Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique最新文献

{"title":"Reverse distribution in two-day stress/rest 99mTc-MIBI myocardial perfusion scintigraphy: A case report","authors":"S. Gülbahar Ateş ,&nbsp;S. Ateş ,&nbsp;S. Günay ,&nbsp;N. Çorakyer ,&nbsp;G. Tatar","doi":"10.1016/j.mednuc.2024.10.003","DOIUrl":"10.1016/j.mednuc.2024.10.003","url":null,"abstract":"<div><div>The clinical significance of the reverse distribution in 99m-Technetium sestamibi (99mTc-MIBI) myocardial perfusion scintigraphy is controversial. In clinical practice, it is often assumed as artefactual. This finding should be approached with caution. We report a case of a 72-year-old patient who exhibited reverse distribution in two-day stress/rest 99mTc-MIBI myocardial perfusion imaging protocol. The patient was diagnosed with non-ST elevation myocardial infarction on the day of rest imaging with scintigraphy.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 3","pages":"Pages 209-212"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"68Ga-DOTATATE PET/CT findings in primary malignant lung glomic tumor","authors":"H. Yin,&nbsp;H. Shi","doi":"10.1016/j.mednuc.2024.12.063","DOIUrl":"10.1016/j.mednuc.2024.12.063","url":null,"abstract":"<div><div>Glomus tumors are neoplasms originating from glomus bodies in the dermis or subcutis of the extremities and are mostly benign. Malignant lung glomic tumors are extremely rare. Here, we report a case of a 31-year-old man who presented with hemoptysis for 1 month. Chest CT scan demonstrated a malignant tumor in the parahilar region of the right upper lobe. A bronchoscopic biopsy was performed and diagnosed as atypical carcinoid tumor. Staging ⁶⁸Ga-DOTATATE PET/CT depicted a tumor with intense tracer uptake in the right pulmonary hilum, with no other lesions. Postoperatively, the mass was diagnosed as a primary malignant lung glomic tumor.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 3","pages":"Pages 213-214"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of brain uptake values in FDG PET-CT study based on body mass index values","authors":"I.E. Çetin,&nbsp;S.A. Tuzcu","doi":"10.1016/j.mednuc.2025.01.187","DOIUrl":"10.1016/j.mednuc.2025.01.187","url":null,"abstract":"<div><h3>Objective</h3><div>In this study, we aimed to compare the calculated SUV values supratentorial and infratentorial areas, and to investigate the effects of BMI differences on brain glucose uptake, in order to evaluate the possible effects of this on the brain in overweight and obese patients who underwent whole body FDG PET/CT study. In addition, we aimed to evaluate the effect of possible treatment supra-infratentorial uptake values.</div></div><div><h3>Method</h3><div>This study included 736 patients who underwent whole-body PET/CT imaging in the last six months to diagnose, stage, respond to treatment, restage, and determine recurrent metastases. Possible effects of body mass index on the brain in overweight and obese patients were measured via SUV_max and SUV_mean values of supratentorial-infratentorial regions and analysing their correlation with body mass index.</div></div><div><h3>Results</h3><div>The group of patients with high BMI, supratentorial SUV_max, supratentorial SUV_mean, infratentorial SUV_max, and infratentorial SUV_mean were significantly higher (<em>P</em> <!-->&lt;<!--> <!-->0.0001). When evaluated according to the imaging indication, considering diagnostic and non-diagnostic indications (response to treatment, recurrence-metastasis investigation, restaging), no statistically significant difference was achieved between the two groups regarding mean age, gender and BMI. However, in the group where PET/CT was performed for diagnostic purposes, supratentorial SUV_max, supratentorial SUV_mean, infratentorial SUV_max, and infratentorial SUV_mean were statistically significantly lower (<em>P</em> <!-->&lt;<!--> <!-->0.0001).</div></div><div><h3>Conclusion</h3><div>Regarding the outcomes of this research, supratentorial SUV_max, supratentorial SUV_mean, infratentorial SUV_max, and infratentorial SUV_mean were statistically significantly higher in obese patients compared to other individuals.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 3","pages":"Pages 202-208"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sommaire","authors":"","doi":"10.1016/S0928-1258(25)00249-9","DOIUrl":"10.1016/S0928-1258(25)00249-9","url":null,"abstract":"","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 3","pages":"Page iii"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting thyroid cancer ablation success: Pre-ablative 99mTc-Pertechnetate and post-ablative 131I scan comparison","authors":"G. Mutevelizade,&nbsp;Y. Parlak,&nbsp;B.C. Bozdemir,&nbsp;C. Sezgin,&nbsp;G. Gumuser,&nbsp;E. Sayit","doi":"10.1016/j.mednuc.2024.05.001","DOIUrl":"10.1016/j.mednuc.2024.05.001","url":null,"abstract":"<div><h3>Introduction</h3><div>The purpose of this study was to evaluate the relationship between pre-ablative ^99mTc-pertechnetate scintigraphy, and therapeutic iodine-131 (¹³¹I) whole-body scan (TxWBS), with ablation status and to investigate the possible predictive factors for successful ablation in differentiated thyroid carcinoma (DTC) patients.</div></div><div><h3>Materials and methods</h3><div>A total of 330 DTC patients underwent ^99mTc-pertechnetate scintigraphy after thyroidectomy. Uptake values were determined using the region-of-interest technique. All patients had neck ultrasonography and TxWBS. Both scintigraphic scans were interpreted visually and qualitatively. The ablation status was evaluated with a diagnostic ¹³¹I whole-body scan.</div></div><div><h3>Results</h3><div>The success rate for residual thyroid ablation was 88.8%. The sensitivity, specificity, accuracy, PPV, and NPV of ^99mTc-Pertechnetate scintigraphy were 82.4%, 87.5%, 82.7%, 99.2%, and 20.2%, respectively. Pre-ablative TG values and ^99mTc uptake (%) were significantly lower in successfully ablated patients. The ^99mTc uptake was determined as a significant predictive factor for ablation success (<em>P</em> <!-->=<!--> <!-->0.000). The optimal ^99mTc uptake cut-off value of 0.75% was demonstrated for successful ablation. There were significant positive correlations between the visual and the calculated uptake (%) of residual tissues on both scintigraphic scans, Considering the number of remnant tissue foci, significant positive correlations were found between ^99mTc-Pertechnetate scintigraphy, TxWBS, and USG.</div></div><div><h3>Conclusion</h3><div>Pre-ablative ^99mTc-Pertechnetate uptake (%) value of the remnant tissue can predict the ablation status in DTC patients. ^99mTc-Pertechnetate scintigraphy, which is an easily applicable and accessible imaging method, has maintained its place in the postoperative and pre-ablative period in DTC patients over the years and has not lost any of its value.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 3","pages":"Pages 179-186"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Que peut nous apprendre l’étude du métabolisme cérébral en TEP au 18F-FDG du syndrome de Lance-Adams ?","authors":"D. Villemonte de la Clergerie ,&nbsp;G. Vellieux ,&nbsp;M-O. Habert ,&nbsp;V. Navarro ,&nbsp;A. Kas","doi":"10.1016/j.mednuc.2024.07.001","DOIUrl":"10.1016/j.mednuc.2024.07.001","url":null,"abstract":"<div><div>Lance-Adams syndrome, also known as “chronic post-anoxic myoclonus”, is a rare syndrome characterised by intention and action myoclonus following cerebral anoxia, leading to major disability. The cortical or subcortical origin of the myoclonus is still debated. Answering this question would open up new avenues of translational research to gain a better understanding of the pathophysiology of this syndrome and better guide the therapeutic management of patients. In addition to a neurological examination, the initial diagnostic work-up includes a biological work-up, electrophysiological investigations and brain imaging to rule out diGerential diagnoses. Cerebral MRI is the reference imaging technique. In the literature, more than a third of patients have a normal MRI. MRI is used to rule out a vascular cause and to look for atrophy or neuronal damage. Few data are available in the literature on the role of nuclear medicine. To date, 13 cases have been published using 18F-FDG PET and 4 using cerebral perfusion scintigraphy. Abnormalities of cortical and/or subcortical perfusion or metabolism are reported in 65% of cases; they are limited to the neocortex in 23% and aGect the cerebellum in 12% of cases. In this article, we present three patients who underwent cerebral 18F-FDG PET scans for Lance-Adams syndrome with normal MRI. The results of these examinations are discussed and compared with the data found in the literature.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 3","pages":"Pages 187-194"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apport de la cisternographie isotopique dans la recherche de fuite du liquide céphalorachidien","authors":"D. Bessac ,&nbsp;J. Todeschi ,&nbsp;A. Coca ,&nbsp;C. Bund ,&nbsp;I.J. Namer","doi":"10.1016/j.mednuc.2024.10.010","DOIUrl":"10.1016/j.mednuc.2024.10.010","url":null,"abstract":"<div><h3>Introduction</h3><div>Intracranial hypotension, primarily characterized by orthostatic headaches, is caused by cerebrospinal fluid (CSF) leakage in almost all cases. Although clinical symptoms can sometimes go unnoticed due to their fluctuating and subjective nature, CSF leakage can cause significant morbidity and potentially lead to irreversible disability. The aim of our study was to evaluate the diagnostic efficacy of radionuclide cisternography in patients presenting with signs of intracranial hypotension where cerebrospinal MRI did not identify the area of leakage.</div></div><div><h3>Materials and methods</h3><div>This was a retrospective, descriptive, monocentric study involving 35 patients. A standardized 2-day acquisition protocol was used for radionuclide cisternography following intrathecal injection of ¹¹¹In-DTPA via suboccipital or lumbar puncture.</div></div><div><h3>Results</h3><div>All 35 patients showed indirect signs of CSF leakage on radionuclide cisternography, compared to 71.4% on MRI. In 15 patients (42.8%), the site of the CSF leak was localized: 1 in the ethmoid bone, 2 adjacent to an osteosynthesis screw, and the remaining 12 at the cervicothoracic junction. These 15 patients received appropriate treatment, resulting in significant clinical improvement: 5 through microsurgery, 2 via injection of biological glue, and 8 with a targeted epidural blood patch.</div></div><div><h3>Conclusion</h3><div>This study demonstrates that radionuclide cisternography, although a technique developed around fifty years ago, remains relevant today as it can localize the site of a CSF leak not identified by conventional MRI, whether in cases of post-traumatic, post-surgical, or spontaneous leaks. The development of new radiotracers for PET is expected to further enhance detection sensitivity by improving spatial resolution.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 3","pages":"Pages 195-201"},"PeriodicalIF":0.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantification en scintigraphie osseuse du poignet : apport des images « pseudo-planaires »","authors":"L. Comas ,&nbsp;A. Paillard ,&nbsp;J. Chhim ,&nbsp;O. Boukhennoufa ,&nbsp;J.M. Nicod ,&nbsp;N. Zerhouni ,&nbsp;H. Boulahdour","doi":"10.1016/j.mednuc.2025.01.015","DOIUrl":"10.1016/j.mednuc.2025.01.015","url":null,"abstract":"<div><h3>Introduction</h3><div>Les fractures du scaphoïde constituent les fractures du carpe les plus courantes. Parfois difficiles à détecter sur des radiographies, il est nécessaire de recourir à d’autres techniques d’imagerie, comme la scintigraphie osseuse, pour confirmer le diagnostic. Des études antérieures ont montré qu’un rapport de 2 entre la région d’intérêt positionnée sur l’os et le côté controlatéral, réalisé sur une image planaire, permettait d’identifier la présence d’une fracture. Nous avons développé un programme permettant de quantifier ces données à partir d’images pseudo-planaires en utilisant des images anatomiques pour positionner les régions d’intérêt (ROI).</div></div><div><h3>Matériels et méthodes</h3><div>Une étude rétrospective a été menée sur 30 patients suspectés de fracture du scaphoïde. Trois séries d’images ont été analysées : planaires, tomographiques et de tomodensitométrie (TDM). Une image « pseudo-planaire » a été générée à partir des images tomographiques en additionnant les coupes coronales. Un traitement similaire a été appliqué aux images de TDM, en additionnant uniquement les intensités de Hounsfield correspondant à la fenêtre osseuse. Les opérateurs ont ensuite réalisé une quantification sur l’image planaire en traçant une ROI sur l’os avec la fixation la plus importante et en reportant cette ROI par symétrie sur le côté controlatéral. Sur les images pseudo-planaires, la même technique a été utilisée, mais en utilisant l’image anatomique pour placer les ROI.</div></div><div><h3>Résultats</h3><div>Les résultats confirment que le seuil pour identifier une fracture est de 2, aussi bien sur les images tomographiques que planaires. Ce facteur est associé aux meilleures sensibilité et spécificité, respectivement, de 100 % et 93 % lorsque la scintigraphie planaire est utilisée comme référence. La répétabilité a été mesurée sur une série de 10 mesures par calcul du coefficient de variation. Ce coefficient est inférieur à 5 % pour toutes les mesures. La reproductibilité a été étudiée à l’aide de l’indice Kappa de Cohen, calculé entre trois opérateurs ayant chacun réalisé des mesures sur 30 cas. En mode planaire, cet indice dépasse 0,80 tandis qu’en mode tomographique, il est supérieur à 0,93.</div></div><div><h3>Conclusion</h3><div>L’utilisation des images pseudo-planaires TEMP et TDM permet de réaliser une quantification efficace pour détecter les fractures du poignet, offrant une bonne répétabilité et une meilleure reproductibilité entre différents observateurs. Ces résultats sont à confirmer sur une population plus large.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 2","pages":"Page 127"},"PeriodicalIF":0.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apport de la TEP au FDG dans le cancer de l’œsophage","authors":"G. Mani,&nbsp;K. Ben Ahmed,&nbsp;R. Ghannem,&nbsp;Z.E. Missaoui,&nbsp;I. Jardak,&nbsp;K. Chtourou","doi":"10.1016/j.mednuc.2025.01.006","DOIUrl":"10.1016/j.mednuc.2025.01.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Le cancer de l’œsophage, associé à un pronostic sombre, requiert des outils d’imagerie performants pour optimiser la prise en charge. La tomographie par émission de positons (TEP) au 18F-FDG est un examen clé pour le bilan d’extension, le suivi thérapeutique et la détection des récidives. Cette étude analyse rétrospectivement l’apport de cet examen dans notre centre.</div></div><div><h3>Matériels et méthodes</h3><div>Nous avons inclus 18 patients ayant bénéficié de 27 TEP au FDG L’examen est réalisé selon le protocole classique avec injection de 3<!--> <!-->MBq/kg.</div></div><div><h3>Résultats</h3><div>L’âge médian était de 62 ans (27–83 ans) avec un sex-ratio de 2 hommes pour 1 femme. Les indications étaient : bilan d’extension initial chez 13 patients, recherche de récidive chez 5 patients et suivi post-thérapeutique chez 9 patients. Les carcinomes épidermoïdes représentaient 72 % des cas. Dans le bilan d’extension initial, les localisations tumorales prédominantes étaient le tiers inférieur de l’œsophage (61 %) avec un SUVmax variant de 4,2 à 31,6 (médiane : 14). Des foyers métastasiques hypermétaboliques osseuses et pulmonaires ont été identifiés chez 4 patients parmi 13. Pour la recherche des récidives, la TEP FDG était positive chez deux patients avec des foyers hépatiques et ganglionnaires. L’évaluation thérapeutique post-radiochimiothérapie a montré une réponse métabolique complète chez 1 patient, partielle chez 5 patients et une progression chez 3 patients.</div></div><div><h3>Conclusion</h3><div>La TEP au FDG demeure indispensable dans la prise en charge des cancers de l’œsophage, en apportant des informations déterminantes pour le staging, la recherche de récidive et l’évaluation thérapeutique. Ces résultats soutiennent la nécessité d’études prospectives pour affiner son rôle dans les recommandations cliniques.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 2","pages":"Pages 123-124"},"PeriodicalIF":0.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Différence entre le 177Lu-PSMA 617 et 177Lu-PSMA I&T : un retour d’expérience après 2 ans","authors":"D. Tonnelet ,&nbsp;A. Coussirou ,&nbsp;L. Augusto ,&nbsp;F. Di Fiore ,&nbsp;P. Vera ,&nbsp;A. Edet Sanson ,&nbsp;P. Bohn","doi":"10.1016/j.mednuc.2025.01.038","DOIUrl":"10.1016/j.mednuc.2025.01.038","url":null,"abstract":"<div><div>En France, le 177Lu-PSMA-617 est disponible depuis décembre 2021 dans le cadre de l’autorisation d’accès précoce chez les patients atteints d’un cancer de la prostate métastatique résistant à la castration (mCRPC) préalablement traité par au moins un inhibiteur de la voie des récepteurs androgènes (ARPI) et au moins ou deux un régime de taxane et qui ont une TEP PSMA positive. Le 177Lu-PSMA I&amp;T est également disponible en France mais dans le cadre d’une autorisation d’accès compassionnel et peut être proposé à des patients atteints de mCRPC préalablement traités par au moins un ARPI. Cependant, contrairement au 177Lu-PSMA-617, le 177Lu-PSMA I&amp;T est disponible chez les patients naïfs de chimiothérapie par taxane. Le dossier médical expérimental du 177Lu-PSMA I&amp;T a été rédigé entre mars et mai 2023. Il a été déposé auprès des autorités le 13 juin 2023 et accepté le 7 juillet 2023. Nous présentons notre retour d’expérience après deux ans dans le traitement de patients atteints de mCRPC en utilisant 177Lu-PSMA-617 ou 177Lu-PSMA I&amp;T. Entre décembre 2021 et novembre 2024, 179 patients ont été adressés en vue d’un traitement par 177Lu-PSMA-617 dont 111 ont reçu au moins une cure de 177Lu-PSMA-617. Tous les patients présentaient des lésions positives en TEP PSMA. Depuis novembre 2023, 10 patients nous ont été adressés en vue d’un traitement au 177Lu-PSMA I&amp;T dont 8 ont reçu au moins une cure de 177Lu-PSMA I&amp;T. Tous les patients adressés pour 177Lu-PSMA I&amp;T avaient une contre-indication à la chimiothérapie en raison de : multiples comorbidités (<em>n</em> <!-->=<!--> <!-->5), d’un terrain cardiaque fragile (<em>n</em> <!-->=<!--> <!-->3), d’antécédents médicaux de fasciite nécrosante liée à une chimiothérapie sans taxane (<em>n</em> <!-->=<!--> <!-->1) ou de neuropathie périphérique pré-existante due à une amylose (<em>n</em> <!-->=<!--> <!-->1). Les raisons de ne pas traiter avec le 177Lu-PSMA I&amp;T étaient la présence de nombreuses lésions FDG positive/PSMA négative (<em>n</em> <!-->=<!--> <!-->1) et l’absence de maladie évolutive claire (<em>n</em> <!-->=<!--> <!-->1). Les données d’efficacité et de tolérance seront mises à jour pour mars 2025. Aucune toxicité hématologique de grade III ou IV n’a été observée avec le 177Lu-PSMA I&amp;T Notre expérience montre que le 177Lu-PSMA I&amp;T est un traitement alternatif chez les patients atteints de mCRPC ayant une contre-indication à la chimiothérapie par taxane. Ses critères d’éligibilité plus larges peuvent aider les unités de médecine nucléaire à traiter des patients fragiles. Il est également économiquement plus rationnel.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 2","pages":"Page 136"},"PeriodicalIF":0.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}