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

{"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":"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":"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}

{"title":"Pittsburgh compound B positron emission tomography detects cardiomyopathy in hereditary transthyretin amyloidosis patients with negative bone scintigraphy: a pilot study.","authors":"Hendrea S A Tingen, Gilles N Stormezand, Paul van Snick, Yingqi Hu, Paul Van Der Zwaag, Marish Oerlemans, Peter van der Meer, Bouke P C Hazenberg, Gert Luurtsema, Hans L A Nienhuis, Riemer H J A Slart","doi":"10.3389/fnume.2026.1747625","DOIUrl":"10.3389/fnume.2026.1747625","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effectiveness of positron emission tomography (PET) with [¹¹C]-Pittsburgh Compound-B ([¹¹C]PiB) for detecting transthyretin amyloid (ATTR) cardiomyopathy in patients with transthyretin gene (<i>TTR</i>) variants associated with reduced bone scintigraphy sensitivity, and its ability to detect brain involvement in hereditary transthyretin amyloidosis.</p><p><strong>Methods: </strong>This prospective case series included four hereditary ATTR amyloidosis patients with <i>TTR</i> variants associated with reduced bone scintigraphy sensitivity, and two patients with positive bone scintigraphy (one hereditary ATTR and one wild-type ATTR amyloidosis patient). All patients underwent diagnostic work-up at the Groningen Amyloidosis Centre of Expertise between April 2024 and March 2025, including [¹¹C]PiB PET/CT. Cardiac and brain [¹¹C]PiB uptake were assessed visually. Target-to-background ratios (TBRs) and cortical SUV ratios were calculated. TBR ≥1.09 was considered positive for ATTR cardiomyopathy and SUV ratios ≥0.7 was considered positive for brain involvement.</p><p><strong>Results: </strong>Cardiac [¹¹C]PiB uptake was observed in three of four hereditary ATTR amyloidosis patients despite negative bone scintigraphy. In one of four patients, there was visually equivocal radiotracer uptake, but elevated TBRs did indicate ATTR cardiomyopathy. Conversely, both hereditary ATTR and wild-type ATTR amyloidosis patients with a positive bone scintigraphy had negative or inconclusive [¹¹C]PiB PET results. Brain uptake was observed in two asymptomatic patients, while no uptake was seen in two patients with suspected brain involvement.</p><p><strong>Conclusion: </strong>[¹¹C]PiB PET could be an effective tool for detecting ATTR cardiomyopathy in patients with <i>TTR</i> variants associated with reduced bone scintigraphy sensitivity. However, its utility for detecting brain involvement in symptomatic hereditary ATTR patients remains uncertain.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"6 ","pages":"1747625"},"PeriodicalIF":1.4,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12926488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286023","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":"Prevalence and clinical significance of unsuspected intracranial findings in patients undergoing oncological whole-body 18F-FDG PET/CT imaging.","authors":"Diana Nyamieri, Samuel Nguku Gitau, Sheila Waa","doi":"10.3389/fnume.2025.1668088","DOIUrl":"10.3389/fnume.2025.1668088","url":null,"abstract":"<p><strong>Purpose: </strong>Routine oncological whole-body 18F-1-fluoro-2-deoxyglucose (FDG) PET/CT in the majority of institutions is performed from the base of the skull to the mid-thigh. However, at our institution, the brain is included. The aim of this study was to identify the prevalence of unsuspected intracranial findings in patients undergoing oncological 18F-FDG PET/CT examinations with inclusion of the brain in the field of view.</p><p><strong>Methods: </strong>A total of 3,523 patients who underwent oncological limited whole-body 18F-FDG PET/CT scans between February 2019 and December 2021 were retrospectively reviewed. The study variables included the patient's age, sex, type of malignancy, disease stage, and clinical presentation and the presence of clinically unsuspected intracranial findings. The intracranial findings were correlated with brain MRI findings in a subset of patients. Clinical significance, defined by a change in disease stage and/or patient management informed by the identification of unsuspected intracranial findings, was assessed.</p><p><strong>Results: </strong>In total, 132/3,523 (3.7%) oncological whole-body 18F-FDG PET/CT scans had unsuspected intracranial findings, of which clinically significant unsuspected intracranial findings were found in 62 cases (1.4%). The most common intracranial findings were metastasis, followed by subclinical vascular findings. Moreover, 22/62 cases underwent follow-up brain MRI, and the sensitivity and specificity of the 18F-FDG PET/CT scans were 94.7% and 66.7%, respectively. Data on post-PET/CT management were available for 32/132 patients. A change in management was observed in 25/32 (78%) cases.</p><p><strong>Conclusion: </strong>The inclusion of the brain in the field of view in oncological whole-body 18F-FDG PET/CT may lead to the early detection of unsuspected intracranial metastases and changes in patient management. This is especially true for breast and lung cancers, which have a greater propensity to metastasize to the brain.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"5 ","pages":"1668088"},"PeriodicalIF":1.4,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12868128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127751","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: Musculoskeletal disorders related to dysparathyroidism.","authors":"Emmanouil Panagiotidis, Jules Zhang-Yin","doi":"10.3389/fnume.2026.1776939","DOIUrl":"https://doi.org/10.3389/fnume.2026.1776939","url":null,"abstract":"","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"6 ","pages":"1776939"},"PeriodicalIF":1.4,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114959","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: PET-avid compensatory tensor fascia lata hypertrophy mimicking metastatic disease in a patient with a chronic Achilles tendon rupture.","authors":"Ian Strohbehn, James Graham, Christopher Kanner","doi":"10.3389/fnume.2025.1699313","DOIUrl":"10.3389/fnume.2025.1699313","url":null,"abstract":"<p><p>In this case report, we describe an unusual case of PET-avid muscle enlargement in the right tensor fascia lata (TFL) muscle mimicking metastatic disease during lung cancer staging. The patient, a 67-year-old woman, had a history of left Achilles tendon rupture, which had been managed non-operatively. A PET/CT scan revealed focal fluorodeoxyglucose (FDG) uptake in a markedly expanded right TFL muscle. The presence of concurrent ipsilateral pelvic lymphadenopathy on the scan initially raised concern for muscle metastasis in this context. However, subsequent MRI of the hip showed diffuse muscle enlargement without a discrete mass, favoring benign muscle hypertrophy, particularly given the presence of a concurrent chronic Achilles tendon rupture that altered the patient's gait. A follow-up surveillance PET/CT and subsequent CT scans obtained over several years showed stability of the muscle abnormality, supporting the diagnosis of benign muscle hypertrophy and preventing an unnecessary biopsy. This case highlights the importance of correlating imaging findings with prior biomechanical injuries that can impact muscle architecture, particularly in a malignancy workup where FDG uptake in muscle may be misleading.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"5 ","pages":"1699313"},"PeriodicalIF":1.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12832617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146069029","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}