{"title":"Utility of various positron emission tomography tracers in differentiating primary central nervous system lymphoma from glioblastoma multiforme.","authors":"Nobuhiko Kawai, Nobuyuki Miyatake, Kenta Suzuki, Daisuke Ogawa, Tetsuhiro Hatakeyama, Yoshihiro Nishiyama, Keisuke Miyake","doi":"10.1186/s41824-026-00302-x","DOIUrl":"10.1186/s41824-026-00302-x","url":null,"abstract":"<p><p>BACKGROUND: Primary central nervous system lymphoma (PCNSL) can be differentiated from glioblastoma multiforme (GBM) using positron emission tomography (PET) with [18F]fluoro-2-deoxy-D-glucose (FDG). However, differentiation is often difficult with magnetic resonance imaging (MRI) or FDG PET alone. We have used various PET tracers to aid glioma diagnosis; here, we assessed whether multiple PET tracers improve the distinction between GBM and PCNSL. METHODS: We studied 148 patients with newly diagnosed brain tumors: 96 with GBM and 52 with PCNSL (according to the 2016 World Health Organization classification). Tumor-to-normal tissue ratios (TNRs) were calculated for FDG, L[methyl[11C]]methionine, and 3′deoxy3′[18F]fluorothymidine (FLT). Tumor-to-blood ratio (TBR) was measured for [18F]fluoromisonidazole (FMISO). RESULTS: Median FDG TNR was 1.52 (interquartile range [IQR], 1.13–2.13) for GBM and 2.89 (IQR, 1.95–3.85) for PCNSL. MET TNR was 6.38 (IQR, 4.68–7.48) for GBM and 4.01 (IQR, 3.28–7.52) for PCNSL. FLT TNR was 17.35 (IQR, 11.10–22.28) for GBM and 25.61 (IQR, 15.91–55.30) for PCNSL. FMISO TBR was 2.72 (IQR, 2.22–3.62) for GBM and 1.58 (IQR, 1.04–1.93) for PCNSL. Receiver operating characteristic analysis showed areas under the curve of 0.78 (FDG), 0.62 (MET), 0.69 (FLT), and 0.85 (FMISO). FLT TNR had the highest sensitivity of 83.2% while FMISO TBR had the highest specificity of 84.2%. Among the four tracers, FLT showed the highest sensitivity and FMISO showed the highest specificity. Dual‑tracer combinations did not improve overall diagnostic accuracy beyond the best single tracers. CONCLUSIONS: Among four PET tracers, FMISO was most effective in distinguishing GBM from PCNSL. Diagnostic accuracy was highest when each tracer was used individually. </p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"10 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825589","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}
EJNMMI reportsPub Date : 2026-04-24DOI: 10.1186/s41824-026-00297-5
Xiaodan Xu, Guanyun Wang, Xiaojun Zhang, Ruimin Wang, Guangyu Ma
{"title":"Uptake of <sup>18</sup>F-AlF-NOTA-octreotide PET/CT in gastrointestinal stromal tumors.","authors":"Xiaodan Xu, Guanyun Wang, Xiaojun Zhang, Ruimin Wang, Guangyu Ma","doi":"10.1186/s41824-026-00297-5","DOIUrl":"10.1186/s41824-026-00297-5","url":null,"abstract":"<p><p>Gastrointestinal stromal tumors (GISTs) are rare stromal neoplasms that predominantly arise in the gastrointestinal tract. 18F-AlF-NOTA-octreotide (18F-OC) is a novel molecularly targeted probe that specifically binds to tumors expressing somatostatin receptors. A 45-year-old male patient underwent 18F-OC PET/CT due to clinical suspicion of a pancreatic neuroendocrine tumor. Imaging revealed a mass with increased 18F-OC uptake inferior to the pancreatic head. The patient subsequently underwent surgical resection, and histopathological assessment confirmed a low-risk gastrointestinal stromal tumor.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"10 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794156","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":"⁶⁸GA-Pentixafor PET/CT: a non-invasive molecular alternative to adrenal venous sampling in primary aldosteronism.","authors":"Parth Bambhroliya, Kanhaiyalal Agrawal, Girish Kumar Parida, Gopinath Gnanasegaran","doi":"10.1186/s41824-026-00287-7","DOIUrl":"10.1186/s41824-026-00287-7","url":null,"abstract":"<p><p>Primary aldosteronism (PA) is the most common cause of secondary hypertension, where accurate subtype differentiation between unilateral aldosterone-producing adenoma (APA) and bilateral adrenal hyperplasia (BAH) determines therapeutic strategy. Adrenal venous sampling (AVS) remains the reference standard but is invasive, technically demanding, and not widely available. Recent advances in molecular imaging have introduced CXCR4-targeted positron emission tomography using ⁶⁸Ga-Pentixafor as a promising non-invasive tool for functional characterization and lateralization of aldosterone-producing lesions. CXCR4 is highly expressed in the zona glomerulosa and in aldosterone-producing adenomas, and it closely correlates with CYP11B2 (aldosterone synthase) expression. Across multiple clinical studies, ⁶⁸Ga-Pentixafor PET/CT has demonstrated high diagnostic accuracy, with reported sensitivities ranging from 74% to 98% and specificities from 84% to 100%, showing substantial concordance with AVS findings. In addition, PET-guided adrenalectomy yields biochemical and clinical outcomes comparable to AVS-guided management while avoiding procedural risks. By targeting CXCR4 expression, ⁶⁸Ga-Pentixafor PET/CT offers reliable lateralization with good agreement to AVS and strong clinicopathological correlation. Ongoing studies will further clarify its diagnostic role and integration into routine evaluation of primary aldosteronism.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"10 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13087077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701529","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}
EJNMMI reportsPub Date : 2026-04-10DOI: 10.1186/s41824-026-00284-w
C M Mayur, Keerthana Kiran Kandula, M A Ashique Rahman, Suprava Naik, Bijayini Behera, Girish Kumar Parida, Sanjeev Kumar Bhoi, P Sai Sradha Patro, Kanhaiyalal Agrawal
{"title":"[⁶⁸Ga]Ga-FAPI-46 PET/CT imaging in neuromelioidosis: a case series demonstrating potential utility in diagnosis and response assessment.","authors":"C M Mayur, Keerthana Kiran Kandula, M A Ashique Rahman, Suprava Naik, Bijayini Behera, Girish Kumar Parida, Sanjeev Kumar Bhoi, P Sai Sradha Patro, Kanhaiyalal Agrawal","doi":"10.1186/s41824-026-00284-w","DOIUrl":"10.1186/s41824-026-00284-w","url":null,"abstract":"<p><p>Neuromelioidosis is a rare but severe manifestation of melioidosis with central nervous system (CNS) involvement, caused by gram negative saprophytic bacteria named Burkholderia pseudo-mallei and is associated with high morbidity and mortality. Early and accurate detection of active disease is crucial for appropriate management. We report a series of three cases of neuromelioidosis evaluated using Gallium-68–labelled fibroblast activation protein inhibitor ([⁶⁸Ga]Ga-FAPI) positron emission tomography/computed tomography (PET/CT). [⁶⁸Ga]Ga-FAPI, a novel molecular imaging tracer targeting activated fibroblasts, has demonstrated utility in imaging infection and inflammation in addition to malignancies. Unlike [¹⁸F]FDG (F-18 Fluorodeoxyglucose), [⁶⁸Ga]Ga-FAPI shows negligible physiological uptake in normal brain parenchyma, allowing superior lesion conspicuity. In the three cases reported, [⁶⁸Ga]Ga-FAPI PET/CT clearly demonstrated active CNS inflammatory lesions better than [¹⁸F]FDG PET-CT, facilitating accurate disease assessment and aiding clinical decision-making. The findings on [⁶⁸Ga]Ga-FAPI PET/CT correlated with the MRI findings and further it was found to be better than MRI for response evaluation in one case. This highlights the potential role of [⁶⁸Ga]Ga-FAPI PET/CT as a promising functional imaging modality in the evaluation of neuromelioidosis and other CNS infections.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"10 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648149","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}
EJNMMI reportsPub Date : 2026-04-03DOI: 10.1186/s41824-026-00291-x
Badriah Alasmari, Reham Salah El-Din Sherif, Magdy Mohamed Ghannam, Khalid Elsaban, Mohammed Abdullah Al-Amri
{"title":"Diagnostic accuracy of SPECT/CT in parathyroid adenoma detection: impact of radiopharmaceutical choice and quality control practices.","authors":"Badriah Alasmari, Reham Salah El-Din Sherif, Magdy Mohamed Ghannam, Khalid Elsaban, Mohammed Abdullah Al-Amri","doi":"10.1186/s41824-026-00291-x","DOIUrl":"10.1186/s41824-026-00291-x","url":null,"abstract":"<p><p>PURPOSE: To evaluate the diagnostic accuracy of SPECT/CT for localizing parathyroid adenomas and to determine how radiopharmaceutical choice (MIBI vs. Myoview) and quality control (QC) practices affect detection performance and administered dose consistency in clinical practice. METHODS: This retrospective study included 136 patients who underwent dual-phase parathyroid scintigraphy with SPECT/CT at Al-Hada Armed Forces Hospital. Patients were classified into four groups according to radiopharmaceutical (MIBI or Myoview) and QC status (Regular or Irregular QC). Administered activity, detection accuracy, lesion localization, and concordance with surgical findings were assessed. Diagnostic performance was compared between SPECT/CT and planar imaging. Statistical analyses included ANOVA, χ² tests, and correlation analysis. RESULTS: SPECT/CT demonstrated significantly higher diagnostic accuracy than planar imaging across all groups. Regular QC conditions produced the most consistent administered activities and the highest detection rate (97.1%), whereas Irregular QC significantly reduced accuracy to 72.1%. MIBI showed superior performance under QC variability, maintaining higher sensitivity and more consistent lesion localization than Myoview. SPECT/CT also improved detection of ectopic and multi-gland disease compared with planar imaging. CONCLUSION: SPECT/CT provides high diagnostic accuracy for parathyroid adenoma detection, but performance is strongly influenced by QC practices and, to a lesser extent, by radiopharmaceutical choice. Regular QC ensures optimal dose consistency and diagnostic reliability, while MIBI offers greater robustness under variable QC conditions. These findings support QC standardization and radiopharmaceutical selection as key determinants of improved clinical outcomes. </p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"10 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611219","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}
EJNMMI reportsPub Date : 2026-03-27DOI: 10.1186/s41824-026-00296-6
Xueqin Zhao, Zhenzhen Wang, Xingyu Mu, Yang Wu, Jie Qin, ZuGuo Li, Wei Fu
{"title":"<sup>18</sup>F-FDG PET/CT and MRI findings of an atypical glomus tumor of the thoracic spine: a rare case report.","authors":"Xueqin Zhao, Zhenzhen Wang, Xingyu Mu, Yang Wu, Jie Qin, ZuGuo Li, Wei Fu","doi":"10.1186/s41824-026-00296-6","DOIUrl":"10.1186/s41824-026-00296-6","url":null,"abstract":"<p><strong>Background: </strong>Glomus tumors (glomangiomas) are rare mesenchymal neoplasms derived from modified smooth muscle cells of the glomus body. Since they most commonly occur in the subungual regions of the extremities, primary involvement of the spine is exceedingly rare, particularly in atypical variants with borderline biological behavior.</p><p><strong>Case presentation: </strong>A 61-year-old man presented with a long-standing history of intermittent back pain that had recently worsened. Magnetic resonance imaging revealed a solid lesion involving the T10-T11 vertebral region with intermediate T1 signal intensity, mildly hypointense T2 signal, intralesional hemorrhagic foci, and marked heterogeneous enhancement causing spinal canal stenosis. <sup>18</sup>F-FDG PET/CT demonstrated mild to moderate focal radiotracer uptake (SUVmax 5.6) corresponding to the spinal lesion, without evidence of other FDG-avid lesions suggestive of a primary malignancy or metastatic disease. Surgical resection was primarily indicated based on progressive symptoms and MRI findings; PET/CT findings did not alter the surgical decision but provided additional staging information, and histopathological examination established the diagnosis of an atypical glomus tumor.</p><p><strong>Conclusion: </strong>This case highlights the complementary role of MRI and <sup>18</sup>F-FDG PET/CT in the evaluation of rare spinal glomus tumors. <sup>18</sup>F-FDG PET/CT may provide supportive metabolic information and help assess the presence of additional FDG-avid lesions in atypical presentations.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"10 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13022147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147523183","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}
EJNMMI reportsPub Date : 2026-03-20DOI: 10.1186/s41824-026-00294-8
Swen Hesse, Manja Schiefer, Solveig Tiepolt, Dorit Prochnow, Larissa Mämecke, Frank Hoffmann, Iñaki Schniewind, Osama Sabri, Björn Falkenburger, Sebastian Brock
{"title":"An MSA-P patient presenting with preserved glucose metabolism in the putamen, cerebellar hypometabolism and pronounced loss of presynaptic dopamine transporter in the striatum.","authors":"Swen Hesse, Manja Schiefer, Solveig Tiepolt, Dorit Prochnow, Larissa Mämecke, Frank Hoffmann, Iñaki Schniewind, Osama Sabri, Björn Falkenburger, Sebastian Brock","doi":"10.1186/s41824-026-00294-8","DOIUrl":"10.1186/s41824-026-00294-8","url":null,"abstract":"<p><p>Positron emission tomography (PET) of the brain using [18F]fluorodeoxyglucose (FDG) is becoming increasingly important for the diagnosis and differential diagnosis of atypical parkinsonian syndrome such as multiple system atrophy (MSA), which is characterized by hypometabolism of the putamen, pons, and cerebellum. We report on a patient with clinically established MSA based on a rapidly progressive, poorly levodopa-responsive parkinsonian syndrome, multidomain autonomic failure, and imaging findings where hereditary spastic paraplegia was discussed as a differential diagnosis. PET images revealed a well-preserved glucose metabolism in the striatum, specifically in the putamen, while metabolism in the cerebellum was significantly reduced. This pattern of glucose metabolism might indicate a distinct subtype of synucleinopathy as proven by seed-amplification assay and should be taken into account when diagnosing patients with MSA.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"10 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13003084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489249","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}
EJNMMI reportsPub Date : 2026-03-13DOI: 10.1186/s41824-026-00292-w
Jacob Ingvar, Johan Wittgren, Vigdis Sverrisdottir, Elin Trägårdh, Anders Bjartell
{"title":"Prognostic value of tumour volume based on [<sup>18</sup>F]PSMA-1007 PET/CT in prostate cancer.","authors":"Jacob Ingvar, Johan Wittgren, Vigdis Sverrisdottir, Elin Trägårdh, Anders Bjartell","doi":"10.1186/s41824-026-00292-w","DOIUrl":"10.1186/s41824-026-00292-w","url":null,"abstract":"<p><p>BACKGROUND: Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) enables sensitive detection and staging of prostate cancer, yet its relationship with long-term survival remains unclear. This study aimed to assess whether total lesion volume (TLV) measured on [18F]PSMA-1007 PET/CT predicts overall survival (OS) in prostate cancer patients. METHODS: A cohort of 282 patients scanned between 2019 and 2021 was retrospectively studied, including both patients undergoing primary staging and imaging for biochemical recurrence (BCR). Tumour lesions in the prostate/prostate bed, lymph nodes and bone were manually segmented and TLV was calculated for each compartment and as total of all lesions. Based on TLV, patients were categorized into three groups for each compartment: no detectable tumour, TLV ≤ median, and TLV > median. Bone analyses were dichotomised into any vs. no detectable tumour. The association with OS was assessed using age-adjusted Cox proportional-hazards models and Kaplan–Meier analysis, separately for the primary staging subgroup and the BCR subgroup. RESULTS: Over a mean follow-up of almost 5 years, 49 patients (17%) died. In the primary staging subgroup (n = 171), detectable bone metastases on PSMA PET-CT predicted poorer survival compared to no detectable bone metastasis (HR 2.39, p = 0.031). Among patients with BCR (n = 111), total TLV above the median and a prostate TLV above the median both predicted an almost 5 times increased risk of death. CONCLUSION: Total lesion volume on [18F]PSMA-1007 PET/CT was associated with OS, with different prognostic patterns in primary staging and BCR. The results support future incorporation of volumetric PSMA PET metrics into personalized staging and therapeutic decision-making. </p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"10 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446427","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}
EJNMMI reportsPub Date : 2026-03-06DOI: 10.1186/s41824-026-00295-7
Emil Novruzov, Frederik L Giesel, Eduards Mamlins, Tadashi Watabe, Jens Cardinale, Christina Antke, Yuriko Mori, Nils Schupps, Claudio Pinto, Cristian Soza-Ried, Rene Fernandez, Horacio Amaral, Vasko Kramer, Leonardo Badinez
{"title":"The analysis of biodistribution and tumor uptake of [<sup>18</sup>F]AlF-FAPI-74 in patients with soft tissue sarcoma and gastro-intestinal tumors compared with [<sup>18</sup>F]FDG in a prospective, exploratory study.","authors":"Emil Novruzov, Frederik L Giesel, Eduards Mamlins, Tadashi Watabe, Jens Cardinale, Christina Antke, Yuriko Mori, Nils Schupps, Claudio Pinto, Cristian Soza-Ried, Rene Fernandez, Horacio Amaral, Vasko Kramer, Leonardo Badinez","doi":"10.1186/s41824-026-00295-7","DOIUrl":"10.1186/s41824-026-00295-7","url":null,"abstract":"<p><p>BACKGROUND: The roll-out of FAP (fibroblast-activation-protein) imaging with small-molecule PET tracers marks one of the major breakthroughs in nuclear medicine. The majority of current evidence, however, has been generated by 68Ga-labelled FAPI tracers, a reliance that presents serious economical and logistic challenges to the oncological community. Hence, current research focuses on development of 18F-labelled FAPI tracers to overcome the limitations of 68Ga-labelling. [18F]AlF-FAPI-74, a recently introduced radiotracer, emerges as a promising candidate to fulfill those unmet clinical needs. This single-center, exploratory study sought to investigate the biodistribution and tumor uptake of [18F]AlF-FAPI-74 across various tumor entities in a head-to-head comparison with [18F]FDG imaging. MATERIAL AND METHOD: A total of 19 patients (15 males and 4 females) were enrolled in this prospective study with a head-to-head analysis of [18F]FAPI-74 and [18F]FDG PET/CT imaging between May 2021 and January 2024. According to inclusion criteria, patients underwent PET/CT scans, when they had either a biopsy-proven or highly suspected malignancy with a prior FDG imaging, or highly suspected or proven recurrence by clinical or other imaging findings or therapy monitoring after neoadjuvant or also palliative radiochemotherapy. All patients had histologically proven malignancies of pancreatic adenocarcinoma (PDAC) in 8 patients, soft tissue sarcoma (STS) in 6 patients, colorectal carcinoma (CRC) in 4 patients and gastric carcinoma in 1 patient. The mean injected activity for [18F]FAPI-74 and [18F]FDG PET/CT was 239 MBq (± 57) and 209 MBq (± 74) and the mean uptake time was 72 min (± 10) and 73 min (± 17), respectively. RESULTS: [18F]AlF-FAPI-74 demonstrated superior imaging characteristics compared to [18F]FDG, identifying a greater number of both primary and metastatic lesions across all tumor entities. Our SUV-metrics analysis revealed more favorable results for the detection of primary lesions with [18F]FAPI-74 imaging (e.g. SUVmax ± SD, 9.79 ± 4.2 vs. 6.41 ± 2.8, [18F]FAPI-74 vs. [18F]FDG, respectively), whereas only the TBR in relation to blood pool appeared to be statistically significant (5.08 vs. 3.15 (p: 0.03); [18F]FAPI-74 vs. [18F]FDG, respectively). We observed a similar tendency in the analysis of SUV-metrics (e.g. SUVmax ± SD, 7.42 ± 2.8 vs. 6.18 ± 2.7, [18F]FAPI-74 vs. [18F]FDG, respectively) in metastatic lesions as well. CONCLUSIONS: In this prospective, exploratory study cohort, [18F]FAPI-74 appeared to display more favorable imaging characteristics such as lesion contrast and delineation compared with [18F]FDG. Given the advantages of 18F-labeling, [18F]FAPI-74 warrants further investigation with larger cohorts to determine its diagnostic potential and clinical impact. </p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"10 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367784","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}