World Journal of Nuclear Medicine最新文献

{"title":"Incremental Value of Digital PET/MRI over PET/CT in the Assessment of Neoplastic Liver Lesions.","authors":"Pawan Gulabrao Shinkar, Mohana Vamsy, Dileep Kumar, Palak Wadhwa","doi":"10.1055/s-0045-1814145","DOIUrl":"10.1055/s-0045-1814145","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to assess the performance of positron emission tomography/magnetic resonance imaging (PET/MRI) compared with PET/computed tomography (PET/CT) in the clinical management of patients with neoplastic hepatic lesions.</p><p><strong>Materials and methods: </strong>This is a retrospective study and includes a sample size of 15 patients, referred for diagnostic evaluation and staging of neoplastic hepatic lesions. The patients included in this study underwent a simultaneous PET/CT scan on uMI-Vista and a complementary liver PET/MRI scan on uPMR 790. PET/CT and PET/MRI were compared based on the number of detected lesions, the smallest detected lesion diameter, and tumor-to-liver ratio (TLR). The histopathological analysis was considered the standard of reference.</p><p><strong>Results: </strong>PET/MRI reported extra information in 87% (13/15) of patients, and additional lesions were identified in 73% (11/15) of patients. Furthermore, PET/MRI could identify subcentimeter liver lesions and added great value in the evaluation of lesion viability. Overall, 40 additional lesions were detected with PET/MRI in contrast with PET/CT within the given patient cohort. The smallest revealed lesion measured 2 mm in the long-axis diameter, and the average long-axis diameter of small lesions detected by PET/MRI across 15 patients was 3.4 mm with a standard deviation of 1.3 mm. These findings significantly affected the final outcomes in 12 out of 15 patients, leading to modifications in the response assessment category in 5 patients and defined the malignant hepatic lesions on staging/restaging scans (10/15).</p><p><strong>Discussion: </strong>PET/MRI has been found to outperform PET/CT in terms of conspicuity of liver lesions, with better sensitivity and specificity. Overall, coregistered PET and MR images have been shown to outperform PET/CT in the imaging of liver lesions, with better delineation of small lesions as well as reliable localization of lesions to the corresponding liver segment.</p><p><strong>Conclusion: </strong>In addition to a significant decrease in radiation exposure, the PET/MRI combination resulted in higher detection rates and more precise characterization of small malignant liver lesions and tends to be more powerful than PET/CT, which has a direct impact on the patient's diagnosis, staging, and further therapeutic strategies.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"24 4","pages":"335-345"},"PeriodicalIF":0.9,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12774521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918668","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":"Consideration of Radioactive Iodine Therapy in a Graves' Disease Patient with Secondary Psychosis: A Case Report.","authors":"Violerien U Sultan, Budi Darmawan, Trias Nugrahadi, Achmad Hussein Sundawa Kartamihardja","doi":"10.1055/s-0045-1813678","DOIUrl":"10.1055/s-0045-1813678","url":null,"abstract":"<p><p>Psychosis is a rare but recognized neuropsychiatric complication of hyperthyroidism, most commonly associated with Graves' disease. Although anxiety and mood disturbances are more frequent, acute psychosis has been reported in approximately 1% of cases. We report the case of a 30-year-old man with a 1-year history of Graves' disease who developed acute psychotic symptoms, including hallucinations and disorganized behavior. Laboratory findings revealed severe thyrotoxicosis with a suppressed thyroid-stimulating hormone and markedly elevated free T4. Thyroid scintigraphy using technetium-99m pertechnetate demonstrated diffuse increased uptake consistent with toxic diffuse goiter. The patient with severe thyrotoxicosis was initially managed with methimazole, propranolol, and psychiatric medications. Although the scheduled 1-week follow-up was missed, he returned at 4 weeks while continuing his prescribed therapy. At that visit, repeat thyroid function tests were obtained and psychiatric care was maintained. Subsequently, radioactive iodine (RAI) therapy at a fixed dose of 370 MBq (10 mCi) was administered after a short withdrawal of antithyroid drugs. One month posttreatment, both thyroid function and psychiatric symptoms improved significantly, allowing for discontinuation of antipsychotics. At 3 months, he became hypothyroid and was started on levothyroxine replacement. This case highlights the importance of a multidisciplinary approach in managing patients with coexisting psychiatric conditions. Psychosis secondary to hyperthyroidism may mimic primary psychiatric disorders, potentially delaying diagnosis. Stabilizing psychiatric symptoms prior to definitive therapy and ensuring close psychiatric follow-up are essential to achieving optimal clinical outcomes. Radioiodine remains a safe and effective treatment for Graves' disease, even in patients with neuropsychiatric complications. The psychotic symptoms in this case are caused by hyperthyroidism. RAI therapy can effectively and safely treat hyperthyroidism in Graves' disease patients with secondary psychosis.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"25 1","pages":"42-45"},"PeriodicalIF":1.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821582","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":"Pleural Hemangioma Detected by ¹⁸ F-PSMA PET/CT in High-Risk Prostate Cancer Staging: A Case Report and Review of the Literature.","authors":"André Marcondes Braga Ribeiro, Cíntia Natália Gotardo, Stephania Martins Bezerra, Lizieux Matos Fernandes","doi":"10.1055/s-0045-1813679","DOIUrl":"10.1055/s-0045-1813679","url":null,"abstract":"<p><p>Prostate cancer (PCa) staging has advanced significantly with the emergence of prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT). However, PSMA-labeled radiotracers uptake is not exclusive to PCa, leading to potential pitfalls. We report an unusual case of a 71-year-old man with high-risk PCa undergoing initial staging with PET/CT using ¹⁸ F-labeled PSMA ( ¹⁸ F-PSMA), which revealed an unexpected uptake in a pleural nodular lesion. Given the extreme rarity of PCa pleural metastases, an excisional biopsy of the lesion was performed. Histopathological analysis confirmed the diagnosis of a pleural lobular capillary hemangioma, a benign vascular tumor extremely rare in this location. This case represents the first documented instance of PSMA radiopharmaceutical uptake in a pleural hemangioma, expanding the spectrum of known PSMA PET/CT pitfalls. This finding underscores the importance of histopathological confirmation for atypical PSMA PET/CT findings in unusual locations, preventing incorrect staging and avoiding inappropriate therapeutic decisions.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"25 2","pages":"156-160"},"PeriodicalIF":1.0,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377099","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":"Incidental ⁶⁸ Ga -DOTATATE Uptake in Metastatic Clear Cell Renal Cell Carcinoma: A Case Report.","authors":"Fatemeh Saboktakin, Saeed Farzanehfar, Nasim Vahidfar, Niloofar Tabatabaeian","doi":"10.1055/s-0045-1813681","DOIUrl":"10.1055/s-0045-1813681","url":null,"abstract":"<p><p>⁶⁸ Ga-DOTATATE positron emission tomography/computed tomography (PET/CT) is a more accurate way to distinguish neuroendocrine tumors compared with conventional diagnostic methods and a standard impressive way to evaluate disease entities. This is based on ⁶⁸ Ga-DOTATATE affinity to somatostatin receptors that are overexpressed in the majority of neuroendocrine tumors. In this case presentation, it is aimed to demonstrate the role of ⁶⁸ Ga-DOTATATE PET/CT scan beyond the detection of neuroendocrine tumors. A 59-year-old Iranian male patient with clear cell renal cell carcinoma who underwent nephrectomy 4 years ago has been referred for evaluation of a diagnosed painful abdominal mass by CT. ⁶⁸ Ga-DOTATATE PET/CT scan showed a large, lobulated border ⁶⁸ Ga-DOTATATE avid retroperitoneal tumoral mass in the region of pancreatic head and uncinate process, with fat plane obliteration with duodenum and inferior vena cava. Conspicuous physiological uptake has been reported in the pancreatic head in 16 to 70% of ⁶⁸ Ga-DOTATATE. Pathological results and immunohistochemistry evaluations confirmed the renal cell carcinoma based on metastases; so, the suspicious diagnosis of neuroendocrine tumor was ruled out. Malignancies, a part of neuroendocrine tumors, may express somatostatin receptors and ⁶⁸ Ga-DOTATATE or other octreotide derivatives based radiopharmaceuticals uptake appears.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"25 2","pages":"164-167"},"PeriodicalIF":1.0,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377082","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":"Precision Medicine in Action: Multi-Tracer PET/CT Uncovers Tumor Heterogeneity and a Synchronous Malignancy.","authors":"Siven Kar, Harshita Gupta, Vikram R Lele, Nusrat Shaikh","doi":"10.1055/s-0045-1813676","DOIUrl":"10.1055/s-0045-1813676","url":null,"abstract":"<p><p>Precision oncology leverages molecular profiling to tailor cancer treatment, with nuclear medicine playing an increasingly central role, particularly in elderly patients, where noninvasive approaches are preferable. We present a case of a 76-year-old male with metastatic prostate carcinoma (Gleason score: 5 + 5 = 10) exhibiting neuroendocrine differentiation. Imaging with multiple positron emission tomography (PET) tracers- ⁶⁸ Ga-PSMA, ¹⁸ F-FDG, ⁶⁸ Ga-DOTATATE, and ⁶⁸ Ga-FAPI-revealed significant tumor heterogeneity. Tumor heterogeneity is multifactorial, influenced not only by genetic changes but also by epigenetic, microenvironmental, and therapeutic pressures. While ⁶⁸ Ga-PSMA PET/computed tomography (CT) showed variable expression in osteosclerotic lesions, ¹⁸ F-FDG PET/CT detected metabolic activity, and ⁶⁸ Ga-DOTATATE PET/CT confirmed low somatostatin receptor expression. Despite ¹⁷⁷ Lu-PSMA radioligand therapy, the disease progressed with rising prostate-specific antigen levels. Subsequent gastrointestinal symptoms led to the diagnosis of sigmoid colon adenocarcinoma, confirmed by ⁶⁸ Ga-FAPI PET/CT. This case exemplifies the critical role of nuclear imaging in characterizing tumor biology, guiding therapeutic strategies, and reducing reliance on invasive procedures. The integration of multi-tracer PET imaging enabled a nuanced understanding of tumor evolution, reinforcing nuclear medicine's importance in precision oncology and the management of complex, heterogeneous malignancies.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"25 3","pages":"271-274"},"PeriodicalIF":1.0,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040845","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":"A Normalized Spot-Sample Estimation of α-1 Antitrypsin Clearance: The Search for a Simpler Test in Protein Losing Enteropathy.","authors":"Anjilivelil J Joseph, Anoop John, Junita Rachel John, Julie Hephzibah, Ebby George Simon, Amit K Dutta, Sudipta Dhar Chowdhury, Reuben Thomas Kurien, Dilip Abraham","doi":"10.1055/s-0045-1813661","DOIUrl":"10.1055/s-0045-1813661","url":null,"abstract":"<p><strong>Introduction: </strong>Protein losing enteropathy (PLE) is usually a diagnosis of exclusion, which requires cumbersome tests to confirm. In the quest for a simpler diagnostic test, we hypothesized that a spot stool sample estimation of α-1 antitrypsin will be sufficient to make a diagnosis of PLE, if we control for serum α-1 antitrypsin concentration and degree of stool dilution.</p><p><strong>Materials and methods: </strong>Consecutive patients with a clinical suspicion of PLE and who had been advised a scintigraphy study were recruited after getting informed consent. The study excluded patients less than 1 year of age, pregnant women, and those with a clinical suspicion of chronic pancreatitis. Serum α-1 antitrypsin, spot stool α-1 antitrypsin, and stool elastase was assessed in all the patients. The diagnostic value of the index test was estimated from the patients with positive scintigraphy scan compared with a negative scan, expressed as sensitivity and specificity and the area under the receiver operating characteristic curve (AUROC).</p><p><strong>Result: </strong>A total of 33 patients underwent scintigraphy with a clinical suspicion of PLE. Twenty patients (60%) showed tracer activity in the gut suggestive of PLE. Spot stool α-1 antitrypsin below 0.26 mg/g had a sensitivity of 100% to rule out PLE; however, the specificity was only 46%. Spot stool α-1 antitrypsin/(serum α-1 antitrypsin * elastase) ratio performed similar to spot stool α-1 antitrypsin as a diagnostic test (AUROC: 0.814 [0.61-1.0] vs. 0.796 [0.54-1.0]).</p><p><strong>Conclusion: </strong>Random stool antitrypsin is a sensitive test for diagnosing PLE; however, it lacks specificity. Spot stool α-1 antitrypsin/(serum α-1 antitrypsin * stool elastase) does not provide any additional value in the diagnosis of this syndrome.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"24 4","pages":"346-351"},"PeriodicalIF":0.9,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12774530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918646","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":"[ ^99m Tc]Tc-Pyrophosphate Scintigraphy for Cardiac Amyloidosis: Evaluation of Scintigraphy Findings and Their Prognostic Value.","authors":"Elife Akgün, Ümit Aksu, Arda Güler, Gamze Babur Güler, Meryem Kaya, Burcu Esen Akkaş","doi":"10.1055/s-0045-1813662","DOIUrl":"10.1055/s-0045-1813662","url":null,"abstract":"<p><strong>Background: </strong>Association of [ ^99m Tc]Tc-pyrophosphate (PYP) uptake with survival of cardiac amyloidosis (CA) is still unknown. This study aimed to describe the scintigraphic findings of CA suspected cases and determine the prognostic value of scintigraphy.</p><p><strong>Methods: </strong>Between September 2020 and December 2023, all [ ^99m Tc]Tc-PYP scintigraphy images of CA suspected cases were evaluated retrospectively. The scintigraphy images were obtained 1 and 3 hours after intravenous injection of 740 MBq [ ^99m Tc]Tc-PYP. The quantitative and semiquantitative results of scintigraphy were analyzed, and their correlation with survival was evaluated.</p><p><strong>Results: </strong>Among the 268 cases (147 females, 121 males; median age: 65), 12 (4.5%) were diagnosed with transthyretin (ATTR) CA and 19 (7.1%) with light chain (AL) CA. The median follow-up time was 386 days. ATTR CA cases exhibited significantly higher [ ^99m Tc]Tc-PYP uptake than AL CA and non-CA cases. The 1- and 3-hour heart-to-contralateral lung ratios were positively highly correlated with each other, and SPECT/CT (single-photon computed tomography/computed tomography) imaging reduced equivocal results from 82 to 37%. Eight of the AL CA cases (42.1%), 1 ATTR CA case (8.3%), and 15 of non-CA cases (6%) died on follow-up. Median survival was 22 days in ATTR CA, 201 days in AL CA, and 105 days in non-CA deceased cases. Survival analysis indicated significantly lower survival in non-CA cases compared with ATTR CA and AL CA.</p><p><strong>Conclusion: </strong>[ ^99m Tc]Tc-PYP scintigraphy is highly sensitive and specific for detecting ATTR CA and differentiating from AL CA. Even in the absence of a diagnosis of CA, the fact that survival may be short in cases with high uptake on scintigraphy should be considered in the follow-up of these cases.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"24 4","pages":"352-359"},"PeriodicalIF":0.9,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12774519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918675","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":"Small Cell Transformation of Metachronous ALK + ve Lung and Prostatic Adenocarcinoma following Initial Response to Ceritinib and Androgen Deprivation Therapies and Metastases to Two Different Organs: Guidance through FDG-PET/CT and ⁶⁸ Ga-PSMA-11 PET-CT and Biopsy-Immunohistochemistry Correlation.","authors":"Rangat Bagasariya, Keerti Sitani, Trupti Pai, Sandip Basu","doi":"10.1055/s-0045-1813675","DOIUrl":"10.1055/s-0045-1813675","url":null,"abstract":"<p><p>Metachronous malignancies carry poor prognosis and pose certain challenges for management of two different malignancies simultaneously. A 59-year-old male, a patient of ALK+ lung adenocarcinoma demonstrating excellent initial response to targeted therapy with ALK inhibitor ceritinib, developed prostatic adenocarcinoma with neuroendocrine differentiation 36 months later, which was treated with abiraterone and leuprolide. Dual-tracer positron emission tomography (PET) imaging with ¹⁸ F-FDG-PET/computed tomography (CT) and ⁶⁸ Ga-PSMA-11 PET/CT showed complete response of prostatic adenocarcinoma with controlled serum prostate-specific antigen level, showed new-onset metastatic brain and liver lesions 12 months later, the biopsy of the later revealed metastatic small cell neoplasia. The clinical profile, dual tracer PET/CT and immunohistochemistry correlation assisted in concluding that prostate adenocarcinoma had transformed into small cell type, which metastasized to liver, whereas the lung adenocarcinoma had metastasized to brain.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"25 1","pages":"75-79"},"PeriodicalIF":1.0,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820632","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":"Diagnostic Performance of [ ¹⁸ F]FDG PET/MRI and [ ¹⁸ F]FDG PET/CT in the Detection of Lymph Node Metastases in Colorectal Cancer: A Meta-analysis.","authors":"Dapeng Shen, Lexuan Chen, Pengyuan Su, Peng Chen, Wei Zeng, Shen Chen, Jiemiao Shen","doi":"10.1055/s-0045-1812491","DOIUrl":"10.1055/s-0045-1812491","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) ranks among the leading causes of cancer-related mortality worldwide. Accurate detection of lymph node metastases plays a crucial role in determining disease stage and guiding treatment decisions. Fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) and 18F-FDG PET/magnetic resonance imaging (MRI) are advanced imaging modalities widely used in clinical practice. The study aimed to compare the diagnostic accuracy of [ ¹⁸ F]FDG PET/CT and [ ¹⁸ F]FDG PET/MRI in detecting lymph node metastases in CRC patients.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across PubMed, Embase, and Web of Science databases to identify relevant studies published up to February 2025. Inclusion criteria encompassed studies evaluating the diagnostic performance of [ ¹⁸ F]FDG PET/CT and [ ¹⁸ F]FDG PET/MRI for detecting lymph node metastases in CRC patients. Sensitivity and specificity were analyzed using the DerSimonian and Laird random-effects model, with results adjusted by the Freeman-Tukey double arcsine transformation. The quality of the included studies was appraised using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.</p><p><strong>Results: </strong>This meta-analysis incorporated 24 studies with a cumulative total of 3,369 patients. The findings revealed that [ ¹⁸ F]FDG PET/CT exhibited significantly lower sensitivity (0.75 vs. 0.93, <i>p</i>  = 0.0096) and a lower AUC value (0.81 vs. 0.96) compared with [ ¹⁸ F]FDG PET/MRI in detecting lymph node metastases among CRC patients. Both [ ¹⁸ F]FDG PET/CT and [ ¹⁸ F]FDG PET/MRI demonstrated similar specificity (0.77 vs. 0.88, <i>p</i>  = 0.1892). Furthermore, the funnel plot asymmetry test indicated no significant publication bias across any of the outcomes (Egger's test: all <i>p</i>  > 0.05).</p><p><strong>Conclusions: </strong>Our meta-analysis demonstrated that [ ¹⁸ F]FDG PET/MRI has higher sensitivity and comparable specificity to [ ¹⁸ F]FDG PET/CT in detecting lymph node metastases in CRC patients, suggesting its potential superiority for preoperative staging and postoperative surveillance. However, the limited number of direct head-to-head studies (only two) underscores the need for larger, prospective studies to validate these findings and assess their impact on clinical decision-making and patient outcomes.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"24 4","pages":"279-292"},"PeriodicalIF":0.9,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12774531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918695","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":"Crucial Insights from Interictal 99mTc-ECD Brain Perfusion SPECT in Enhancing Pediatric Epilepsy Diagnosis and Management.","authors":"Gupta Sarath Chandra Sanisetty, Manishi L Narayan, Prateek Kumar Panda, Indar Kumar Sharawat, Ramya S","doi":"10.1055/s-0045-1812326","DOIUrl":"10.1055/s-0045-1812326","url":null,"abstract":"<p><strong>Objective: </strong>Epilepsy, a prevalent neurological disorder in children, manifests through recurrent seizures due to abnormal neuronal activity. Drug-resistant epilepsy (DRE) is a significant clinical challenge, often necessitating advanced diagnostic approaches to optimize treatment strategies. Single photon emission computed tomography (SPECT) imaging, particularly using the radiopharmaceutical 99mTc-ethyl cysteinate dimer (99mTc-ECD), offers potential in localizing epileptogenic zones, especially when conventional magnetic resonance imaging (MRI) and electroencephalography (EEG) findings are inconclusive. This study was performed to evaluate patterns of brain perfusion using 99mTc-ECD SPECT in children aged < 18 years diagnosed with DRE, and to correlate these findings with clinical evaluations, MRI, and video EEG reports.</p><p><strong>Materials and methods: </strong>A descriptive observational study was conducted over 18 months on 60 children with DRE. Each participant underwent a detailed clinical history, video EEG, MRI, and a 99mTc-ECD brain perfusion SPECT scan. The SPECT images were analyzed visually and semiquantitatively for hypoperfusion and hyperperfusion patterns. Data were cross-referenced with clinical lateralization, MRI findings, and EEG results to assess concordance.</p><p><strong>Results: </strong>A total of 60 children with DRE and mean age of 11.02 + 3.8 years (1-< 18 years) including 16 (26.7%) female and 44 (73.3%) male patients were prospectively analyzed. Forty of 60 (66.7%) patients had normal MRI brain study and 23/60 (38.3%) patients had normal EEG records. Medial temporal lobe hypoperfusion was seen in all patients, while 16/60 (26.67%) patients had additional foci of hyperperfusion in left frontal lobe and 14/60 (23.3%) patients in right frontal lobe. Thirty-six of 60 (60%) patients had involvement of one hemisphere, 24/60 (40%) showed perfusion abnormalities in both hemispheres. Moderate to severe hypoperfusion was seen in left temporal lobe in 39/60 (65%) patients whereas 30/60 (50%) patients showed moderate to severe hypoperfusion in right temporal lobe. SPECT findings were concordant with EEG in 16/60 (26.67%) of cases and concordant MRI, EEG, and 99mTc-ECD was seen in 5/60 (8.3%) cases.</p><p><strong>Conclusion: </strong>99mTc-ECD brain perfusion SPECT is a valuable diagnostic tool in the comprehensive evaluation of pediatric DRE. It enhances lateralization and localization of epileptogenic zones, especially when conventional imaging is nondiagnostic. Interictal brain SPECT, is easily available, indispensable, and complementary in diagnosis. Combining it with clinical and electrophysiological evaluation can significantly improve clinical outcome and management of patients with DRE.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"24 4","pages":"325-334"},"PeriodicalIF":0.9,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12774517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918650","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}