046-1823001","DOIUrl":"10.1055/s-0046-1823001","url":null,"abstract":"<p><strong>Background: </strong>Nuclear medicine is an integral part of medical practice in Nepal. This article reports on the current infrastructure, human resources, training, and research related to nuclear medicine in Nepal.</p><p><strong>Methods: </strong>A questionnaire was sent to all nuclear medicine services in Nepal to collect data on the number and types of imaging devices, staffing, and procedures conducted in 2025. In addition, nuclear medicine-related publications were extracted from relevant research portals.</p><p><strong>Results: </strong>Nepal, a lower middle-income country of 30 million inhabitants, has nine nuclear medicine departments equipped with four single-photon emission computed tomography (SPECT), two SPECT/CT (computed tomography), and three positron emission tomography/CT (PET/CT) scanners. In 2025, nearly 200 scans per month were performed at each center with a gamma camera, whereas ∼100 PET/CT cases per month were performed at centers equipped with PET/CT scanners. A total of approximately 50 radionuclide therapy cases per month, mainly comprising I-131 therapies, were performed at centers with gamma cameras. Staff members include 9 MD nuclear medicine physicians, 3 MSc nuclear medicine technologists, 20 radiological technologists involved in nuclear medicine services, and a few staff nurses, although resources are unevenly distributed. Research output has increased substantially since 2020, often in collaboration with international institutions.</p><p><strong>Conclusion: </strong>Nepal has a relatively advanced nuclear medicine infrastructure supported by public investment, government regulation, international collaboration, and education. However, challenges remain in service expansion, workforce shortages, research development, and equitable access. If these challenges are addressed, Nepal could serve as a compelling model for improving nuclear medicine services in least-developed countries.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"25 2","pages":"149-155"},"PeriodicalIF":1.0,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¹⁸ F-OC PET/CT Localization of a Phosphaturic Mesenchymal Tumor Presenting with Tumor-Induced Osteomalacia.","authors":"Haifeng Hou, Lijun Zhang, Xiaofeng Zhou","doi":"10.1055/s-0046-1823003","DOIUrl":"10.1055/s-0046-1823003","url":null,"abstract":"<p><p>Phosphaturic mesenchymal tumor (PMT) is an uncommon neoplasm and the leading cause of tumor-induced osteomalacia (TIO). We report a 55-year-old woman with a 2-year history of progressive hip pain and hypophosphatemia. Laboratory findings demonstrated renal phosphate wasting. Conventional imaging revealed a small soft-tissue nodule in the right thigh, and ¹⁸ F-AlF-NOTA-octreotide (18F-OC) PET/CT (positron emission tomography/computed tomography) showed intense radiotracer uptake, accurately localizing the culprit lesion. Surgical excision confirmed a PMT, and serum phosphate levels normalized postoperatively with resolution of symptoms. This case highlights the diagnostic value of ¹⁸ F-OC PET/CT in detecting small PMTs and underscores the importance of considering TIO in patients with persistent hypophosphatemia and unexplained musculoskeletal symptoms.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"25 3","pages":"255-257"},"PeriodicalIF":1.0,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Positron Emission Tomography Myocardial Perfusion Imaging: Seeing Beyond Perfusion.","authors":"Maseeh Uz Zaman, Nosheen Fatima, Sidra Zaman, Rabiya Fatima Hashmi","doi":"10.1055/s-0046-1823006","DOIUrl":"10.1055/s-0046-1823006","url":null,"abstract":"<p><p>Positron emission tomography (PET) myocardial perfusion imaging (MPI) is a highly accurate noninvasive modality for evaluating coronary artery disease due to its excellent sensitivity and specificity, excellent image quality, efficient imaging protocol, and significantly lower radiation exposure. Its ability to absolutely quantify myocardial blood flow (MBF), MBF-R, and left ventricular ejection fraction-reserve also strengthens its diagnostic and prognostic properties and guides physicians about the justification for coronary revascularization. Presence of coronary artery calcification on the CT component indicates atherosclerosis, and its presence with normal PET MPI indicates subclinical nonobstructive coronaries and warrants risk factor medication to avoid future major adverse cardiac events. Metabolic imaging with FDG PET is considered the gold standard for diagnosing hibernating myocardium and helps in the management of sarcoidosis and infection of the cardiovascular system and implanted devices. However, the huge upfront and operational costs are the primary factors for the limited availability of PET MPI.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"25 2","pages":"103-106"},"PeriodicalIF":1.0,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Metastasis of Grade 1 Meningioma Mimicking a Carcinoid Tumor: A Case Report with FDG PET/CT, Ga-68 DOTATATE PET/CT, and Pathological Confirmation.","authors":"Xavier Rabbath, Cheng-Han Shih, Marc-André Morin","doi":"10.1055/s-0046-1822664","DOIUrl":"10.1055/s-0046-1822664","url":null,"abstract":"<p><p>Meningioma metastasis is a rare complication of a common condition. This case report describes the first known instance of detection on both Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) and DOTA-(Tyr ³ )-octreotate Positron Emission Tomography (DOTATATE-PET) of a pulmonary metastasis from grade I meningioma. A 68-year-old woman with grade I meningioma showed a pulmonary lesion post-surgery, with FDG-PET showing mild hypermetabolism and DOTATATE-PET revealing intense uptake, consistent with a well-differentiated carcinoid tumor. However, histopathological analysis confirmed grade I meningioma metastasis. This case highlights DOTATATE-PET's potential in screening for metastases, even in grade I meningiomas.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"25 3","pages":"262-265"},"PeriodicalIF":1.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observation on Discordant Treatment Response on [ ¹⁸ F]FDG and [ ⁶⁸ Ga]Ga-FAPI-04 PET/CT in Radioiodine-Refractory Thyroid Carcinoma Treated with Lenvatinib.","authors":"Rangat Bagasariya, Sunita Sonavane, Sandip Basu","doi":"10.1055/s-0046-1822663","DOIUrl":"10.1055/s-0046-1822663","url":null,"abstract":"<p><strong>Background: </strong>Dual-tracer positron emission tomography/computed tomography (PET/CT) using [ ¹⁸ F]FDG and fibroblast activation protein inhibitor (FAPI) provides complementary metabolic and stromal information in radioiodine-refractory differentiated thyroid carcinoma (DTC). However, response patterns during systemic therapy remain incompletely understood.</p><p><strong>Case: </strong>A 60-year-old male with papillary thyroid carcinoma (pT2 pN1a pM0) underwent total thyroidectomy and bilateral neck dissection. After defaulting from follow-up, he developed diffuse pulmonary and mediastinal metastases. Following one therapeutic dose of 200 mCi (7.4 GBq) [ ¹³¹ I], the disease became radioiodine-refractory (thyroglobulin-elevated negative iodine scintigraphy syndrome). Baseline Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography ([ ¹⁸ F]FDG PET/CT) demonstrated hypermetabolic pulmonary and mediastinal metastases. Gallium-68 fibroblast activation protein inhibitor Positron Emission Tomography/Computed Tomography ([ ⁶⁸ Ga]Ga-FAPI-04 PET/CT) performed the following day showed corresponding fibroblast activation protein expression without discordant lesions, although there was a low expression profile of [ ⁶⁸ Ga]Ga-FAPI-04 PET/CT observed at the baseline compared with the [ ¹⁸ F]FDG PET/CT. After 10 months of lenvatinib (14 mg once daily), [ ¹⁸ F]FDG PET/CT demonstrated stable metabolic disease according to PERCIST 1.0 criteria, whereas [ ⁶⁸ Ga]Ga-FAPI-04 PET/CT showed marked reduction of FAP expression in mediastinal nodes and several pulmonary nodules. Serum thyroglobulin decreased from 574 ng/mL to 457 ng/mL without anti-thyroglobulin antibody interference. The multidisciplinary team classified the case as stable disease based on persistent FDG avidity.</p><p><strong>Conclusion: </strong>Discordant response patterns between FDG and FAPI PET/CT highlight the complementary biological information provided by dual-tracer imaging. Reduction in stromal FAP expression did not equate to metabolic remission. Combined interpretation may improve response assessment in radioiodine-refractory DTC.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"25 2","pages":"168-171"},"PeriodicalIF":1.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tc-99m Renal Scintigraphy in Complex Congenital Systemic Syndromes Associated with Congenital Anomalies of the Kidney and Urinary Tract: A Retrospective Single-Center Study.","authors":"Deepa Singh, Pramit Kumar, Suruchi Jain","doi":"10.1055/s-0046-1820100","DOIUrl":"10.1055/s-0046-1820100","url":null,"abstract":"<p><strong>Objectives: </strong>Congenital anomalies of the kidney and urinary tract (CAKUT) result from embryonic developmental defects and are usually not isolated. We evaluate the functional status of the kidney with Tc-99m renal scintigraphy in CAKUT patients associated with a rare complex systemic syndrome/sequence.</p><p><strong>Materials and methods: </strong>We retrospectively screened 788 Tc-99m EC (ethylenedicysteine) and 187 Tc-99m DMSA (dimercaptosuccinic acid) renal scintigraphies performed between January 2022 and November 2024. Patients were selected based on the presence of congenital systemic syndrome and CAKUT.</p><p><strong>Statistical analysis: </strong>The Kruskal-Wallis test was used to compare grading of functional impairment of kidneys across different systemic syndromes. The Mann-Whitney U-test was used to compare the functional impairment of the kidney for continuous variables.</p><p><strong>Results: </strong>A total of 38 patients (23 males, 15 females, mean age: 6.7 ± 6.7, range 0.03-33 years) of congenital systemic syndrome with associated CAKUT were identified. The most common systemic syndrome was anorectal malformation in 15 patients (39.5%). A few patients had features of more than one syndrome. The most common CAKUT was an orthotopic or ectopic nonfunctioning kidney in 15 patients (39.5%). The Tc-99m renal scintigraphies showed abnormal findings in 31 patients and normal findings in 7 patients. The proportion of abnormal findings was 81.6% (95% confidence interval: 65.7-92.3%). The difference in proportion of abnormal findings of renal scintigraphy across different syndromes was not statistically significant (Fisher's exact test, <i>p</i>  = 0.128). The Kruskal-Wallis H-test revealed significant differences in the grading of functional impairment of kidneys across different systemic syndromes, H(16) = 27.24, <i>p</i>  = 0.039. The Mann-Whitney U-test revealed significant difference ( <i>p</i>  = 0.007) in serum creatinine of normal Tc-99m scintigraphy (mean = 0.49, <i>n</i>  = 7) and abnormal Tc-99m scintigraphy (mean =1.25, <i>n</i>  = 31), U = 36.5, <i>z</i>  = 2.71, <i>r</i>  = 1.65. However, there was no significant difference ( <i>p</i>  = 0.097) in the age of patients who showed normal and abnormal Tc-99m scintigraphies.</p><p><strong>Conclusions: </strong>A complex systemic syndrome may have occult CAKUT that remains silent initially but presents as a complicated case later. Thus, these patients need functional evaluation with Tc-99m EC and Tc-99m DMSA scintigraphies for early diagnosis of renal anomaly and timely management and follow-up, especially after surgical intervention, to avoid future complications.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"25 2","pages":"136-148"},"PeriodicalIF":1.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}