World Journal of Nuclear Medicine最新文献

{"title":"Unilateral Brown Fat FDG Uptake after Childhood Sympathectomy Mimicking Malignancy Resolved by Hybrid PET/MR Image Fusion.","authors":"Freimut Dankwart Eberhard Juengling, Judith Hafer, Alin Chirindel","doi":"10.1055/s-0045-1812308","DOIUrl":"10.1055/s-0045-1812308","url":null,"abstract":"<p><p>Physiologic ¹⁸ F-fluorodeoxyglucose (FDG) uptake in brown adipose tissue (BAT) is a recognized source of false-positive findings on positron emission tomography (PET) scans, typically presenting as symmetric, multifocal activity in fat-density tissue. We report a case of a 30-year-old woman with left-sided cervical swelling and unilateral, left-sided FDG uptake mimicking malignancy, but without corresponding computed tomography abnormalities. The patient's history included right-sided mediastinal ganglioneuroma resection in childhood, resulting in Horner syndrome. Hybrid PET/magnetic resonance (MR) imaging with image fusion definitively localized the FDG activity to left-sided BAT, confirming the tissue origin and linking the unilaterality to sympathetic denervation from prior right stellate ganglion disruption. This case illustrates that hybrid PET/MR can resolve diagnostic uncertainty in atypical BAT presentations and highlights the importance of recognizing altered BAT metabolism after sympathetic injury to avoid misinterpretation of PET findings.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"25 2","pages":"175-177"},"PeriodicalIF":1.0,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377119","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":"ARTnet Perspectives and Contributions to Theranostics.","authors":"Roslyn J Francis, Dale L Bailey, Kathy Willowson, Melissa J Latter, Bridget Chappell, George McGill, Michael S Hofman, Louise Emmett, Andrew M Scott","doi":"10.1055/s-0045-1812309","DOIUrl":"10.1055/s-0045-1812309","url":null,"abstract":"<p><p>Theranostics is a rapidly growing field, providing new therapeutic options for cancer patients. Clinical trials have a key role in establishing the efficacy and safety of new treatments and determining impact on patient care. Multicenter clinical trials with radiopharmaceuticals provide robust data to support clinical implementation; however, there are important considerations to ensure high-quality and reliable clinical data. Australasian Radiopharmaceutical Trials Network (ARTnet) is a multidisciplinary clinical trials network established in 2014 to facilitate multicenter clinical trials with radiopharmaceuticals in Australia. Over the last decade, ARTnet has supported impactful, prospective clinical trials through quality activities and engagement. In theranostics, Australia has had a key role in clinical translation and generating evidence for safety and efficacy, resulting in regulatory approval and health care funding internationally. This report describes the development of ARTnet as a clinical trials network, highlighting the intent, current status, and operations of ARTnet, with a particular focus on theranostics.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"24 3","pages":"231-237"},"PeriodicalIF":0.9,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12602080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496850","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":"Radiotheranostics in Low- and Middle-Income Countries: Challenges, Practice, and Prospects.","authors":"Ismaheel O Lawal, Honest Ndlovu, Joseph Kabunda, Kgomotso M Mokoala, Mike M Sathekge","doi":"10.1055/s-0045-1812307","DOIUrl":"10.1055/s-0045-1812307","url":null,"abstract":"<p><p>There is a global rise in the number of new cancer diagnoses and cancer deaths. Rising new cancer diagnoses and deaths from low- and middle-income countries (LMICs) are the biggest contributors to this global trend. Efforts geared toward prevention, timely diagnosis, effective treatment, and efficient cancer survivorship programs are needed to address the rising scourge of cancer in LMICs. Radiotheranostics entails using radiopharmaceuticals for diagnostic imaging and therapy of diseases. Functional imaging, as in radiotheranostics, is more sensitive for disease detection and treatment response assessment than conventional cross-sectional imaging. Therefore, radiotheranostics has the potential to address some of the strategies to curtail the rising scourge of cancer and its mortality in LMICs, including timely diagnosis, effective management, and disease surveillance. Many key issues hinder the widespread availability, access, and utilization of nuclear medicine (NM) and radiotheranostics services in LMICs. These issues include scarcity of trained (NM) professionals, lack of training for (NM) personnel, poor infrastructure, inadequate awareness of NM and radiotheranostics, poor funding, and poorly conceived regulations that stifle NM practice. Despite these hindrances, many success stories have emerged from LMICs regarding clinical application of radiotheranostics. For example, many practice-defining studies have been published by groups from LMICs regarding prostate-specific membrane antigen-targeted imaging and therapy of prostate cancer. Specifically, notable contributions have been made to the literature by groups from South Africa, India, and Türkiye on the safety and efficacy of 225Ac-PSMA-617 for therapy of advanced prostate cancer. Through the intervention of many international organizations, governments, and private sectors, there has been a steady improvement in the awareness, availability, access, and utilization of NM and radiotheranostics services in LMICs.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"24 3","pages":"221-230"},"PeriodicalIF":1.0,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12602083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496886","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":"Individualized Dosimetry to Guide LuTATE Therapy in Pediatric Neuroblastoma.","authors":"Kevin London, Justine Trpezanovski, Toby Trahair, Geoff McCowage","doi":"10.1055/s-0045-1812305","DOIUrl":"10.1055/s-0045-1812305","url":null,"abstract":"<p><p>Neuroblastoma is the most common extracranial solid tumor in children. Tumor heterogeneity is a hallmark of neuroblastoma and prognosis can be dismal in the presence of high-risk factors such as N-myc gene amplification, aneuploidy, genetic rearrangement, and age at presentation. I-131 MIBG therapy has traditionally been the radionuclide therapy agent used in pediatric neuroblastoma and is incorporated in many treatment protocols. The high cost and limited availability of I-131 MIBG and the required radiation safety measures are barriers to its widespread use. LuTATE has emerged as a more practical radionuclide therapy agent requiring less stringent radiation safety measures and coupled with GaTATE PET/CT forms a potentially useful theranostic pairing for children with neuroblastoma. LuTATE therapy in adults with neuroendocrine tumors uses an empiric dosing schedule with good results. However, a previous study using empiric dosing of LuTATE in pediatric neuroblastoma was not shown to be effective. We present our use of individualized patient dosimetry to optimize the dose of LuTATE in three children with relapsed/resistant neuroblastoma.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"24 3","pages":"259-269"},"PeriodicalIF":1.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12602071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496870","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 Case Report of Incidental Thyroid Cancer Metastasis Detected in a PSMA PET/CT Scan of a Prostate Cancer Patient: Predicting RAI-Refractoriness.","authors":"Isavelina F C Gries, Eduardo E S Ongkeko, Patrick E A Fernando","doi":"10.1055/s-0045-1812053","DOIUrl":"10.1055/s-0045-1812053","url":null,"abstract":"<p><p>Early recognition of patients at risk for radioactive iodine refractoriness (RAIR) is essential, as these individuals often face a poorer prognosis. Consequently, there is a pressing need for advanced therapeutic options in aggressive thyroid cancer cases. We present a case involving a 57-year-old male with prostate adenocarcinoma who, through prostate-specific membrane antigen (PSMA) PET/CT scanning, was incidentally found to have a PSMA-avid lung nodule. Subsequent biopsy confirmed metastatic thyroid carcinoma. Following two sessions of radioactive iodine (RAI) therapy, posttherapy scans showed a noniodine-avid lung nodule. The PSMA-avid lung lesion indicates an aggressive disease form likely to develop RAI resistance, which was subsequently confirmed. This finding suggests that PSMA expression could be an effective early predictor of RAIR. Moreover, the PSMA avidity of these lesions supports the use of Lutetium-177-PSMA therapy, expanding treatment options for RAIR-differentiated thyroid carcinoma (DTC).</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"25 2","pages":"161-163"},"PeriodicalIF":1.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377419","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":"Multidisciplinary Perspectives of Clinical Trials in Theranostics.","authors":"Kunthi Pathmaraj, Sze Ting Lee","doi":"10.1055/s-0045-1812102","DOIUrl":"10.1055/s-0045-1812102","url":null,"abstract":"<p><p>Theranostics and clinical trials are driving the future of nuclear medicine and require a multidisciplinary approach to achieve the best possible care for the patient. Theranostics refers to using chemical compounds with similar diagnostic and radiotherapeutic applications. Therefore, the biodistribution remains the same for the imaging and therapy portions, a low radiation dose being delivered during imaging, and a higher radiation dose being delivered to the target disease areas during the treatment phase. The new era of theranostics has revolutionized nuclear medicine through the prospective phase 3 clinical trials, which have resulted in its adoption into the treatment paradigms of patients, particularly those with neuroendocrine tumors and prostate cancer. Molecular imaging can be used to assess the role and utility of new tracers and molecular endpoints to help improve the understanding of tumor biology and evaluation of treatment response, leading to intelligent clinical trial design and more rapid drug development. Clinical trials networks such as EANM Research Ltd. (EARL), SNMMI Clinical Trials Network (CTN), and Australasian Radiopharmaceutical Trials Network (ARTnet), encourage a standardized approach and promote a collaborative approach to clinical trials in molecular imaging. Clinical Trials in Theranostics require the skills and expertise of a multidisciplinary team including the principal investigator, nuclear medicine specialists, study coordinators, medical physicists, radiopharmaceutical scientists, nuclear medicine technologists, research nurses, and research assistants. All personnel involved in theranostics clinical trials should be certified in Good Clinical Practice (GCP). Accurate documentation and record keeping in clinical trials provides validation that clinical trials is conducted at the highest ethical and clinical standards, meets the expectation of the study protocol, and adheres to GCP. Radiation safety is a critical factor for staff, patients, and the public in theranostics and clinical trials and must follow country-specific guidelines and international guidelines to ensure basic safety standards are met. As theranostics and clinical trials continue to stamp their mark in molecular imaging and radionuclide therapy, it is imperative that nuclear medicine professionals remain upskilled and adequately trained in these two aspects of the profession to ensure optimal care is delivered to the patient.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"24 3","pages":"214-220"},"PeriodicalIF":0.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12602078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496893","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":"Theranostics Implementation: Opportunities and Challenges.","authors":"Kunthi Pathmaraj, Andrew M Scott","doi":"10.1055/s-0045-1812103","DOIUrl":"10.1055/s-0045-1812103","url":null,"abstract":"","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"24 3","pages":"189-191"},"PeriodicalIF":1.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12602076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496210","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":"Complex Regional Pain Syndrome Triggered by Snake Bite: Diagnostic Utility of Triple-Phase Single-Photon Emission Computed Tomography-Computed Tomography Bone Scan-Case Report.","authors":"Osama Ragab, Haneen Alqattan, Manar Al Daas, Hany M A Elrahman","doi":"10.1055/s-0045-1812054","DOIUrl":"10.1055/s-0045-1812054","url":null,"abstract":"<p><p>Complex regional pain syndrome (CRPS) is a chronic pain disorder with complex pathophysiology involving neurogenic inflammation and autonomic dysfunction. While CRPS is typically associated with trauma or surgery, its occurrence following a snakebite is extremely rare. We report the case of a 47-year-old man who developed persistent pain, swelling, and hypersensitivity in the left foot after a snakebite to the dorsum. Despite prompt administration antivenom and admission to the intensive care unit, the symptoms progressed without systemic infection. Magnetic resonance imaging (MRI) revealed evolving soft tissue inflammation, fat necrosis, and periostitis. Triple-phase bone scintigraphy with single-photon emission computed tomography/computed tomography (SPECT/CT) demonstrated increased perfusion and periarticular tracer uptake consistent with CRPS, while effectively excluding osteomyelitis and abscess. The diagnosis was established using the Budapest criteria, supported by clinical assessment and multimodal imaging, including evidence of evolving periostitis without cortical bone destruction. This case underscores the diagnostic challenge of CRPS in the absence of infection or trauma and highlights the crucial role of MRI and triple-phase bone scintigraphy with SPECT/CT in detecting early osseous involvement and guiding appropriate management.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"25 1","pages":"51-55"},"PeriodicalIF":1.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821515","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":"Multi-Tracer PET-Guided Therapy Selection and Theranostics in Radioiodine-Refractory Thyroid Cancer Patient Unsuitable for Tyrosine Kinase Inhibitor Therapy.","authors":"Austin Saju, Sunita Sonavane, Sandip Basu","doi":"10.1055/s-0045-1812056","DOIUrl":"10.1055/s-0045-1812056","url":null,"abstract":"<p><p>Radioactive iodine refractory (RAIR) thyroid cancer and thyroglobulin elevated negative iodine scintigraphy constitute a fraction of thyroid cancer patients with poorer prognosis as opposed to radioiodine concentrating disease. Although not a rare condition and with several treatment options already explored, the selection of an optimal therapy that balances effective disease stabilization, symptom palliation, life prolongation, and minimal side effects remains essential. The use of multi-tracer positron emission tomography (PET) shows potential for radionuclide therapy selection in RAIR thyroid cancer. In this case report, multi-tracer PET imaging was employed to assess the feasibility of available theranostic options. While [ ⁶⁸ Ga]Ga-DOTATATE PET/computed tomography (CT) showed low-level somatostatin receptor expression, [ ⁶⁸ Ga]Ga-prostate specific membrane antigen (PSMA)-11 PET/CT revealed moderate and concordant PSMA expression across all lesions observed on [ ¹⁸ F]F-FDG PET/CT, justifying [ ¹⁷⁷ Lu]Lu-PSMA-617 therapy in this patient.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"25 3","pages":"266-270"},"PeriodicalIF":1.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040887","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":"The Trimodality PET/CT-MRI (3.0 T) System with a Dedicated Shuttle Detects Local Recurrence in a Case Classified as Indeterminate by Means of PSMA PET/CT Alone at Prostatic Fossa.","authors":"Gerardo Gabriel Dos Santos Loureiro, Juan Pablo Gambini González, Martin Rodriguez Parodi, Omar Alonso Núñez","doi":"10.1055/s-0045-1812055","DOIUrl":"10.1055/s-0045-1812055","url":null,"abstract":"<p><p>In the following case study, we evaluate a prostate cancer patient with persistent biochemical relapse and negative conventional imaging. Following interdisciplinary team discussion, it is decided to assess the patient by a ¹¹ C-Choline and ⁶⁸ Ga-PSMA positron emission tomography/computed tomography (PET/CT) scan. Notably, doubtful findings due to physiological urinary activity in the ⁶⁸ Ga-PSMA-11 PET/CT scan were clarified with PET/CT-magnetic resonance imaging (MRI) images. The added value of the trimodality PET/CT-MRI system was very useful in detecting recurrence in a case classified as indeterminate by means of PET/CT alone at prostatic fossa.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"25 2","pages":"178-181"},"PeriodicalIF":1.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377138","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}