Frontiers in nuclear medicine (Lausanne, Switzerland)最新文献

{"title":"Prognostic impact of discordant lesions on [¹⁸F]FDG and [⁶⁸Ga]Ga-FAPI-04 PET/CT compared to histological FAP expression in neuroendocrine neoplasms.","authors":"Tim Jedamzik, Aleksander Kosmala, Stefan Kircher, Marieke Heinrich, Wiebke Schlötelburg, Andreas K Buck, Alexander Meining, Rudolf A Werner, Alexander Weich, Kerstin Michalski","doi":"10.3389/fnume.2026.1777541","DOIUrl":"https://doi.org/10.3389/fnume.2026.1777541","url":null,"abstract":"<p><strong>Objective: </strong>On dual-tracer positron emission tomography/computed tomography (PET/CT) with 2-deoxy-2-[¹⁸F]fluoro-D-glucose ([¹⁸F]FDG) and fibroblast activation protein inhibitor ([⁶⁸Ga]Ga-FAPI-04), discordant lesions (FDG+/FAPI-) in aggressive neuroendocrine neoplasms (NENs) are linked to shorter progression-free survival (PFS). This study evaluated the prognostic value of such lesions in comparison to histological fibroblast activation protein (FAP) expression from a clinically obtained biopsy and their impact on PFS.</p><p><strong>Methods: </strong>23 patients with aggressive NENs underwent both [¹⁸F]FDG and [⁶⁸Ga]Ga-FAPI-04 PET/CT as well as biopsy within a short period of time. PET parameters [standardized uptake values (SUV): SUVmax, SUVmean, SUVpeak] were measured, as were tumor volume (TV), and total lesion uptake (TLU = TV  ×  SUVmean). FDG+/FAPI- lesions were identified. FAP expression was assessed immunohistochemically using the immunoreactive score (IRS-FAP). Correlations between PET metrics, IRS-FAP, and FDG+/FAPI- lesions were analyzed. Cox regression and log-rank test were used to evaluate associations with PFS.</p><p><strong>Results: </strong>IRS-FAP correlated significantly with TV ([¹⁸F]FDG: p=0.0165; [⁶⁸Ga]Ga-FAPI-04: <i>p</i> = 0.0181) and TLU ([¹⁸F]FDG: <i>p</i> = 0.0170; [⁶⁸Ga]Ga-FAPI-04: <i>p</i> = 0.0253). There was no significant correlation for IRS-FAP with SUV parameters. FDG+/FAPI- lesions were found in 9/23 patients and associated with significantly shorter PFS (4 vs. 10 months, HR: 3.383, <i>p</i> = 0.0015). [¹⁸F]FDG-TV and [¹⁸F]FDG-TLU correlated with PFS, but IRS-FAP showed no significant association with either PFS or FDG+/FAPI- lesions.</p><p><strong>Conclusions: </strong>FAP expression on immunohistochemistry obtained from a single biopsy site does not predict discordant PET/CT findings. In contrast, the presence of FDG+/FAPI- lesions is a strong prognostic factor for reduced PFS. Thus, dual-tracer PET/CT may offer superior risk stratification compared to single-lesion histological FAP assessment in aggressive NENs.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"6 ","pages":"1777541"},"PeriodicalIF":1.4,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791003","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":"Case Report: Five positive lesions on bilateral adrenal glands detected by a single ⁶⁸Ga-pentixafor PET/CT.","authors":"Ze Mao, Lu Zheng, Ranliang Hua, Detao Wu, Yaai Shi, Xinchao Zhang, Yujing Hu, Yanzhu Bian","doi":"10.3389/fnume.2026.1676221","DOIUrl":"https://doi.org/10.3389/fnume.2026.1676221","url":null,"abstract":"<p><strong>Background: </strong>Primary aldosteronism (PA) is an endocrine disorder caused by autonomous aldosterone hypersecretion from the adrenal zona glomerulosa, causing sodium retention, plasma volume expansion, and suppressed renin activity, manifesting as hypertension with/without hypokalemia. Aldosterone-producing adenomas (APAs), a common PA subtype, are typically unilateral and solitary; bilateral involvement is rare. We report a patient with hypertension and bilateral multiple adrenal adenomas. ⁶⁸Ga-Pentixafor PET/CT proved crucial for detecting and subtyping lesions, highlighting its significant diagnostic utility for APA subtyping.</p><p><strong>Case presentation: </strong>A 62-year-old male presenting with nausea, generalized fatigue, and poorly controlled hypertension (10-year history; max BP 200/110 mmHg) was admitted. Bilateral adrenal CT, which revealed multiple bilateral adrenal adenomas, raised clinical suspicion for primary aldosteronism. To confirm the diagnosis, ⁶⁸Ga-Pentixafor PET/CT imaging was performed, which identified five nodules with varying intensities of tracer uptake bilaterally.</p><p><strong>Conclusion: </strong>⁶⁸Ga-Pentixafor PET/CT integrates structural and functional assessment, transcending the limitations of CT and adrenal vein sampling (AVS), thereby demonstrating substantial clinical value for evaluating multifocal or bilateral adrenal pathologies.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"6 ","pages":"1676221"},"PeriodicalIF":1.4,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791019","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":"PET rapid image reconstruction challenge (PETRIC).","authors":"Casper da Costa-Luis, Matthias J Ehrhardt, Christoph Kolbitsch, Evgueni Ovtchinnikov, Edoardo Pasca, Kris Thielemans, Charalampos Tsoumpas","doi":"10.3389/fnume.2026.1770002","DOIUrl":"https://doi.org/10.3389/fnume.2026.1770002","url":null,"abstract":"<p><strong>Introduction: </strong>We describe the foundation of PETRIC, an image reconstruction challenge to minimise the computational runtime of related algorithms for Positron Emission Tomography (PET).</p><p><strong>Purpose: </strong>Although several similar challenges are well-established in the field of medical imaging, there have been no prior challenges for PET image reconstruction.</p><p><strong>Methods: </strong>Participants were provided with open-source software for implementation of their reconstruction algorithm(s). We defined the objective function and reconstruct \"gold standard\" reference images, and provided metrics for quantifying algorithmic performance. We also received and curated phantom datasets (acquired with different scanners, radionuclides, and phantom types), which we further split into training and evaluation datasets. The automated computational framework of the challenge is released as open-source software.</p><p><strong>Results: </strong>Four teams with nine algorithms in total participated in the challenge. Their contributions made use of various tools from optimisation theory including preconditioning, stochastic gradients, and artificial intelligence. While most of the submitted approaches appear very similar in nature, their specific implementation lead to a range of algorithmic performance.</p><p><strong>Conclusion: </strong>As the first challenge for PET image reconstruction, PETRIC's solid foundations allow researchers to reuse its framework for evaluating new and existing image reconstruction methods on new or existing datasets. Variant versions of the challenge have and will continue to be launched in the future.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"6 ","pages":"1770002"},"PeriodicalIF":1.4,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679037","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":"Meta-analysis of efficacy and safety of Yttrium-90 radioembolization (TARE) in the treatment of advanced hepatocellular carcinoma.","authors":"Hongyin Lin, Quanhui Tan","doi":"10.3389/fnume.2026.1784215","DOIUrl":"https://doi.org/10.3389/fnume.2026.1784215","url":null,"abstract":"<p><strong>Background: </strong>Transarterial radioembolization (TARE) using Yttrium-90 microspheres has emerged as a promising locoregional therapy for patients with advanced hepatocellular carcinoma (HCC). However, the efficacy and safety of TARE compared to conventional treatments remain uncertain. This meta-analysis aimed to comprehensively evaluate the survival outcomes and safety profile of TARE in advanced HCC.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, Embase, Cochrane Library, and Web of Science up to May 2025, following the PRISMA guidelines. Studies comparing TARE with conventional or systemic therapies in advanced HCC were included. Pooled hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS), and odds ratios (ORs) for adverse events (AEs) were calculated using random-effects models. Subgroup and meta-regression analyses explored the influence of study design, liver function (Child-Pugh, ALBI grade), and combined therapies.</p><p><strong>Results: </strong>Forty studies encompassing over 10,000 patients were included. TARE significantly improved OS (pooled HR = 0.72, 95% CI 0.63-0.83) and PFS (pooled HR = 0.78, 95% CI 0.69-0.89) compared with controls. Rates of grade ≥3 adverse events were lower in the TARE group (pooled OR = 0.74, 95% CI 0.59-0.93). Subgroup analyses indicated consistent benefits across retrospective and prospective studies, and in patients with Child-Pugh A-B liver function. Meta-regression revealed that younger age and higher objective response rate were associated with improved outcomes.</p><p><strong>Conclusion: </strong>TARE with Yttrium-90 microspheres confers significant survival benefits and acceptable safety in advanced HCC. These findings support the integration of TARE into multidisciplinary management strategies for advanced HCC, particularly in patients unsuitable for surgical or systemic therapies.</p><p><strong>Systematic review registration: </strong>PROSPERO (CRD420251163947).</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"6 ","pages":"1784215"},"PeriodicalIF":1.4,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13044050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624648","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":"Conceptual proposal for LLM-generated FDG PET/CT follow-up reports in melanoma: a pilot study on model stability and blinded expert evaluation.","authors":"Wolfram A Bosbach, Marie S Heide, Nasir Gözlügöl, Dana Fatemeh, Foroud Aghapour Zangeneh, David Ventura, Philipp Schindler, Wolfgang Roll, Franziska Strunz, Federico Caobelli, Kuangyu Shi, Ali Afshar-Oromieh, Axel Rominger, Robert Seifert","doi":"10.3389/fnume.2026.1723650","DOIUrl":"10.3389/fnume.2026.1723650","url":null,"abstract":"<p><strong>Purpose: </strong>Oncological patients regularly undergo PET/CT re-staging, which requires a report that outlines their current disease status and highlights relevant changes compared to the previous PET/CT. Large language models (LLMs) may be helpful with documentation in the future. This study is a pilot on LLM performance, focusing on test-retest stability and reproducibility.</p><p><strong>Methods: </strong>Three textbook melanoma follow-up cases of increasing complexity (involving one to eight organs) were selected. From standardized text-only prompts (no imaging data), follow-up reports were written by GPT-4o, Claude Sonnet 4 (each producing three independent revisions), and three nuclear medicine residents. This yielded nine reports per case (27 in total). Six blinded nuclear medicine experts (three internal, three external) performed test-retest evaluations of report quality and authorship identification.</p><p><strong>Results: </strong>The cosine similarity analysis revealed high intra-case coherence (mean: 0.599-0.727) regardless of authorship. The external human readers consistently rated reports higher than the internal human readers. The LLM-generated reports received comparable or superior ratings to human reports, with Claude achieving the highest external reader scores (mean 0.926, standard deviation 0.263, on a 0-1 scale). Human performance declined with case complexity, while Claude, in particular, improved. The external readers significantly preferred the LLM impressions (Fisher's exact test, <i>p</i> = 0.005). Neither the human nor LLM readers reliably identified authorship (balanced accuracy 0.343-0.500).</p><p><strong>Conclusion: </strong>In this pilot, blinded expert evaluation demonstrated that current LLMs can generate reports for melanoma [¹⁸F]fluorodeoxyglucose PET/CT of comparable quality to human-authored reports from text prompts in this study. High test-retest stability was obtained. Larger future studies will be required to confirm these findings.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"6 ","pages":"1723650"},"PeriodicalIF":1.4,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13018137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576771","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":"Radiobiological evaluation of the therapeutic effect of silver-111 for the ISOLPHARM project.","authors":"Alberto Arzenton, Aurora Leso, Francesca Rana, Giulia S Valli, Elena Delgrosso, Laura Cansolino, Cinzia Ferrari, Silva Bortolussi, Isabella Guardamagna, Giorgio Baiocco, Giorgio Grosso, Davide Serafini, Andrea Gandini, Valerio Di Marco, Antonietta Donzella, Emilio Mariotti, Marcello Lunardon, Devid Maniglio, Germano Bonomi, Alberto Andrighetto","doi":"10.3389/fnume.2026.1773638","DOIUrl":"10.3389/fnume.2026.1773638","url":null,"abstract":"<p><strong>Introduction: </strong>The ISOLPHARM project has the aim of developing novel radiopharmaceuticals using the wide choice of radionuclides produced by Isotope Separation OnLine (ISOL) at LNL-INFN in the SPES facility, which is currently nearing completion. One of the most promising candidates for Targeted Radionuclide Therapy (TRT) is the beta-emitting radiometal silver-111, obtainable carrier-free irradiating a uranium carbide target with a proton beam and applying the ISOL technique. Until SPES will become fully operational, small quantities of silver-111 are produced by the TRIGA Mark II nuclear reactor hosted by the LENA facility of the University of Pavia to begin the preclinical research. The present work concerns the first radiobiological experiment involving silver-111.</p><p><strong>Methods: </strong>Different activity concentrations of the aforementioned radiometal are administered to the UMR-106 rat osteosarcoma and LNCaP human prostate cancer cell lines through the culture medium. The survival curves after four and six days of exposure, as well as the recurrence of <i>foci</i> of DNA repair proteins and micronuclei, are evaluated as a function of the absorbed dose and compared to the control cultures. According to the MIRD formalism, a dosimetric analysis is performed taking advantage of cellular S-values simulated with the Monte Carlo code Geant4 in a generalized cell geometry. This makes it possible to relate the experimental outcome, namely the surviving cells after the exposure cycles, to the absorbed dose in the cell nucleus or in the whole cell environment.</p><p><strong>Results and discussion: </strong>The results show a difference in the response of the two cell lines, probably due to the thresholds of their DNA repair pathways, and highlight a possible weakness of the linear-quadratic model when applied to this kind of radiobiological studies.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"6 ","pages":"1773638"},"PeriodicalIF":1.4,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576858","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":"Incidental detection of PDAC via ¹⁸F-PSMA PET/CT in a patient with recurrent prostate cancer. A case report.","authors":"Giordano Savelli, Mattia Bonacina, Alberto Soffientini, Elvira Archiati, Claudio Bnà, Alberto Zaniboni","doi":"10.3389/fnume.2026.1767321","DOIUrl":"10.3389/fnume.2026.1767321","url":null,"abstract":"<p><strong>Introduction: </strong>Prostate specific membrane antigen (PSMA) is a type II transmembrane protein overexpressed in the neovasculature of some pancreatic ductal adenocarcinoma (PDAC). PET/CT can detect this expression and has now become an essential tool in this context. However, this antigen can also be expressed by other neoplasms. While this may create diagnostic uncertainty, it could also open therapeutic opportunities.</p><p><strong>Clinical case: </strong>Here we describe a case in which a PET/CT performed to restage a patient with prostate adenocarcinoma experiencing biochemical recurrence revealed the coexistence of a PDAC.</p><p><strong>Literature review: </strong>A literature review aimed to summarize the bibliographic evidence on the use of this technique in this setting, which is relatively uncommon.</p><p><strong>Conclusion: </strong>Prostate-specific membrane antigen can be overexpressed in PDACs. This finding may offer potential for theranostic applications.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"6 ","pages":"1767321"},"PeriodicalIF":1.4,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13008924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517079","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":"Editorial: Radiomics and artificial intelligence in oncology imaging.","authors":"Vincent Habouzit, Jeppe Friborg, Morgan Michalet","doi":"10.3389/fnume.2026.1803820","DOIUrl":"https://doi.org/10.3389/fnume.2026.1803820","url":null,"abstract":"","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"6 ","pages":"1803820"},"PeriodicalIF":1.4,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13002796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500664","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":"Improved random coincidence estimation including triple coincidence detection in PET.","authors":"Debora Niekämper, Jürgen J Scheins, Elisabeth Pfaehler, Joaquin L Herraiz, N Jon Shah, Christoph Lerche","doi":"10.3389/fnume.2026.1739575","DOIUrl":"https://doi.org/10.3389/fnume.2026.1739575","url":null,"abstract":"<p><p>Coincidence detection in PET is inherently prone to misidentification due to the presence of randomly occurring singles from different decays within the coincidence time window. Random triple coincidences, arising when three singles from at least two decays are detected within this window, can lead to bias by acceptance without further consideration in the double coincidence identification, or result in sensitivity loss if rejected. True triple coincidences, which occur with <math><msup><mi>β</mi> <mo>+</mo></msup> <mtext>-</mtext> <mi>γ</mi></math> -emitters used in dual-tracer PET and positronium lifetime imaging, are also affected by random coincidences, leading to errors that necessitate appropriate correction. The aim of this work was to develop an accurate method for estimating random double and triple coincidences which is crucial for quantitative PET imaging of <math><msup><mi>β</mi> <mo>+</mo></msup> <mo>-</mo></math> and <math><msup><mi>β</mi> <mo>+</mo></msup> <mtext>-</mtext> <mi>γ</mi></math> -emitters. The number of random triple coincidences was evaluated for both emitter types. To process double and triple coincidences separately, coincidence identification schemes were defined with intervals free of other singles as vetoes for accepted coincidences. Random coincidences were estimated using extended delayed window techniques, which match the interval sizes for coincidence windows and vetoes. Coincidences comprising singles from two and three decays were separated in simulation studies, and two delayed windows were applied to guarantee the singles' independence in the latter case. Correction factors from additional coincidence identification schemes were used to compensate for differences in the total veto interval size between the prompt and delayed methods. The methods were evaluated using simulations for different isotopes, coincidence windows, phantom shapes, and activities. The simulation results were then validated against measurements obtained with a brain PET scanner. The total random coincidence rate for the entire scanner was estimated with a relative deviation of <3% for double coincidences and <5% for triple coincidences of two decays of <math><msup><mi>β</mi> <mo>+</mo></msup> </math> -emitters and <math><msup><mi>β</mi> <mo>+</mo></msup> <mtext>-</mtext> <mi>γ</mi></math> -emitters for the investigated coincidence identification schemes and for the simulated cases.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"6 ","pages":"1739575"},"PeriodicalIF":1.4,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500689","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":"Rethinking dynamics: static amino acid PET parameters vs. dynamic amino acid PET parameters for the detection of tumor progression in patients with post-treatment glioma.","authors":"Dylan Henssen, Michael Rullmann, Andreas Schildan, Stephan Striepe, Matti Schürer, Cordula Scherlach, Katja Jähne, Ruth Stassart, Osama Sabri, Clemens Seidel, Swen Hesse","doi":"10.3389/fnume.2026.1762984","DOIUrl":"https://doi.org/10.3389/fnume.2026.1762984","url":null,"abstract":"<p><strong>Background: </strong>It remains unclear whether dynamic amino-acid (AA) positron-emission tomography (PET) has additional diagnostic value over static AA-PET to distinguish tumor progression (TP) from treatment-related abnormalities (TRA) in patients with post-treatment glioma.</p><p><strong>Methods: </strong>This was a retrospective study of patients with glioma with suspected TP who underwent dynamic AA-PET imaging. The final diagnoses were based on histopathology and/or clinical-radiological follow-up. The static PET parameters included the mean and maximum tumor-to-brain ratio (TBR_max and TBR_mean, respectively) and the dynamic PET parameters included time to peak (TTP) and area under the time activity curve (AUTAC). Diagnostic accuracy was assessed using the area under the receiver operating characteristic curve (AUROC).</p><p><strong>Results: </strong>In total, 33 patients with adult diffuse glioma (17 females: mean age: 55.7 ± 12.2 years) were included [13 [S-methyl-¹¹C]methionine ([¹¹C]MET) and 20 O-(2-[¹⁸F]fluoroethyl)-L-tyrosine (¹⁸F]FET) PET examinations]. The static parameters (TBR_mean and TBR_max) were significantly different between the TP and TRA groups when using [¹¹C]MET (<i>p</i> = 0.019 and <i>p</i> = 0.013, respectively), resulting in very-good-to-excellent diagnostic accuracy (AUROC values of 0.85 and 0.93, respectively). The TBR_mean values derived from [¹⁸F]FET PET data were not significantly different between the TP and TRA groups (<i>p</i> = 0.066). However, the [¹⁸F]FET PET data-derived TBR_max values were significantly higher in the individuals with TP (<i>p</i> = 0.005), indicating very good diagnostic accuracy (AUROC = 0.84). The dynamic PET parameters (time to peak and area under the time activity curve) were not significantly different between the TP and TRA groups.</p><p><strong>Conclusion: </strong>This study suggests that dynamic and static AA-PET parameters have similar diagnostic capacities to distinguish TP from TRA. While static AA-PET parameters may suffice for clinical decision-making, this study did not formally assess the incremental value of using dynamic metrics in addition to static measures.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"6 ","pages":"1762984"},"PeriodicalIF":1.4,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367432","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}