{"title":"Editorial: Rising stars in PET and SPECT: 2024.","authors":"Mario Petretta","doi":"10.3389/fnume.2025.1723945","DOIUrl":"https://doi.org/10.3389/fnume.2025.1723945","url":null,"abstract":"","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"5 ","pages":"1723945"},"PeriodicalIF":1.4,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12620350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552197","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}
E Panagiotidis, G Angelidis, V Valotassiou, I Tsougos, P Georgoulias, J T Zhang-Yin
{"title":"PET/CT imaging of bone disorders in dysparathyroidism: a comprehensive review.","authors":"E Panagiotidis, G Angelidis, V Valotassiou, I Tsougos, P Georgoulias, J T Zhang-Yin","doi":"10.3389/fnume.2025.1645497","DOIUrl":"10.3389/fnume.2025.1645497","url":null,"abstract":"<p><p>Parathyroid disorders profoundly affect bone metabolism, often long before structural damage is apparent on conventional imaging. Positron emission tomography/computed tomography (PET/CT) has emerged as a transformative tool in dysparathyroidism, enabling visualization of early metabolic bone changes and accurate localization of parathyroid pathology. This review explores the pathophysiology of bone disease in hyper- and hypoparathyroidism and highlights the role of key PET radiotracers: fluorine-18 sodium fluoride ([18F]NaF), fluorine-18 fluorodeoxyglucose ([18F]FDG), fluorine-18 fluorocholine ([18F]FCH), gallium-68 prostate-specific membrane antigen ([68Ga]PSMA). Distinct imaging patterns, such as the [18F]NaF \"superscan\" in secondary hyperparathyroidism and focal uptake in brown tumors, are discussed alongside tracer-specific strengths. Clinical applications including diagnosis, monitoring response to therapy, and prognostication are examined. We also consider emerging technologies such as artificial intelligence (AI)-assisted interpretation and positron emission tomography/magnetic resonance imaging (PET/MRI) fusion imaging. As PET/CT becomes more accessible, it is likely to play an increasingly central role in the early detection and personalized management of parathyroid-related bone disease.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"5 ","pages":"1645497"},"PeriodicalIF":1.4,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12591098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483821","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":"Production of <sup>64</sup>Cu and <sup>67</sup>Cu with accelerator neutrons by deuterons and their separation from zinc.","authors":"Yasuki Nagai, Masako Kawabata, Hideya Saeki, Shoji Motoishi, Kazuyuki Hashimoto, Kazuaki Tsukada, Arata Motomura, Akio Ohta, Naoki Takashima, Shintaro Hashimoto, Masatoshi Itoh, Hidetoshi Kikunaga, Shozo Furumoto","doi":"10.3389/fnume.2025.1657125","DOIUrl":"10.3389/fnume.2025.1657125","url":null,"abstract":"<p><p>The <sup>64</sup>Cu/<sup>67</sup>Cu pair is an ideal set of theranostic radionuclides for treating patients based on their genetic profiles. We propose a novel production route for this radionuclide pair using accelerator-generated neutrons. We report experimental measurements of the absolute activity and radionuclide purity of <sup>64</sup>Cu and <sup>67</sup>Cu, produced by irradiating <sup>64</sup>Zn and <sup>68</sup>Zn with these neutrons. The measured results were consistent with simulated values. <sup>64</sup>Cu and <sup>67</sup>Cu were separated from the irradiated natural Zn and <sup>68</sup>Zn using sublimation and column separation techniques. The production methods for <sup>64</sup>Cu and <sup>67</sup>Cu developed in this study are expected to enhance their availability in an economically sustainable manner.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"5 ","pages":"1657125"},"PeriodicalIF":1.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12546246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380252","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}
Deni Hardiansyah, Bisma Barron Patrianesha, Gerhard Glatting
{"title":"Population pharmacokinetic modeling in radiopharmaceutical therapy: a review.","authors":"Deni Hardiansyah, Bisma Barron Patrianesha, Gerhard Glatting","doi":"10.3389/fnume.2025.1695332","DOIUrl":"10.3389/fnume.2025.1695332","url":null,"abstract":"<p><p>Population pharmacokinetic (PopPK) has emerged as a robust framework for characterizing inter-individual variability in the absorbed dose estimates in radiopharmaceutical therapy (RPT). By enabling the analysis of biokinetic data from heterogeneous patient populations, PopPK allows individualized absorbed dose estimates while simultaneously leveraging population-level information. This review presents and evaluates the current applications of PopPK, such as nonlinear mixed-effects modeling (NLMEM) and Bayesian fitting methods in RPT, emphasizing its advantages over traditional individual-based modeling approaches. We summarize key studies that have implemented PopPK for modeling radiopharmaceutical biokinetics, with a focus on time-integrated activity (TIA) estimation, including single-time-point (STP) dosimetry, uncertainty analysis, as well as pharmacodynamic (PD) analysis. The flexibility of PopPK in handling sparse and irregularly sampled data makes it particularly relevant for clinical scenarios where comprehensive imaging schedules are impractical. However, despite its potential, the widespread adoption of PopPK in RPT remains limited due to challenges such as computational complexity and the need for specialized expertise. This review discusses critical aspects of PopPK implementation while emphasizing the importance of interdisciplinary collaboration in translating PopPK methodologies into clinical practice. Future directions include integrating PopPK into adaptive dosimetry frameworks and applying it in STP dosimetry and PD modeling to optimize treatment personalization. By providing a comprehensive overview of PopPK applications in RPT, this review aims to facilitate the integration of advanced modeling techniques into routine clinical workflows, ultimately supporting the development of accurate and precise RPTs.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"5 ","pages":"1695332"},"PeriodicalIF":1.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12546074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380262","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":"Fast PET reconstruction with variance reduction and prior-aware preconditioning.","authors":"Matthias J Ehrhardt, Zeljko Kereta, Georg Schramm","doi":"10.3389/fnume.2025.1641215","DOIUrl":"10.3389/fnume.2025.1641215","url":null,"abstract":"<p><p>We investigated subset-based optimization methods for positron emission tomography (PET) image reconstruction incorporating a regularizing prior. PET reconstruction methods that use a prior, such as the relative difference prior (RDP), are of particular relevance because they are widely used in clinical practice and have been shown to outperform conventional early-stopped and post-smoothed ordered subset expectation maximization. Our study evaluated these methods using both simulated data and real brain PET scans from the 2024 PET Rapid Image Reconstruction Challenge (PETRIC), where the main objective was to achieve RDP-regularized reconstructions as fast as possible, making it an ideal benchmark. Our key finding is that incorporating the effect of the prior into the preconditioner is crucial for ensuring fast and stable convergence. In extensive simulation experiments, we compared several stochastic algorithms-including stochastic gradient descent (SGD), stochastic averaged gradient amelioré (SAGA), and stochastic variance reduced gradient (SVRG)-under various algorithmic design choices and evaluated their performance for varying count levels and regularization strengths. The results showed that SVRG and SAGA outperformed SGD, with SVRG demonstrating a slight overall advantage. The insights gained from these simulations directly contributed to the design of our submitted algorithms, which formed the basis of the winning contribution to the PETRIC 2024 challenge.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"5 ","pages":"1641215"},"PeriodicalIF":1.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214615","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":"Platinum group metals for nuclear medicine, a luxurious dream or the future of imaging and therapy: a review.","authors":"Daniel G Racz, Ivis F Chaple","doi":"10.3389/fnume.2025.1656374","DOIUrl":"10.3389/fnume.2025.1656374","url":null,"abstract":"<p><p>Platinum group metals (PGMs) consist of six transition metals: platinum (Pt), palladium (Pd), rhodium (Rh), osmium (Os), iridium (Ir), and ruthenium (Ru). PGMs have been used notably in industrial, electronic, and medical applications. For example, Ir-192 is often utilized in industry to detect structural defects in metal and assess pipeline integrity. Pd-104 is irradiated to produce Pd-103 seeds, used for prostate cancer treatment. Other isotopes of elements in this group can be sourced to facilitate critical applications, discussed in this review. Due to their unique chemical and nuclear properties, these metals may be promising candidates for various nuclear medicine applications, including diagnostic imaging via Positron Emission Tomography (PET), Single Photon Emission Computed Tomography (SPECT) and Targeted Radionuclide Therapy (TRT). This review will explore PGMs in nuclear medicine, focusing on their production routes, nuclear characteristics, and suitability for past and future development of radiopharmaceuticals. We will highlight methods for radiochemical separation and purification of each radionuclide, discussing potential challenges and emphasizing the need for further research to ensure sustainability. As the demand for advanced nuclear medicine techniques continues to grow, PGMs may play a significant role in addressing current challenges in the field. We will discuss several radionuclides of interest to nuclear medicine including <sup>191</sup>Pt, <sup>193m</sup>Pt, <sup>195m</sup>Pt, <sup>103</sup>Pd, <sup>109</sup>Pd, <sup>103m</sup>Rh, <sup>105</sup>Rh, <sup>191</sup>Os, <sup>192</sup>Ir, <sup>97</sup>Ru, and <sup>103</sup>Ru.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"5 ","pages":"1656374"},"PeriodicalIF":1.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187663","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}
Eve Lennie, Steven Sourbron, Nigel Hoggard, Thomas Jenkins, Charalampos Tsoumpas
{"title":"Quantification of FDG in the spinal cord using PET/MRI.","authors":"Eve Lennie, Steven Sourbron, Nigel Hoggard, Thomas Jenkins, Charalampos Tsoumpas","doi":"10.3389/fnume.2025.1646662","DOIUrl":"10.3389/fnume.2025.1646662","url":null,"abstract":"<p><strong>Background: </strong>In this study, we investigate the impact of MR-derived attenuation maps and limited detector resolution on the quantification of positron emission tomography (PET) activity uptake in the spinal cord during PET/MRI. This was performed by simulating [ <math><msup><mi></mi> <mrow><mn>18</mn></mrow> </msup> </math> F]FDG PET data in the neck and thorax and then modifying the attenuation map to remove bone features. We then compared Ordered Subset Expectation Maximisation-reconstructed images to those with full attenuation correction. This simulation was performed at two detector resolutions of 2.1 and 4.4 mm. Acquisitions from a clinical study were then used to assess the ability of point spread function (PSF) modelling and time-of-flight (TOF) corrections, as implemented on the SIGNA PET/MR scanner (GE HealthCare), to correct for these quantification errors. For comparison, mean uptake was measured in regions of interest at each vertebral position along the spinal cord.</p><p><strong>Results: </strong>Simulation results showed a decreasing pattern of uptake from the cervical to the thoracic spinal cord. When bone was not included in attenuation correction, the mean uptake decreased by 3%-10.4%. This difference in measured uptake was 6.4%-23.9% in images simulated at a detector resolution representative of a clinical PET/MRI scanner. At a detector resolution of 4.4 mm, a 32.2% decrease in uptake was measured compared to the 2.1 mm simulation. In patient data, introducing vertebral bone to the attenuation correction pseudo-CT led to a 1.8%-18.3% difference in <math> <msub><mrow><mi>SUV</mi></mrow> <mrow><mrow><mi>mean</mi></mrow> </mrow> </msub> </math> in the spinal cord. Applying PSF modelling did not lead to any statistically significant changes. TOF correction reduces the difference in <math> <msub><mrow><mi>SUV</mi></mrow> <mrow><mrow><mi>mean</mi></mrow> </mrow> </msub> </math> between data attenuation corrected with and without vertebral bone to 4.3%-7%. TOF Q.Clear images with beta = 100 showed the smallest difference between attenuation correction approaches at 0.6%-5.2%.</p><p><strong>Conclusion: </strong>Ignoring bone during image reconstruction in PET/MRI reduces the activity measured during quantification of the spinal cord; however, the partial volume effect has a greater impact on reducing measured uptake in lower-resolution data. While time-of-flight correction goes somewhat resolves these quantification errors, further research is needed into partial volume correction.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"5 ","pages":"1646662"},"PeriodicalIF":1.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042575","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}
Ivo J Lutke Schipholt, Gwendolyne G M Scholten-Peeters, Meghan A Koop, Michel W Coppieters, Ronald Boellaard, Elsmarieke van de Giessen, Bastiaan C Ter Meulen, Marieke Coenen, Carmen Vleggeert-Lankamp, Paul R Depaauw, Bart N M van Berckel, Adriaan A Lammerstma, Maqsood Yaqub
{"title":"Quantification of neuroinflammation in spinal cord and neuroforamina of patients with painful cervical radiculopathy using [<sup>11</sup>C]DPA713 PET/CT.","authors":"Ivo J Lutke Schipholt, Gwendolyne G M Scholten-Peeters, Meghan A Koop, Michel W Coppieters, Ronald Boellaard, Elsmarieke van de Giessen, Bastiaan C Ter Meulen, Marieke Coenen, Carmen Vleggeert-Lankamp, Paul R Depaauw, Bart N M van Berckel, Adriaan A Lammerstma, Maqsood Yaqub","doi":"10.3389/fnume.2025.1569991","DOIUrl":"10.3389/fnume.2025.1569991","url":null,"abstract":"<p><strong>Background: </strong>Animal models of nerve compression have revealed neuroinflammation not only at the entrapment site, but also remotely at the spinal cord. However, there is limited information on the presence of neuroinflammation in human compression neuropathies. The objectives of this study were to: (1) assess which tracer kinetic model most optimally quantified [<sup>11</sup>C]DPA713 uptake in the spinal cord and neuroforamina in patients with painful cervical radiculopathy, (2) evaluate the performance of linearized methods (e.g., Logan) and simplified (e.g., standardized uptake value - SUV) methods, and (3) assess the test-retest reliability of these methods. Microglia activation associated with neuroinflammation was quantified using positron emission tomography (PET) with the radiotracer [<sup>11</sup>C]DPA713, targeting the 18 kDa translocator protein (TSPO). The Akaike information criterion, visual inspection of the fits and number of outliers were used to select the optimal kinetic model. As unaffected tissue, the spinal cord and neuroforamina three cervical levels above the affected target tissue was used.</p><p><strong>Results: </strong>The single tissue (1T2k) compartment model was the preferred model to describe [<sup>11</sup>C]DPA713 kinetics at the spinal cord and neuroforamina. Higher levels of 1T2k <i>V</i> <sub>T</sub> were observed in the affected neuroforamina and spinal cord compared with corresponding unaffected tissues. Logan <i>V</i> <sub>T</sub> (≥0.73) showed high correlation with 1T2k <i>V</i> <sub>T</sub> at both locations. Of the simplified methods, neuroforamina and spinal cord SUV normalized for the metabolite corrected plasma (TBR-PP) exhibited high correlations with 1T2k <i>V</i> <sub>T</sub> (r ≥ 0.84). Test-retest reliability varied between fair to excellent.</p><p><strong>Conclusions: </strong>These results indicate that a 1T2k model with metabolite corrected image derived input function can be used to describe the kinetics of [<sup>11</sup>C]DPA713 in the spinal cord and neuroforamina in humans. 1T2k <i>V</i> <sub>T</sub> or Logan <i>V</i> <sub>T</sub> can be used as binding metric, while TBR-PP is the recommended choice among simplified models.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"5 ","pages":"1569991"},"PeriodicalIF":1.4,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016772","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}
Amir Jabbarpour, Eric Moulton, Sanaz Kaviani, Siraj Ghassel, Wanzhen Zeng, Ramin Akbarian, Anne Couture, Aubert Roy, Richard Liu, Yousif A Lucinian, Nuha Hejji, Sukainah AlSulaiman, Farnaz Shirazi, Eugene Leung, Sierra Bonsall, Samir Arfin, Bruce G Gray, Ran Klein
{"title":"Correction: On the construction of a large-scale database of AI-assisted annotating lung ventilation-perfusion scintigraphy for pulmonary embolism (VQ4PEDB).","authors":"Amir Jabbarpour, Eric Moulton, Sanaz Kaviani, Siraj Ghassel, Wanzhen Zeng, Ramin Akbarian, Anne Couture, Aubert Roy, Richard Liu, Yousif A Lucinian, Nuha Hejji, Sukainah AlSulaiman, Farnaz Shirazi, Eugene Leung, Sierra Bonsall, Samir Arfin, Bruce G Gray, Ran Klein","doi":"10.3389/fnume.2025.1671281","DOIUrl":"https://doi.org/10.3389/fnume.2025.1671281","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fnume.2025.1632112.].</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"5 ","pages":"1671281"},"PeriodicalIF":1.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12345769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849921","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}
Katherine N Haugh, Alexis M Sanwick, Ivis F Chaple
{"title":"Targeted radionuclide therapy and diagnostic imaging of SSTR positive neuroendocrine tumors: a clinical update in the new decade.","authors":"Katherine N Haugh, Alexis M Sanwick, Ivis F Chaple","doi":"10.3389/fnume.2025.1655419","DOIUrl":"10.3389/fnume.2025.1655419","url":null,"abstract":"<p><p>Neuroendocrine tumors (NETs) are a heterogeneous group of neoplasms characterized by their overexpression of somatostatin receptors (SSTRs), which can be utilized for peptide receptor radionuclide therapy. This review provides a comprehensive update on the clinical trials of radiolabeled SSTR-targeting radiopharmaceuticals since 2020, with a focus on somatostatin receptor agonists and antagonists radiolabeled with <sup>68</sup>Ga, <sup>18</sup>F, <sup>99m</sup>Tc, <sup>177</sup>Lu, <sup>161</sup>Tb, <sup>212</sup>Pb, <sup>67</sup>Cu, and <sup>225</sup>Ac. Head-to-head clinical trials demonstrate that radiolabeled SSTR antagonists such as [<sup>68</sup>Ga]Ga-DOTA-JR11 and [<sup>68</sup>Ga]Ga-DOTA-LM3 offer improved lesion detection and tumor-to-background ratios (particularly in liver metastases) compared to radiolabeled agonists like [<sup>68</sup>Ga]Ga-DOTA-TOC and [<sup>64</sup>Cu]Cu-DOTA-TATE. Additionally, <sup>18</sup>F-labeled agents offer logistical and dosimetric advantages over <sup>68</sup>Ga, due to <sup>18</sup>F's longer half-life and cyclotron production, allowing for delayed imaging and increased availability to a wider range of patients. Emerging targeted alpha therapy agents, including [<sup>225</sup>Ac]Ac-DOTA-TATE, show promising results in treating disease resistant to conventional therapies due to the high linear energy transfer of alpha particles, which leads to improved localized cytotoxicity. Collectively, these developments support a shift toward more precise, receptor-specific theragnostics, emphasizing the need for further head-to-head clinical trials and integration of dosimetry-driven, personalized treatment planning in the management of NETs.</p>","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"5 ","pages":"1655419"},"PeriodicalIF":1.4,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981062","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}