EJNMMI reports最新文献

{"title":"AI based automatic measurement of split renal function in [¹⁸F]PSMA-1007 PET/CT.","authors":"Kristian Valind, Johannes Ulén, Anni Gålne, Jonas Jögi, David Minarik, Elin Trägårdh","doi":"10.1186/s41824-025-00254-8","DOIUrl":"10.1186/s41824-025-00254-8","url":null,"abstract":"<p><strong>Background: </strong>Prostate-specific membrane antigen (PSMA) is an important target for positron emission tomography (PET) with computed tomography (CT) in prostate cancer. In addition to overexpression in prostate cancer cells, PSMA is expressed in healthy cells in the proximal tubules of the kidneys. Consequently, PSMA PET is being explored for renal functional imaging. Left and right renal uptake of PSMA targeted radiopharmaceuticals have shown strong correlations to split renal function (SRF) as determined by other methods. Manual segmentation of kidneys in PET images is, however, time consuming, making this method of measuring SRF impractical. In this study, we designed, trained and validated an artificial intelligence (AI) model for automatic renal segmentation and measurement of SRF in [¹⁸F]PSMA-1007 PET images.</p><p><strong>Results: </strong>Kidneys were segmented in 135 [¹⁸F]PSMA-1007 PET/CT studies used to train the AI model. The model was evaluated in 40 test studies. Left renal function percentage (LRF%) measurements ranged from 40 to 67%. Spearman correlation coefficients for LRF% measurements ranged between 0.98 and 0.99 when comparing segmentations made by 3 human readers and the AI model. The largest LRF% difference between any measurements in a single case was 3 percentage points. The AI model produced measurements similar to those of human readers.</p><p><strong>Conclusions: </strong>Automatic measurement of SRF in PSMA PET is feasible. A potential use could be to provide additional data in investigation of renal functional impairment in patients treated for prostate cancer.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304309","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":"Systematic double reading for oncological PET/CT scans: insights from a prospective multicentre study in 678 patients.","authors":"Fabrice Gutman, Didier Poncin, Renaud Guedec-Ghelfi, Rémi Génin, Pierre-Maxime David, Amélie Cuif, Geoffrey Popinat, Vincent Nogueira, Nicolas Aide","doi":"10.1186/s41824-025-00253-9","DOIUrl":"10.1186/s41824-025-00253-9","url":null,"abstract":"<p><strong>Introduction: </strong>As PET/CT's role in oncology expands, with increasing demands for staging, restaging, and therapy monitoring across a range of malignancies, and with the rise of theranostics, PET facilities are experiencing higher workloads, raising concerns about the accuracy of reports. This prospective study evaluates the frequency and nature of errors identified through a double-reading protocol.</p><p><strong>Materials and methods: </strong>Patients scheduled for baseline or follow-up PET/CT scans were prospectively included in the study between May and June 2024. PET scans included [18 F]FDG, [18 F]Choline, [18 F]Dopa, and [18 F]PSMA. Each scan was independently reviewed by a second reader before finalizing the report. Significant changes were discussed before validation, and a third reader's input was sought if consensus was needed. Data collection focused on potential factors influencing PET report errors, using a survey completed by second readers evaluating report changes (minor versus impactful), reader confidence, modified diagnostic hypotheses, and whether the initial reader was a permanent doctor or a locum doctor. Information regarding the indication, the number of previous scans for comparison, and the timing (period of the day) of PET readings was also recorded.</p><p><strong>Results: </strong>Two-thirds of second readings were completed within 2-5 min. Changes were reported in 17% of PET reports (117/678), although impactful changes were rare. In therapy monitoring, only 5 out of 20 changes were significant. In staging and restaging, two major changes were noted. Most changes involved phrasing or formatting (59%), laterality (10%), and target lesions that did not affect TNM staging (29%). Regarding the degree of certainty, 18 changes were observed: 8 cases shifted from doubtful to certain, and 10 from certain to doubtful, necessitating follow-up scans. Factors such as the timing of the first reading, indication for PET, number of previous comparative PET scans, PET request clarity, first reader's experience, type of PET tracer, and patient BMI, as a surrogate of image quality, showed no significant correlation with changes in PET reports.</p><p><strong>Conclusion: </strong>Systematic double reading effectively identifies and corrects both rare impactful and minor errors in PET reports, though no specific predictive factors for error occurrence were identified, indicating that double reading, if performed, must be systematic.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288096","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":"Managing incidental findings in total body PET/CT studies: balancing ethical considerations and resource constraints.","authors":"Georgios I Angelis, Katie Ockenden, Steven R Meikle, Fernando Calamante","doi":"10.1186/s41824-025-00251-x","DOIUrl":"10.1186/s41824-025-00251-x","url":null,"abstract":"<p><p>Total body positron emission tomography (TB-PET) represents a major advancement in molecular imaging. While this technology expands the capabilities of PET imaging for both research and clinical applications, it also introduces significant ethical and operational challenges, particularly in the management of incidental findings. Current ethical and regulatory guidance acknowledge the need to address incidental findings that arise during research studies, but often provides ambiguous or insufficient direction. This leaves institutions to independently balance participant safety, ethical responsibilities, and resource constraints. Using the Australian National Total Body PET Facility as a case study, this article explores strategies for managing incidental findings in PET/CT research. By comparing research workflows with clinical practices, we highlight critical differences and propose a practical framework to help institutions establish ethically sound and feasible protocols. This framework aims to balance the duty of care to the participant with the logistical demands of PET research, contributing to the ongoing discourse on ethical imaging practices and offering guidance for managers of TB-PET research facilities.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121837","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":"Comparison of inter- and intraobserver agreement between [¹⁸F]AlF-NOTA-octreotide and [⁶⁸Ga]Ga-DOTA-SSA PET/CT.","authors":"Hannes Leupe, Niloefar Ahmadi Bidakhvidi, Karolien Goffin, Bliede Van den Broeck, Sander Jentjens, Annouschka Laenen, Elin Pauwels, Willem Lybaert, Eric Van Cutsem, Guy Bormans, Timon Vandamme, Frederik Cleeren, Jeroen Dekervel, Karen Geboes, Sigrid Stroobants, Chris Verslype, Christophe M Deroose","doi":"10.1186/s41824-025-00250-y","DOIUrl":"https://doi.org/10.1186/s41824-025-00250-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study compares inter- and intraobserver agreement between [¹⁸F]AlF-NOTA-octreotide ([¹⁸F]AlF-OC) and [⁶⁸Ga]Ga-DOTA-somatostatin analogues (SSAs) in PET/CT imaging for neuroendocrine neoplasm (NEN) patients.</p><p><strong>Materials and methods: </strong>This is a secondary endpoint analysis from our multicenter trial (clin trial.gov identifier: NCT04552847) including 75 NEN patients who received both [⁶⁸Ga]Ga-DOTATATE (n = 56) or [⁶⁸Ga]Ga-DOTA-NOC (n = 19) and [¹⁸F]AlF-OC PET imaging. Five readers assessed lesion detection and characterization across multiple organs, scoring lesions by number and conspicuity using a 5-point Likert scale. Agreement was measured using Gwet's agreement coefficient.</p><p><strong>Results: </strong>Results demonstrated nearly perfect interobserver agreement for lesion characterization across all organs for both tracers (0.921 for [¹⁸F]AlF-OC; 0.934 for [⁶⁸Ga]Ga-DOTA-SSA). Similar agreement was observed for the number of lesions across organs (0.736 for [¹⁸F]AlF-OC and 0.749 for [⁶⁸Ga]Ga-DOTA-SSAs). Organ-specific analysis revealed strong agreement for bone and liver lesions, with slightly lower agreement for lymph nodes. Both tracers also showed excellent agreement in determining Krenning scores (0.925 for [¹⁸F]AlF-OC and 0.927 for [⁶⁸Ga]Ga-DOTA-SSAs). While mean lesion conspicuity was similar between tracers, [¹⁸F]AlF-OC had a higher global image quality score (4.22 vs. 3.86, p < 0.0001). Intraobserver agreement was consistent between tracers for lesion characterization (> 0.95 for both readers) and lesion count (> 0.80 for both readers).</p><p><strong>Conclusion: </strong>[¹⁸F]AlF-OC and [⁶⁸Ga]Ga-DOTA-SSAs demonstrate comparable and excellent inter- and intraobserver agreement, reinforcing the clinical interchangeability of [¹⁸F]AlF-OC PET/CT with [⁶⁸Ga]Ga-DOTA-SSAs in routine practice.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"17"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082312","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":"Practical use of radiomic features as a metric for image quality discrimination in [¹⁸F] FDG-PET: a pilot study.","authors":"Jane Burns, Hannah O'Driscoll, Eamon Loughman","doi":"10.1186/s41824-025-00243-x","DOIUrl":"https://doi.org/10.1186/s41824-025-00243-x","url":null,"abstract":"<p><strong>Purpose: </strong>Radiomics features have been utilised as group metrics of image quality in many areas of diagnostic radiology. In this pilot study, the relationship between technical metrics used in image quality assurance and visual grading scores provided by a radiologist were evaluated. Image dataset harmonisation allowed comparison between the two and allowed trends to be extracted. We propose a reproducible technique to identify the metrics.</p><p><strong>Methods: </strong>A retrospective chart review of 30 [¹⁸F] FDG-PET/CT performed in a nuclear medicine referral centre was performed. Image datasets were reprocessed to correspond to a bed duration of 180, 120, 60, 30 s per bed position and were analysed according to a pre-set bank of semi-quantitative features by a radiology resident. The extraction of radiomic features in PET images was performed using SLICER-RADIOMICS Module version 5.2.2. To facilitate the comparison of radiomic features and radiologist scoring data, normalisation was performed on both data sets. Fréchet distance analysis, Mean Square Error and Mean Absolute Error display the level of agreement between features and radiologist following the rescale of the data.</p><p><strong>Results: </strong>Of the 120 reprocessed image datasets, 115 were included in the study. We focused on overall image quality score rather than individual radiomic metrics as this identified the most robust trend. A significant difference in the 30 s image dataset with respect to each group individually and combined for the radiologist overall score was observed.</p><p><strong>Conclusion: </strong>Our results show that a large percentage change in certain features can indicate a significant change in quality in clinically processed images.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061585","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":"Fatal mycosis fungoides, misdiagnosed as contact dermatitis.","authors":"Ghazal Shadmani, Justin Dumrongkulraksa, Amin Haghighat Jahromi","doi":"10.1186/s41824-025-00249-5","DOIUrl":"https://doi.org/10.1186/s41824-025-00249-5","url":null,"abstract":"<p><strong>Background: </strong>Mycosis fungoides (MF) is a rare subtype of non-Hodgkin's lymphoma that primarily involves the skin. Its slow progression over several years and diverse clinical presentations-including itchy patches, plaques, or tumors-often lead to initial diagnosis of inflammatory dermatoses such as eczema or psoriasis, making accurate diagnosis challenging.</p><p><strong>Case presentation: </strong>We present Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) findings of a 61-year-old man with histologically confirmed cutaneous T-cell lymphoma (CTCL), mycosis fungoides (MF). The disease initially manifested as an itching rash on his palms, which gradually progressed over a year to involve his trunk and extremities, ultimately affecting 70% of his body surface area despite multiple treatments, including prednisone, dupilumab, methotrexate, and adalimumab. The patient was initially misdiagnosed and treated for contact dermatitis for three years. After the final diagnosis of MF, his condition continued to deteriorate despite IV antibiotics, palliative radiation, and one cycle of brentuximab vedotin. The patient succumbed to the disease 23 days after the MF diagnosis.</p><p><strong>Conclusion: </strong>This report highlights the clinical overlap between inflammatory dermatoses and mycosis fungoides and serves as a reminder to clinicians to consider MF in patients with persistent, atypical dermatitis and to employ comprehensive diagnostic tools to guide management.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"15"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056779","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":"Brazilian profile of Radium-223 in metastatic prostate cancer: a multicentric, retrospective study.","authors":"Stephan Souza, Felipe Ribeiro, Ana Brito, Thaís Minekawa, Flávia Lopes, Sumara Matedi, Renata Fockink, Dalton Anjos, Gustavo Gomes, Laura Silva, Mariana Camacho, Allan Santos, Whemberton Araújo, Ana Teixeira, Raul Martins, Adelina Sanches, Nilton Hanaoka, Rafael Tavares, Felipe Villela-Pedras, Felipe Mourato, Caroline Torricelli, Thiago Alves, Marcelo Tavares, Mariana Lima, André Moraes, André Sasse, Paulo Almeida, Elba Etchebehere","doi":"10.1186/s41824-025-00245-9","DOIUrl":"https://doi.org/10.1186/s41824-025-00245-9","url":null,"abstract":"<p><strong>Background: </strong>Radium-223 (²²³Ra) therapy has been available since 2013 for metastatic castrate-resistant prostate cancer (mCRPC). However, only in 2017 ²²³Ra was approved by the National Health Surveillance Agency in Brazil. We aimed to perform a multicenter analysis of mCRPC patients treated with ²²³Ra in referral centers in Brazil and describe their clinical outcomes. For this reason, we retrospectively analyzed mCRPC patients who underwent ²²³Ra treatment. Clinical and laboratory data were evaluated.</p><p><strong>Results: </strong>308 patients submitted to 1402 ²²³Ra cycles from 9 centers were studied. Previous treatments prior to ²²³Ra were chemotherapy (59.1%), radiation therapy (54.8%) and hormone therapy (92.2%). ²²³Ra was used as the fifth or more line of treatment in 58.4% of the patients. The mean number of ²²³Ra cycles was 4.6; 51% of patients completed all 6 cycles and 52.9% progressed during ²²³Ra. Concomitant treatment with ²²³Ra occurred in 69.4% of patients. The median overall survival (OS) for all patients was 13.7 months. The OS was higher for patients completing 6 cycles compared to < 6 cycles (22.6 vs 6.4 months, respectively). When stratified according to Brazilian regions, the median OS for the southeast region was higher (range: 14.5-30.2 months) than the other regions.</p><p><strong>Conclusions: </strong>The OS of ²²³Ra for patients completing 6 cycles was very high. However, there were major discrepancies when stratified according to different regions in the nation. The data is an important demonstration of the country's educational referral discrepancies related to proper patient management for ²²³Ra therapy, which has a major impact on maximum OS benefit.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049077","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":"Integration of amide proton transfer-weighted imaging and methionine positron emission tomography histogram parameters enhances the prediction of isocitrate dehydrogenase mutations in adult diffuse gliomas.","authors":"Masaoki Kusunoki, Takuro Isoda, Koji Yamashita, Yoshiyuki Kitamura, Kazufumi Kikuchi, Motohiro Sando, Shingo Baba, Daisuke Kuga, Yutaka Fujioka, Fumiya Narutomi, Koji Yoshimoto, Kousei Ishigami, Osamu Togao","doi":"10.1186/s41824-025-00248-6","DOIUrl":"https://doi.org/10.1186/s41824-025-00248-6","url":null,"abstract":"<p><strong>Background: </strong>To evaluate whether the combination of amide proton transfer-weighted imaging (APT-WI) and methionine positron emission tomography (MET-PET) enhances the non-invasive prediction of isocitrate dehydrogenase (IDH) mutation status in adult diffuse gliomas.</p><p><strong>Results: </strong>We retrospectively analysed 28 adult patients with histologically confirmed diffuse gliomas who underwent preoperative APT-WI and MET-PET imaging at our institution. Histogram analyses were conducted for both imaging modalities, extracting parameters such as the 10th, 50th, 70th, and 90th percentiles, mean, variance, skewness, and kurtosis. Parameters between IDH-mutant and IDH-wildtype gliomas were compared using the Mann-Whitney U test. Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis, and combined models of the two parameters were constructed using multivariable logistic regression. IDH-wildtype gliomas exhibited significantly higher APT-WI 90th percentile (APT₉₀) values (median: 3.51%, interquartile range [IQR]: 1.92-4.23%) compared to IDH-mutant gliomas (median: 2.24%, IQR: 1.52-2.85%, p = 0.039). Similarly, IDH-wildtype gliomas showed elevated MET-PET maximum tumour-to-normal ratios (TNR_max) (median: 2.51, IQR: 2.13-3.41) compared to IDH-mutant gliomas (median: 1.62, IQR: 1.30-2.77, p = 0.020). ROC curve analysis indicated that the combined model of APT₉₀ and TNR kurtosis achieved an area under the curve of 0.85, demonstrating superior diagnostic accuracy compared to that of single-parameter models.</p><p><strong>Conclusions: </strong>Combining histogram-derived parameters from APT-WI and MET-PET significantly improves the diagnostic accuracy for predicting IDH mutation status in diffuse gliomas. This non-invasive approach may serve as a valuable adjunct for preoperative evaluation and the development of personalised treatment strategies in patients with gliomas.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11996729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060131","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":"Medium-vessel vasculitis following COVID-19 moderna (mRNA-1273) vaccination and the utility of PET-CT as a diagnostic tool: a case report.","authors":"Martin H Cherk, Luigi Zolio, Sadid Khan, Sharmayne Brady","doi":"10.1186/s41824-025-00247-7","DOIUrl":"10.1186/s41824-025-00247-7","url":null,"abstract":"<p><p>There have been several case reports of COVID-19 \"BNT162b2\" (Pfizer-BioNTech) and \"mRNA-1273\" (Moderna) vaccination associated small and medium vessel vasculitis described in the literature however none have had ¹⁸F-FDG Positron Emission Tomography scans (PET/CT) performed for diagnosis. We report the case of a 57-year-old Caucasian male patient from Australia where ¹⁸F-FDG PET/CT scanning facilitated early detection of a medium-vessel vasculitis following Moderna (mRNA-1273) COVID-19 vaccination. The diagnosis would otherwise have been difficult and allowed exclusion of alternative diagnoses and sparing of more invasive investigations such as muscle biopsy. Our case highlights the development of a medium vessel vasculitis following mRNA based COVID-19 vaccination and demonstrates the utility of ¹⁸F-FDG PET/CT as an excellent non-invasive test for the detection of this serious rare and often difficult to diagnose condition.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805238","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":"Economic evaluation of [¹⁸F]fluorocholine PET/CT in pre operative assessment of hyperfunctional parathyroids in primary hyperparathyroidism: a cost effectiveness analysis.","authors":"Adel Mamou, Sihame Chkair, Olivier Gilly, Laurent Maimoun, Yassine Mamou, Sean C Sheppard, Pierre Olivier Kotzki, Benjamin Lallemant, Vincent Boudousq","doi":"10.1186/s41824-025-00244-w","DOIUrl":"10.1186/s41824-025-00244-w","url":null,"abstract":"<p><strong>Background: </strong>Primary hyperparathyroidism (PHPT) is characterized by persistent hypercalcemia caused by parathyroid adenomas. Preoperative localization of hyperfunctional parathyroids is crucial to optimize surgical outcomes. Current standard practice combines cervical ultrasound (CU), [^99mTc]Tc-sestaMIBI SPECT scintigraphy (MIBI), and [¹⁸F]Fluorocholine PET/CT (PET) centered on the cervico-thoracic region. This study evaluates the cost-effectiveness of PET as a stand-alone first-line imaging strategy compared to CU + MIBI + PET and CU + PET strategies in the French healthcare system.</p><p><strong>Methods: </strong>A Markov model estimated costs and quality-adjusted life years (QALYs) for each imaging strategy. Imaging performance parameters were derived from a cohort of 145 PHPT patients who underwent surgery after all three imaging exams. Costs were calculated from the perspective of the French healthcare system, and utilities were sourced from the literature and validated by experts. Probabilistic and deterministic sensitivity analyses assessed robustness, while a Budget Impact Analysis (BIA) evaluated financial implications of national adoption over three years (2025-2027).</p><p><strong>Results: </strong>The average costs per patient were €5175 for CU + MIBI + PET, €5406 for CU + PET, and €5320 for PET alone, with corresponding QALYs of 13.80, 13.81, and 13.82. PET alone had an incremental cost-effectiveness ratio (ICER) of €12,650/QALY and an incremental net monetary benefit (iNMB) of 855€ compared to CU + MIBI + PET but offered only marginal QALY gains (+ 0.02), which were not substantially different. Sensitivity analyses revealed PET alone becomes dominant if [99mTc]Tc-MIBI SPECT sensitivity falls below 75.5% or PET costs drop below €632.</p><p><strong>Conclusion: </strong>[¹⁸F]Fluorocholine PET/CT stand-alone could be a cost-effective option and considered as a first line imaging strategy. Imaging strategies should be adapted to local healthcare contexts, reimbursement models, and diagnostic performance to optimize cost-effectiveness and patient care.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11958853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143757275","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}