EJNMMI reports最新文献

{"title":"Capivasertib treatment associated with hypermetabolism of the spleen.","authors":"Maria Ly, Gary Z Yu, Amin Haghighat Jahromi","doi":"10.1186/s41824-024-00231-7","DOIUrl":"10.1186/s41824-024-00231-7","url":null,"abstract":"<p><p>Capivasertib has emerged as a promising treatment for advanced breast and prostate cancer. Here, we report two cases of metastatic breast cancer patients who developed splenic hypermetabolism on [18 F]-FDG PET/CT following treatment with capivasertib. To our knowledge, these are the first documented instances of this treatment-related phenomenon. Although the mechanism behind this side effect remains unclear, these cases highlight an important imaging phenomenon that radiologists should consider when interpreting [18 F]-FDG PET/CT scans in patients treated with capivasertib.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695066","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":"Supraclavicular nodal metastasis at primary staging of prostate cancer using ¹⁸F-PSMA-1007 PET/CT.","authors":"Samuel Nguku Gitau, Jasmit Shah, William Olwit, Samnakay Saeed, Manel Haj Mansour, Khalid Makhdomi","doi":"10.1186/s41824-025-00241-z","DOIUrl":"10.1186/s41824-025-00241-z","url":null,"abstract":"<p><strong>Background: </strong>The most common sites of metastasis in prostate cancer are bone, pelvic and retroperitoneal lymph nodes, liver and lungs. This study aimed to evaluate the prevalence of supraclavicular nodal metastasis in newly diagnosed prostate cancer using ¹⁸F-PSMA-1007 PET/CT which has hitherto been understudied.</p><p><strong>Methods: </strong>¹⁸F-PSMA-1007 PET/CT examinations performed at our institution between June 2020 and June 2022 for primary staging of prostate cancer were reviewed to identify supraclavicular nodal metastasis from prostate cancer. Data variables included age, stage of disease, PSA level, Gleason score and ISUP/WHO grade group and how these compare with the presence of supraclavicular nodal metastasis.</p><p><strong>Results: </strong>A total of 240 patients with prostate cancer staged with ¹⁸F-PSMA-1007 PET/CT were analyzed. More than half of the patients presented with stage IVA or IVB disease, 54.1% (n = 130/240), and with high or very high-risk disease, 74.6% (n = 179/240). The prevalence of supraclavicular nodal metastasis in this cohort was 7.9% (n = 19/240). Advanced stage and high-risk groups were strongly associated with the presence of supraclavicular nodal metastasis.</p><p><strong>Conclusion: </strong>There is moderate prevalence of supraclavicular nodal metastasis in patients with intermediate to very high-risk prostate cancer which has likely previously been underdiagnosed with conventional imaging and has been brought to the fore with new-generation imaging such as PSMA PET/CT. It should therefore be an area of consideration during diagnostic work up and follow up of prostate cancer patients. The prognostic significance of supraclavicular nodal metastasis in prostate cancer requires further research.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653029","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":"Assessing large language models for Lugano classification of malignant lymphoma in Japanese FDG-PET reports.","authors":"Rintaro Ito, Keita Kato, Kosuke Nanataki, Yumi Abe, Hiroshi Ogawa, Ryogo Minamimoto, Katsuhiko Kato, Toshiaki Taoka, Shinji Naganawa","doi":"10.1186/s41824-025-00246-8","DOIUrl":"10.1186/s41824-025-00246-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the performance of four large language models (LLMs) in classifying malignant lymphoma stages using the Lugano classification from free-text FDG-PET reports in Japanese Specifically, we assess GPT-4o, Claude 3.5 Sonnet, Llama 3 70B, and Gemma 2 27B in their ability interpret unstructured radiology texts.</p><p><strong>Materials and methods: </strong>In a retrospective single-center study, 80 patients who underwent staging FDG-PET/CT for malignant lymphoma were included. The \"Findings\" sections of their reports were analyzed without pre-processing. Each LLM assigned Lugano stages based on these reports. Performance was compared to reference standard stages determined by expert radiologists. Statistical analyses involved overall accuracy, weighted kappa for agreement.</p><p><strong>Results: </strong>GPT-4o achieved the highest accuracy at 75% (60/80 cases) with substantial agreement (weighted kappa κ = 0.801). Claude 3.5 Sonnet had 61.3% accuracy (49/80, κ = 0.763). Gemma 2 27B and Llama 3 70B showed accuracies of 58.8% and 57.5%, respectively, all indicating substantial agreement.</p><p><strong>Conclusion: </strong>GPT-4o outperformed other LLMs in assigning Lugano classification from Japanese FDG-PET free-text reports. This demonstrated the potential of advanced LLMs to interpret clinical texts. While the immediate clinical utility of automatically predicting a Lugano stage from an existing report may be limited, these results highlight the value of LLMs for understanding and standardizing free-text radiology data.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143589206","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 [¹⁸F]fluorodeoxyglucose and [⁶⁸Ga]Gallium DOTA-TATE in patients with active giant cell arteritis.","authors":"Alison H Clifford, Jonathan Abele, Ryan Hung, Frank Wuest, Jan Andersson, Susan Pike, Elaine Yacyshyn, Eric Lenza, Glen Jickling, Paolo Raggi, Jan Willem Cohen Tervaert","doi":"10.1186/s41824-025-00242-y","DOIUrl":"10.1186/s41824-025-00242-y","url":null,"abstract":"<p><strong>Purpose: </strong>[¹⁸F]Fluorodeoxyglucose (FDG) is widely used in PET/CT imaging to detect large vessel vasculitis in giant cell arteritis (GCA), but its performance is suboptimal in patients receiving glucocorticoids. We aimed to compare [⁶⁸Ga]Ga-HA-DOTA-TATE, a somatostatin 2-analogue tracer, to [¹⁸F]FDG in a pilot study of patients with GCA.</p><p><strong>Methods: </strong>Eight patients with active GCA were prospectively, sequentially scanned with both [¹⁸F]FDG PET/CT and [⁶⁸Ga]Ga-HA-DOTA-TATE PET/CT imaging. Images were evaluated by 2 blinded nuclear medicine specialists. Tracer uptake was assessed in 8 vascular territories using SUVmax, and target-background ratios (TBR) were calculated using both right atrium (TBR_RA) and liver mean (TBR_liver). Mean SUVmax and TBR of individual vascular territories and index vessels were compared.</p><p><strong>Results: </strong>The patient median age was 71.5 years (range 64-82), and 4 (50%) were women. Active vasculitis (≥ grade 2 visual uptake in large vessels) was present in 62.5% of [¹⁸F]FDG scans. [¹⁸F]FDG scans had higher RA background activity than [⁶⁸Ga]Ga-HA-DOTA-TATE (mean RA SUVmean 1.88 vs. 0.36, p < 0.001), while [⁶⁸Ga]Ga-HA-DOTA-TATE had a significantly higher liver uptake (mean liver SUVmean 7.54 vs. 2.39, p < 0.001). Vascular uptake (as measured by both SUVmax and TBR_liver) was significantly higher in [¹⁸F]FDG than [⁶⁸Ga]Ga-HA-DOTA-TATE scans in every vascular territory (p < = 0.05 for all comparisons), including index vessels (SUVmax 4.04 vs. 1.91, p = 0.01, TBR_liver 1.73 vs. 0.27, p < 0.001).</p><p><strong>Conclusion: </strong>In this pilot study of patients with active GCA, the arterial uptake of [⁶⁸Ga]Ga-HA-DOTA-TATE was lower and less conspicuous compared to [¹⁸F]FDG. While further evaluation in larger cohorts is needed, a clear advantage of [⁶⁸Ga]Ga-HA-DOTA-TATE over [¹⁸F]FDG for detecting vascular inflammation in GCA was not identified. TRIAL REGISTRATION, CLINICALTRIALS.GOV: NCT03812302, registered 2019-01-18, URL: https://clinicaltrials.gov/search?cond=dotatate%20%26;term=giant%20cell%20arteritis .</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532124","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":"Prospective evaluation of the diagnostic accuracy of FDG-PET/CT for the detection of sternal wound infection post-sternotomy.","authors":"Angela Cai, Mehrshad Bakhshi, Yoan Lamarche, Francois Harel, Matthieu Pelletier-Galarneau","doi":"10.1186/s41824-024-00237-1","DOIUrl":"10.1186/s41824-024-00237-1","url":null,"abstract":"<p><strong>Purpose: </strong>Sternal wound infections (SWI) are complications of sternotomy and can be divided into deep SWI (DSWI) and superficial SWI (SSWI). In recent years, the use of 18F-Fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in diagnosing infections and inflammation has expanded significantly, with a growing number of clinical indications. This study assesses FDG-PET/CT diagnostic role in DSWI detection, the evolution of FDG uptake intensity in patients without DSWI and the potential biomarkers for DSWIs prediction.</p><p><strong>Methods: </strong>We conducted a single center prospective study of consecutive patients referred for suspected SWI post-median sternotomy. Gold standard diagnosis was established by chart review of clinical follow-up, surgical findings, and cultures. To characterize the time between sternotomy and imaging, participants were subsequently subdivided into recent (< 3 months) or remote surgery (≥ 3 months) groups.</p><p><strong>Results: </strong>44 FDG-PET/CT scans, 12 (27%) of which had DSWI according to the gold standard, were collected and analyzed. 20 studies were assigned to the recent group, and 24 studies to the remote surgery group. Sensitivity and specificity of FDG-PET/CT for detection of DSWI were 67% and 66%, respectively and an accuracy of 66% was obtained. Positive and negative predictive values were 42% and 84%, respectively. The NPV was higher in the remote surgery group (100%) compared to the recent surgery group (73%). SUV_max of the median sternal wound was significantly higher in the DSWI (9.3 ± 2.3) than the non-DSWI group (7.1 ± 3.0) (p = 0.025). There was however significant overlap of SUV_max between the two groups. CRP, WBC counts, and PCT levels were not significantly different between the DSWI and non-DSWI groups (p ≥ 0.34).</p><p><strong>Conclusion: </strong>FDG-PET/CT has modest sensitivity and specificity for the detection of DSWI post-sternotomy. FDG-PET/CT results must take into account time since surgery; when PET/CT is performed more than 3 months following surgery, a negative scan can exclude DSWI with a high level of certainty.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371462","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":"Impact of delayed pelvic imaging on the staging of biochemical recurrence in prostate cancer patients using [¹⁸F]DCFPYL PET/CT: a retrospective evaluation.","authors":"Ana Rodríguez-Pajuelo, Miriam Guerra-Gómez, Juan Ignacio Cuenca Cuenca, José María Freire-Macías, José Manuel Jiménez-Hoyuela García, Rosa María Álvarez-Pérez","doi":"10.1186/s41824-025-00238-8","DOIUrl":"10.1186/s41824-025-00238-8","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the added diagnostic value of additional second stage pelvic scanning as part of the [¹⁸F]DCFPYL PET/CT procedure in patients treated for prostate cancer (PCa) who have biochemical recurrence (BR).</p><p><strong>Materials and methods: </strong>Consecutive patients with a diagnosis of PCa who underwent a dual-phase PSMA-PET scan between September 2022 and December 2023, were retrospectively included. We analyzed the number and maximum SUV (SUVmax) of lesions only in the pelvic region (prostate, locoregional lymph nodes and bone), based on PSMA-RADS version 2.0 and miTNM criteria. To assess the potential diagnostic benefit of additional delayed pelvic PET/CT imaging as part of the PSMA-PET procedure, the change in molecular TNM classification was evaluated after the procedure.</p><p><strong>Results: </strong>Additional delayed pelvic PET/CT imaging as part of the PSMA-PET procedure resulted in a change in molecular TNM classification in 22 out of 136 patients (16.2%). The highest percentage change was obtained in the miN classification (14/22 patients), followed by the miT classification (7/22) and lastly miM (1/22). Moreover, we found that patients in whom delayed pelvic imaging resulted in a change in molecular TNM classification were significantly older and had a higher PSA level than those in whom delayed imaging did not provide additional information.</p><p><strong>Conclusions: </strong>Pelvic delayed imaging in patients with biochemical recurrence of prostate cancer undergoing PET/CT with [¹⁸F]DCFPYL shows a non-negligible influence on patient staging, modifying the miTNM classification in 16.2% of cases, with pelvic lymphatic involvement benefiting the most from the dual study.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076754","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":"FDG-PET-based brain network analysis: a brief review of metabolic connectivity.","authors":"Pham Minh Tuan, Mouloud Adel, Nguyen Linh Trung, Tatiana Horowitz, Ismail Burak Parlak, Eric Guedj","doi":"10.1186/s41824-024-00232-6","DOIUrl":"10.1186/s41824-024-00232-6","url":null,"abstract":"<p><strong>Background: </strong>Over the past decades, the analysis metabolic connectivity patterns has received significant attention in exploring the underlying mechanism of human behaviors, and the neural underpinnings of brain neurological disorders. Brain network can be considered a powerful tool and play an important role in the analysis and understanding of brain metabolic patterns. With the advantages and emergence of metabolic-based network analysis, this study aims to systematically review how brain properties, under various conditions, can be studied using Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) images and graph theory, as well as applications of this approach. Additionally, this study provides a brief summary of graph metrics and their uses in studying and diagnosing different types of brain disorders using FDG-PET images.</p><p><strong>Main body: </strong>In this study, we used several databases in Web of Science including Web of Science Core Collection, MEDLINE to search for related studies from 1980 up to the present, focusing on FDG-PET images and graph theory. From 68 articles that matched our keywords, we selected 28 for a full review in order to find out the most recent findings and trends. Our results reveal that graph theory and its applications in analyzing metabolic connectivity patterns have attracted the attention of researchers since 2015. While most of the studies are focusing on group-level based analysis, there is a growing trend in individual-based network analysis. Although metabolic connectivity can be applied to both neurological and psychiatric disorders, the majority of studies concentrate on neurological disorders, particularly Alzheimer's Disease and Parkinson's Disease. Most of the findings focus on changes in brain network topology, including brain segregation and integration.</p><p><strong>Conclusion: </strong>This review provides an insight into how graph theory can be used to study metabolic connectivity patterns under various conditions including neurological and psychiatric disorders.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019496","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":"Primary staging with 2[18F]-FDG-PET/CT and -PET/MRI and radiotherapy response evaluation with MRI in uterine cervical cancer: an interim analysis of a prospective clinical trial.","authors":"Maja Aasa, David Lindquist, Ulrika Ottander, Sara N Strandberg","doi":"10.1186/s41824-024-00236-2","DOIUrl":"10.1186/s41824-024-00236-2","url":null,"abstract":"<p><strong>Background: </strong>In uterine cervical cancer (UCC), tumour staging is performed according to the 2018 International Federation of Gynecology and Obstetrics (FIGO) system, where imaging is incorporated, or the more generic Tumour Node Metastasis (TNM) classification. With the technical development in diagnostic imaging, continuous prospective evaluation of the different imaging methods contributing to stage determination is warranted. The aims of this interim study were to (1) evaluate the performance of radiological FIGO (rFIGO) and T staging (rT) with 2-fluorine-18-fluoro-deoxy-glucose (2[18F]-FDG)-positron emission tomography with computed tomography (PET/CT) and with magnetic resonance imaging (PET/MRI), compared to clinical FIGO (cFIGO) and T (cT) staging based on clinical examination and conventional imaging, in treatment-naïve UCC, and to (2) identify possible MRI biomarkers for early treatment response after radiotherapy.</p><p><strong>Methods: </strong>Ten consecutive patients with newly diagnosed UCC from the prospective PRODIGYN (Prognostic and Diagnostic Added Value of Medical Imaging in Staging and Treatment Planning of Gynecological Cancer) study (ethical approval number 2022-04207-01; NCT05855941) were included. Study participants underwent 2[18F]FDG-PET/CT and -PET/MRI, and an additional MRI one week after radiotherapy. Agreement between rFIGO and cFIGO was analysed using Cohen's kappa. Differences in rFIGO between 2[18F]FDG-PET/CT and -PET/MRI were evaluated with Wilcoxon signed ranks test, and added value of rFIGO for metastasis assessment was demonstrated with descriptive statistics.</p><p><strong>Results: </strong>In 2/10 patients, a higher stage was obtained with rFIGO compared to cFIGO, where presence of metastases led to upstaging. In 3/10, rFIGO was lower than cFIGO, and in 5/10 rFIGO and cFIGO were similar. Degree of agreement between rFIGO and cFIGO was poor, (κ = 0.091, p < 0.005) with 2[18F]FDG-PET/CT and (κ = - 0.010, p > 0.05) with FDG/PET/MRI). There was no significant difference between 2[18F]FDG-PET/CT and -PET/MRI for rFIGO (p = 0.18), or rT stage assessment (p = 0.32). MRI-derived tumour volume and apparent diffusion coefficient (ADC) were most affected on MRI one week after radiotherapy.</p><p><strong>Conclusions: </strong>Our results indicate that there is an added value of rFIGO staging with 2[18F]FDG-PET/CT and -PET/MRI compared to clinical examination and conventional radiology, for metastasis assessment in treatment-naïve UCC. In early treatment response evaluation with MRI, ADC and tumour volume may be predictive parameters of interest in future prognostic analyses.</p><p><strong>Trial registration: </strong>Clinical Trials, NCT05855941. Registered 02 May 2023, https://clinicaltrials.gov/study/NCT05855941?term=NCT05855941&rank=1 .</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142961100","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":"B-CLL with negative ¹⁸F-FDG PET/CT and intensive solitary lesion on PSMA PET/CT mimicking prostate cancer bone metastases.","authors":"Theresa Jung, Daniel Neureiter, Gregor Schweighofer-Zwink, Gundula Rendl, Christian Pirich, Mohsen Beheshti","doi":"10.1186/s41824-024-00235-3","DOIUrl":"https://doi.org/10.1186/s41824-024-00235-3","url":null,"abstract":"<p><p>Positron emission tomography/computed tomography (PET/CT) using prostate-specific membrane antigen (PSMA)-radioligands is currently suggested by several clinical guidelines for the assessment of prostate cancer (PCa) in various clinical settings. However, PSMA will also be overexpressed in different cancers, which should be considered on the PSMA PET/CT reading in patients with concomitant neoplastic diseases. We report a case of 82-year-old male presented with prostate and history of oesophageal cancer and B-cell chronic lymphocytic leukemia (B-CLL). Both ⁶⁸Ga-PSMA-11 and 2-(3-(1-carboxy-5-((6-(18f)fluoro-pyridine-3-carbonyl)-amino)-pentyl)-ureido)-pentanedioic acid (¹⁸F-DCFPyL) PET/CT, which were performed for prostate cancer staging and re-staging in about 1 year interval, showed focal uptake in the primary prostate tumor as well as an intense focal lesion in L2, suggestive of bone metastasis. ¹⁸F-FDG PET/CT scans performed before and after PSMA PET/CT examinations showed no abnormal uptake related to oesophageal and/or B-CLL. This pattern could present an oligometastatic PCa disease, which might change the treatment plan of the patient to radiation of the bone metastasis. However, bone biopsy of the detected lesion on L2 revealed infiltrates of B-CLL. The role of ⁶⁸Ga- and ¹⁸F-labeled PSMA PET/CT in prostate cancer is evolving and has been demonstrated to have high sensitivity, but may present limited specificity in patients with coexisting cancer(s), which should be considered in PSMA PET/CT reading.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Semi-standardized evaluation of extraprostatic extension and seminal vesicle invasion with [¹⁸F]PSMA-1007 PET/CT: a comparison to MRI using histopathology as reference.","authors":"Erland Hvittfeldt, Fredrik Hedeer, Erik Thimansson, Kevin Sandeman, David Minarik, Jacob Ingvar, Anders Bjartell, Elin Trägårdh","doi":"10.1186/s41824-024-00234-4","DOIUrl":"10.1186/s41824-024-00234-4","url":null,"abstract":"<p><strong>Background: </strong>Positron emission tomography/computed tomography (PET/CT) with prostate specific membrane antigen ligands (PSMA) is established for use in primary staging of prostate cancer to screen for metastases. It has also shown promise in local tumor staging, including detection of extraprostatic extension (EPE) and seminal vesicle invasion (SVI). Previous studies have shown high heterogeneity in methods and results. Our aim was to compare [¹⁸F]PSMA-1007 PET/CT to magnetic resonance imaging (MRI) in evaluation of EPE and SVI, building on a previously described method for standardized evaluation. We retrospectively included 124 patients who had undergone MRI, PSMA PET/CT and prostatectomy. PSMA PET/CT images were evaluated by two nuclear medicine physicians. Using a standardized method, they measured length of capsular contact (LCC) and assessed EPE and SVI visually with the use of 5-point Likert scales. A radiologist evaluated MRI images using criteria based on Prostate Imaging-Reporting and Data System version and incorporating LCC measurement and Likert scales. We evaluated diagnostic performance with histopathology as reference, and the interrater reliability of the PET evaluations.</p><p><strong>Results: </strong>The sensitivity and specificity for detecting EPE with the quantitative LCC method for PSMA PET/CT was 0.46/0.91, for the visual method 0.28/0.82 and for the combination of the two 0.54/0.76. AUC in ROC analysis for the LCC method was 0.70. For MRI the sensitivity and specificity were 0.80/0.64. For SVI, PET/CT and MRI had sensitivity and specificity of 0.14/1.0 and 0.50/0.92 respectively. The intraclass correlation coefficient for the PET LCC measurement was 0.68, the kappa values for the visual Likert scales for PET were 0.53 for EPE and 0.63 for SVI.</p><p><strong>Conclusions: </strong>In this study, we attempted to standardize quantitative and qualitative PSMA PET/CT evaluation of EPE and SVI and compare the method with MRI. MRI had a higher sensitivity for EPE while PSMA had a higher specificity. For SVI, both methods had high specificity. The interrater reliability for the PSMA PET/CT evaluations was moderate to substantial.</p>","PeriodicalId":519909,"journal":{"name":"EJNMMI reports","volume":"9 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924343","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}