World Journal of Nuclear Medicine最新文献

{"title":"Pediatric Theranostics in a 13-Year-Old Female with Bronchial Carcinoid.","authors":"Justine Trpezanovski, Jonathan Karpelowsky, Elizabeth Hesketh, Kevin London","doi":"10.1055/s-0045-1809341","DOIUrl":"10.1055/s-0045-1809341","url":null,"abstract":"<p><p>Pediatric bronchial carcinoid tumors are rare, accounting for a significant proportion of primary lung tumors in children but only a small fraction in adults. These tumors can present with symptoms such as cushing's syndrome due to ACTH secretion. Complete surgical resection typically results in favorable outcomes, with most tumors expressing somatostatin receptors, making them amenable to peptide receptor radionuclide therapy (PRRT) with (177Lu)Lu-DOTA-TATE (LuTATE). This case report describes a 13-year-old female with a bronchial carcinoid tumor treated with multi-cycle high-dose LuTATE therapy in the neoadjuvant setting. Initial imaging and biopsy confirmed a grade G1 pulmonary carcinoid with intense somatostatin receptor expression. The patient underwent two cycles of LuTATE, with dosimetry calculations guiding dose escalation while maintaining safe kidney radiation exposure. Posttherapy scans showed a significant metabolic response of suspected nodal metastases and evidence of partial response of the primary tumor. Two further LuTATE cycles were administered, with continued monitoring of kidney dosimetry to ensure safety. The treatment was well-tolerated, and the patient showed no significant complications. The case highlights the potential of LuTATE therapy to downstage tumors and reduce surgical morbidity in pediatric patients. Given the rarity of pediatric bronchial carcinoid tumors, phase III clinical trials are unlikely, but this report supports the inclusion of LuTATE in multidisciplinary treatment planning. In conclusion, LuTATE therapy, guided by dosimetry calculations, offers a valid treatment option for pediatric bronchial carcinoid tumors, balancing efficacy, and safety in a challenging clinical scenario.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"24 3","pages":"270-277"},"PeriodicalIF":1.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12602075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496957","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":"Theranostic Radioembolization: Radiation Dosimetry-Guided Treatment Planning and Delivery.","authors":"Dale L Bailey, Elizabeth J Bernard, Richard Maher, Albert C Goh, Yaser H Gholami, Nick Pavlakis, Kathy P Willowson","doi":"10.1055/s-0045-1809343","DOIUrl":"10.1055/s-0045-1809343","url":null,"abstract":"<p><p>Radioembolizaton of hepatic malignancy is an accepted palliative treatment option in many subjects. The process of working up an individual for a radioembolization procedure permits pretreatment radiation dosimetry to be estimated, which is not possible with many other theranostic pairs of radionuclides. These estimates can then be used to prescribe the desired amount of radionuclide therapy (RNT), in radiation dose units of gray (Gy), to treat the cancer tissues to a desired level as well as permitting the radiation dose to the normal liver compartment to be minimized. As such, radioembolization represents an excellent example of a theranostic approach to treatment where individualization of the therapy can be highly tailored. The necessary tools are now available to implement this approach on a wider scale, which should improve outcomes for the treated individuals. The aim of this review article was to present a contemporary approach to personalized treatment planning for radioembolization and to emphasize the theranostic aspects of the process. A clinical case is presented demonstrating the potential for excellent clinical outcomes using an image-based and informed treatment plan developed by the multidisciplinary team of nuclear physicians, interventional radiologists, medical oncologists, and medical physicists.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"24 3","pages":"204-213"},"PeriodicalIF":1.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12602074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496985","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 Challenges in a Case of Suspected Breast Cancer with Low FDG Uptake and an Incidental Thyroid Lesion: A Case Report and Literature Review.","authors":"Raydel Briankwee Amalo, Yustia Tuti, Ayu Rosemeilia Dewi","doi":"10.1055/s-0045-1809310","DOIUrl":"10.1055/s-0045-1809310","url":null,"abstract":"<p><strong>Introduction: </strong>The coexistence of multiple malignancies presents diagnostic and therapeutic challenges. Breast and thyroid cancers are among the most frequently diagnosed malignancies in women, and studies suggest a potential bidirectional association. While fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) is a valuable imaging modality for evaluating breast cancer, its sensitivity in detecting low-metabolic subtypes remains limited. Additionally, incidental FDG-avid thyroid lesions require further evaluation due to their potential malignancy risk.</p><p><strong>Case report: </strong>We present a 61-year-old female with a suspected left breast malignancy, suggestive of luminal A subtype, showing low FDG uptake (maximum standardized uptake value [SUVmax] 2.0) on PET/CT, despite mammographic and ultrasound findings suggestive of malignancy (Breast Imaging-Reporting and Data System 4A and V). Additionally, an incidental left thyroid lesion (4.0 × 3.8 cm, SUVmax 3.4) with calcifications was detected, raising suspicion for malignancy. The discordant imaging findings in this case highlight the limitations of FDG-PET/CT and emphasize the necessity of multimodal imaging and histopathological confirmation.</p><p><strong>Conclusion: </strong>This case underscores the importance of integrating multiple imaging modalities for accurate diagnosis. While PET/CT is useful for systemic staging, its limitations in detecting certain breast cancer subtypes necessitate complementary imaging techniques and histopathological confirmation. The incidental thyroid lesion also required further assessment, reinforcing the need for a comprehensive diagnostic approach.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"24 4","pages":"373-376"},"PeriodicalIF":0.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12774523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918707","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]PSMA Tracer and ₁₃₁ I Avid Retroperitoneal Thyroid Tissue in a Patient with Synchronous Thyroid and Prostate Carcinomas: First Case Report and Literature Review.","authors":"Chamani Punchihewa, Juliette Zeilmaker, Maged Elsewafy, Sabina Dizdarevic","doi":"10.1055/s-0045-1809147","DOIUrl":"10.1055/s-0045-1809147","url":null,"abstract":"<p><p>We present the first described case of retroperitoneal metastasis from follicular thyroid carcinoma (FTC). This was incidentally discovered as a PSMA (prostate-specific membrane antigen)-positive lesion on PSMA-positron emission tomography (PET)-computed tomography (CT) in a patient with synchronous prostate cancer (PCa).The expanding utilization of PSMA-PET-CT has revealed tracer uptake in several nonprostatic conditions. A 68-year-old man investigated for PCa, underwent magnetic resonance imaging, which revealed an 18-mm retroperitoneal soft tissue nodule lateral to the left psoas and a left pelvic node. PSMA-PET-CT showed tracer uptake in the primary PCa, retroperitoneal lesion, and pelvic node with an incidental high-grade focus in the thyroid. A CT following a period of androgen deprivation demonstrated no response in the retroperitoneal lesion, while the pelvic node became smaller. Fine-needle aspiration (FNA) of the thyroid was performed, although an ultrasound was initially reported as benign. FNA cytology (FNAC) was interpreted as a benign nodule. However, CT-guided biopsy of the retroperitoneal lesion revealed follicular thyroid tissue. The differential diagnoses were ectopic thyroid tissue and FTC. FNAC and ultrasound were reviewed at the thyroid multidisciplinary meeting (MDM) and upgraded to follicular atypia and suspicious for malignancy, respectively. Left hemithyroidectomy confirmed an angioinvasive follicular carcinoma. Completion thyroidectomy revealed a small incidental micropapillary carcinoma. Single photon emission computed tomography (SPECT)-CT post- ¹³¹ I treatment showed intensely iodine-avid tissue within the thyroid bed and retroperitoneal deposit. On follow-up ¹²³ I-SPECT-CTs, there was no abnormal iodine uptake and the retroperitoneal deposit decreased from 18 to 5 mm, presumed as scar tissue. Thyroglobulin reduced from 7.7 to < 0.1 ug/L. MDM recommended 6 monthly surveillance. PSMA-positive lesion evaluation can be challenging due to PSMA expression in nonprostatic conditions. As illustrated by this case, unusual distribution of tracer uptake requires further investigations and a multidisciplinary approach to guide management. High PSMA expression in differentiated thyroid cancer was associated with shorter progression-free survival and may be considered a marker of aggressiveness. Such tumors could be candidates for targeted PSMA-radioligand therapy (e.g., ¹⁷⁷ lutetium), particularly in radioiodine-negative/refractory cases, which are difficult to treat.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"24 4","pages":"363-368"},"PeriodicalIF":0.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12774524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918672","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 of Lung Cancer Unexpectedly Detected with ^99m Tc (V)-DMSA Whole-Body/SPECT Imaging.","authors":"Esmaeil Gharepapagh, Leila Namvar, Sahar Rezaei","doi":"10.1055/s-0045-1809053","DOIUrl":"10.1055/s-0045-1809053","url":null,"abstract":"<p><p>In terms of cancer-related deaths, lung cancer is the most common type. To prevent this malignant and dangerous disease from progressing, early and differential diagnoses are very critical. A combination of dimercaptosuccinic acid and pentavalent ^99m Tc under alkaline conditions, ^99m Tc (V)-DMSA, can be used for malignant tumors' early diagnosis and prognosis. The ^99m Tc (V)-DMSA radiotracer is most commonly used for follow-up of medullary thyroid cancer metastases, but it is also successful in lung cancer and other malignancies. In this case, a 65-year-old woman with a recent history of nonproductive cough and mild dyspnea and suspicious small masses of lungs in computed tomography was selected for imaging with ^99m Tc (V)-DMSA to evaluate the condition of radiotracer uptake in the lung masses. The whole-body and single-photon emission computed tomography imaging with semiquantitative analysis showed abnormal uptakes in the lesions and the patient underwent to transbronchial biopsy and bronchial washing cytology that confirmed non-small cell lung cancer.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"24 4","pages":"369-372"},"PeriodicalIF":0.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12774526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918660","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":"Considerations for Establishing Peptide Receptor Radionuclide Therapy: A Nationally Coordinated, Collaborative, and Equitable Service for New Zealand.","authors":"Rachelle Steyn, Andrew Henderson, Karin Wells, Trish Mead, Yasmin Rennie, Avril Hull, Liana Meredith, Michelle Sullivan, Saskia Simmers, Jenny Davidson, Tame Hauraki, Dragan Damianovich, Veronica Boyle, Ben Lawrence","doi":"10.1055/s-0045-1807726","DOIUrl":"10.1055/s-0045-1807726","url":null,"abstract":"<p><p>Inspired by international frameworks, New Zealand established a nationally coordinated peptide receptor radionuclide therapy service. This article reflects on the key steps involved in building the service, including the formation of a national neuroendocrine tumor (NET) multidisciplinary meeting, the role of patient advocacy, and the integration of local research. The successful creation of the service, despite significant challenges, demonstrates the value of collaboration between clinicians, government, universities, and patient groups in achieving equitable, high-quality care.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"24 3","pages":"244-252"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12602073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496888","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":"Orbital Metastasis as the Initial Manifestation of Lung Adenocarcinoma: 18F-FDG PET-CT Findings.","authors":"Oueriagli Nabih Salah, Aboussabr Meryem, Ait Sahel Omar, Doudouh Abderrahim","doi":"10.1055/s-0045-1808247","DOIUrl":"10.1055/s-0045-1808247","url":null,"abstract":"<p><p>Orbital metastases from malignant tumors are uncommon. In 25% of cases, they are the first sign of an undiagnosed cancer, and they account for approximately 7 to 12% of lung cancer cases. A lack of awareness about this condition can lead to misdiagnosis, distinguishing malignant from benign lesions. We present the case of a 65-year-old patient with orbital metastasis from lung cancer. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) was crucial in diagnosing this, revealing hypermetabolism in the left lung mass as well as intense uptake in the right retro-orbital region, which was confirmed as orbital metastasis through cerebro-orbital magnetic resonance imaging. For 2 months, our patient had right eye pain and decreased visual acuity and no attention was paid to these symptoms. Through this clinical case, the authors highlight the utility of 18F-FDG PET/CT in the diagnosis of primary malignancy in lung cancer patients, who presented with orbital metastasis as the first sign.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"24 4","pages":"360-362"},"PeriodicalIF":0.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12774527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918484","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":"Global Challenges in the Provision of Theranostic Services the International Atomic Energy Agency (IAEA) Perspective.","authors":"Anita Brink, Juliano J Cerci, Francesco Giammarile, Danylo Yurystovskyi, Aruna Korde, Enrique Estrada-Lobato, Miriam Mikhail-Lette, Olivier Pellet, Homer A Macapinlac, Diana Paez","doi":"10.1055/s-0045-1807251","DOIUrl":"10.1055/s-0045-1807251","url":null,"abstract":"<p><p>The global expansion of theranostics, a field combining molecular imaging and targeted therapy, has accelerated with the Food and Drug Administration approvals of Lutathera and Pluvicto. However, significant challenges hinder equitable access, particularly in low- and middle-income countries (LMICs). These include infrastructure limitations, such as the high cost of gamma cameras, positron emission tomography/computed tomography scanners, cyclotrons, and maintenance, as well as disparities in the availability of radiopharmaceuticals. In LMICs, one single-photon emission computerized tomography scanner may serve 33 million people, compared with 57,000 in high-income countries. Furthermore, shortages of key isotopes like 99Mo and 177Lu highlight vulnerabilities in global supply chains. Staffing and training are critical issues, as delivering theranostic services requires specialized teams that are often scarce in LMICs. The International Atomic Energy Agency (IAEA) addresses these challenges by offering training programs, developing databases like IMAGINE and NUMDAB, and fostering technical cooperation among member states. To improve access to theranostic services, strategies such as using alternative imaging methods and enhancing local radiopharmaceutical production are recommended. The IAEA's Rays of Hope initiative aims to strengthen regional capacities, improve infrastructure, and address the critical shortage of trained professionals. A coordinated global effort is essential to overcome these barriers, reduce costs, and ensure equitable access to theranostics, particularly in resource-limited settings.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"24 3","pages":"238-243"},"PeriodicalIF":1.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12602077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496936","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":"Gallium-68 Citrate PET/CT for Diagnosis and Treatment Response Assessment of Infections-Prospective Study.","authors":"Hanna Elizabeth Johnson, Saumya Sara Sunny, David Mathew, Regi Oommen, Nylla Shanthly, Priscilla Rupali, Regi Thomas, Rajan Sundaresan, Sumant Samuel, Anil Oommen, Venkatesh Krishnan, Julie Hephzibah","doi":"10.1055/s-0045-1807256","DOIUrl":"10.1055/s-0045-1807256","url":null,"abstract":"<p><strong>Objective: </strong>This article aims to assess the presence of skeletal and soft tissue infections before or after treatment and to assess treatment response in Ga-68 citrate positron emission tomography/computed tomography (PET/CT) scan positive patients.</p><p><strong>Materials and methods: </strong>A prospective study was conducted for 43 patients. The eligibility criteria included those patients clinically suspected of infections who underwent a Ga-68 citrate PET/CT. Exclusion criteria were pregnancy and lactation. Patients with suspicion of infection or treatment failure underwent a Ga-68 citrate PET/CT between January 2020 and November 2021. Among these, eight patients underwent a follow-up scan posttreatment to assess their treatment response. The Institutional Review Board (IRB No.12511) approved the study.</p><p><strong>Results: </strong>Forty-three patients underwent a diagnostic Ga-68 citrate PET/CT scan. The scan interpretation was based on visual comparison of uptake of Ga-68 citrate in the region of interest, which was compared with the normal side/adjacent soft tissue/blood pool. The semiquantitative parameter maximum standardized uptake value was retrospectively analyzed as well. PET/CT findings were correlated with tissue diagnosis, clinical symptoms, biochemical parameters like C-reactive protein (CRP), erythrocyte sedimentation rate, and total leukocyte count, and other imaging modalities with a statistically significant association with CRP ( <i>p</i>  = 0.001). Tissue diagnosis was considered the gold standard and out of the 43 patients included in the study, 27 had a tissue diagnosis. Sensitivity, specificity, negative predictive value, positive predictive value, and accuracy were calculated at 100, 87.5, 100, 95, and 96.3%, respectively.</p><p><strong>Conclusion: </strong>Ga-68 citrate is a promising tool to assess the presence of bone and soft tissue infections before or after treatment.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"24 4","pages":"305-318"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12774518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918721","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":"Locoregional Recurrence after Biochemical Incomplete Response in Differentiated Thyroid Cancer Patients: Insights into Influencing Clinicopathological Factors and the Potential Role of ¹⁸ F-FDG PET/CT.","authors":"Mai Amr Elahmadawy, Ismail Mohamed Ali, Ibrahim Mansour Nasr, Omnia Talaat","doi":"10.1055/s-0045-1806800","DOIUrl":"10.1055/s-0045-1806800","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate the clinicopathological factors and stimulated thyroglobulin (Tg) course related to the occurrence of locoregional recurrence (LRR) in differentiated thyroid cancer (DTC) patients with biochemical incomplete response (BIR) as well as the value of fluorine-18 fluorodeoxyglucose ( ¹⁸ F-FDG) positron emission tomography (PET)/computed tomography (CT) in these patients.</p><p><strong>Methods: </strong>A total of 253 DTC adult patients initially treated with total thyroidectomy and iodine-131 (RAI-131) ablation and showed BIR on follow-up were enrolled in the study. All clinical, laboratory, pathological, radiological, and follow-up data were retrieved from their records.</p><p><strong>Results: </strong>Seventy-three out of the 253 BIR patients developed LRR during follow-up with the median time to recurrence of 27 months. In all, 61.6% of those who developed LRR were females, 78.1% were papillary thyroid carcinomas, 35.6% had initial regional nodal deposits, and the primary tumors were T2 and T3 in 78.2% of these patients ( <i>p</i>  < 0.05). The median Tg level for those who developed LRR compared with those who remained free was 18 versus 17 ng/mL, respectively, at 6 months of follow-up. Meanwhile, on further 1-year follow-up, the median value spontaneously increased for the positive group to 37.6 ng/mL and decreased for those who remained free to 3 ng/mL. Eighty percent of the patients with a rising course of Tg level developed structural LRR ( <i>p</i>  < 0.001). ¹⁸ F-FDG PET/CT showed the highest sensitivity and negative predictive value (NPV) of 100% in the detection of LRR compared with sensitivity values of 92.86 and 85.71% and NPV of 99.58 and 99.17%, respectively, with ultrasound (US) and RAI-131 scan. Meanwhile the highest specificity and positive predictive value (PPV) of 100% were observed noted with RAI-131 compared to specificity values of 99.16 and 99.58% and PPV of 87.50 and 92.86% with PET/CT and US, respectively. A cutoff point (SUVmax of 3.65) was successfully marked to discriminate those positive versus negative LRR with sensitivity and specificity of 100% and <i>p</i> -value of less than 0.001.</p><p><strong>Conclusion: </strong>Structural LRR after BIR appears to be more commonly associated with worse clinicopathological parameters and the incremental Tg levels serve as an indicator of its higher incidence. ¹⁸ F-FDG PET/CT has been shown to be a valuable diagnostic tool rather than a prognostic one in these patients.</p>","PeriodicalId":23742,"journal":{"name":"World Journal of Nuclear Medicine","volume":"24 4","pages":"293-304"},"PeriodicalIF":0.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12774525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918003","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}