Annals of Nuclear Medicine最新文献

{"title":"Interobserver and intraobserver agreement for equivocal lesions in Ga-68 PSMA PET/CT according to PSMA-RADS 2.0 criteria.","authors":"Khanim Niftaliyeva, Selin Kesim, Nuh Filizoglu, Zeynep Ceren Balaban Genc, Salih Ozguven, Feyza Cagliyan, Tunc Ones, Fuat Dede, Halil Turgut Turoglu, Tanju Yusuf Erdil","doi":"10.1007/s12149-025-02103-x","DOIUrl":"https://doi.org/10.1007/s12149-025-02103-x","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to systematically evaluate the inter- and intra-observer agreement regarding lesions with uncertain malignancy potential in Ga-68 PSMA PET/CT imaging of prostate cancer patients, utilizing the PSMA-RADS 2.0 classification system, and to emphasize the malignancy evidence associated with these lesions.</p><p><strong>Methods: </strong>We retrospectively reviewed Ga-68 PSMA PET/CT images of patients diagnosed with prostate cancer via histopathology between December 2016 and November 2023. Seventy-six patients and 98 target lesions, classified with PSMA-RADS scores 3A-3D by an experienced nuclear medicine specialist, were included. Three observers (two experienced and one less experienced nuclear medicine physician) evaluated the lesions at two different time points, three months apart, in a blinded manner. Intra-observer agreement was assessed using Cohen's kappa, while inter-observer agreement was analyzed using Fleiss' kappa.</p><p><strong>Results: </strong>All observers demonstrated significant intra-observer agreement, with percentages ranging from 67.3 to 80.6% and kappa values between 0.62 and 0.76. The highest intra-observer agreement was noted for bone lesions, while non-regional lymph nodes exhibited the lowest agreement. For inter-observer assessments, moderate agreement was observed across all lesions (Fleiss k = 0.51), with the highest agreement in regional lymph nodes and the lowest in non-regional lymph nodes and bone lesions. Follow-up results indicated malignancy detection rates of 63.4% for 3A, 47% for 3B, 44.5% for 3C, and 41.4% for 3D scored lesions.</p><p><strong>Conclusions: </strong>The PSMA-RADS classification system demonstrated substantial intra-observer agreement and moderate inter-observer agreement for lesions with uncertain malignancy potential, supporting its clinical applicability. However, notable variability and limitations in reporting bone lesions, non-regional lymph nodes, and lung lesions were observed among readers. The ambiguous nature and management of PSMA-RADS 3 lesions underscore the need for further research to enhance risk stratification.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145028772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment of National Diagnostic Reference Levels 2025 for nuclear medicine in Japan","authors":"Koichiro Abe,&nbsp;Shingo Baba,&nbsp;Reo Etani,&nbsp;Takahiro Fujimto,&nbsp;Makoto Hosono,&nbsp;Takashi Iimori,&nbsp;Anri Inaki,&nbsp;Masanobu Ishiguro,&nbsp;Noriaki Miyaji,&nbsp;Atsutaka Okizaki,&nbsp;Takeshi Sasaki,&nbsp;Hiroyuki Tsushima,&nbsp;Hiroshi Watanabe,&nbsp;Masanori Watanabe,&nbsp;Nobuhiro Yada","doi":"10.1007/s12149-025-02102-y","DOIUrl":"10.1007/s12149-025-02102-y","url":null,"abstract":"<div><p>Diagnostic reference levels (DRLs) are practical benchmarks for optimizing patient radiation exposure in medical imaging. In Japan, national DRLs, including those for nuclear medicine together and other radiological procedures, were first established in 2015 and revised in 2020. In this study, we revised the DRL values of nuclear medicine for the establishment of DRLs2025, based on data collected from institutions nationwide throughout Japan. Data were collected via an online survey from facilities performing nuclear medicine procedures, including SPECT, PET, and hybrid CT imaging. Information on dose activity of the administered radiopharmaceuticals and CT parameters (CTDIvol and DLP) were collected. DRL values were determined through analysis of the submitted data, supplemented by panel discussions among experts taking into account the clinical appropriateness of the values and various technological factors. Overall, the newly established DRLs2025 demonstrated a decreasing trend in administered radiopharmaceutical activities, CTDIvol, and DLP compared with the previous surveys. This trend reflects ongoing efforts toward the optimization of radiation exposure and radiopharmaceutical dose reduction, likely driven by the introduction of image reconstruction methods based on newer technologies. However, substantial interfacility variations were observed, particularly in the CT parameters, suggesting disparities in equipment, imaging protocols, and the balance between image quality and radiation dose. The establishment of DRLs2025 underscores continued progress in optimizing radiation exposure in nuclear medicine practice in Japan. Although issues regarding data variability and quality remain, DRLs continue to be a key tool in radiation protection and quality assurance. Ongoing efforts to improve data collection systems and to align procedures with international standards are essential for the future refinement of DRLs.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"39 10","pages":"1027 - 1036"},"PeriodicalIF":2.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12149-025-02102-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SPECT reconstruction using preprocessing masking for extra-cardiac uptake versus standard processing in ^99mTc-sestamibi myocardial perfusion imaging.","authors":"Keiko Tanimoto, Yoshifumi Kawamura, Satoshi Kimura, Yumi Hasuike, Erina Tachibana, Ayako Kudo, Tadao Aikawa, Koji Murakami, Shinichiro Fujimoto","doi":"10.1007/s12149-025-02085-w","DOIUrl":"https://doi.org/10.1007/s12149-025-02085-w","url":null,"abstract":"<p><strong>Objective: </strong>In ^99mTc myocardial perfusion SPECT, extra-cardiac accumulation from organs such as the liver or gastrointestinal tract may overlap with the inferior wall, causing artifacts that interfere with image interpretation. This study aimed to quantitatively evaluate the effectiveness of a novel image reconstruction method, the masking process on unsmoothed images (MUS method; CardioMUSk®, PDRadiopharma Inc., Tokyo, Japan), in reducing the influence of extra-cardiac accumulation using both phantom and clinical images.</p><p><strong>Methods: </strong>This retrospective study included 200 patients (400 scans) who underwent a one-day stress-rest protocol using ^99mTc-sestamibi (MIBI) with pharmacologic stress administered first. Image reconstruction was performed using filtered back projection (FBP) and ordered subset expectation maximization with resolution recovery (OS-EM-RR), both with and without the MUS method. First, visual classification of extra-cardiac accumulation patterns relative to the inferior wall was performed, and the separation capability of each reconstruction method was assessed. Next, phantom experiments were conducted to investigate the effects of extra-cardiac accumulation volume, proximity, and concentration on contrast in the inferior wall. Furthermore, quantitative comparison of relative contrast between the inferior wall and the lateral and septal walls was performed using clinical data.</p><p><strong>Results: </strong>The MUS method reduced the proportion of visually unseparated cases from 15.5% to 3.5% compared with the conventional method. In phantom studies, larger extra-cardiac accumulation and closer proximity to the myocardium resulted in greater degradation of inferior wall contrast. When a distance of 2 cm was maintained between extra-cardiac accumulation and the myocardium, the effect was substantially reduced. In clinical images, the MUS method significantly improved relative contrast in the inferolateral/inferior wall at the mid-ventricular level (Wilcoxon p = 0.030) and in the inferoseptal/inferior wall at the basal level (Wilcoxon p < 0.001), while no significant improvement was observed in the basal inferolateral/inferior wall region (Wilcoxon p = 0.605).</p><p><strong>Conclusion: </strong>The MUS method demonstrated enhanced separation of extra-cardiac accumulation and improved contrast in the inferior myocardial wall compared with conventional methods. It was particularly effective in cases where extra-cardiac accumulation overlapped or closely contacted the myocardium, indicating its potential clinical utility in ^99mTc myocardial perfusion SPECT.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of previous ¹⁷⁷Lu-DOTATATE treatment on ⁹⁰Y-microsphere treatment response in neuroendocrine tumor patients with liver metastasis.","authors":"Fuad Aghazada, Lebriz Uslu-Besli, Ali Kibar, Onur Erdem Sahin, Nami Yeyin, Eren Ertek, Ahmet Bas, Haluk Burcak Sayman","doi":"10.1007/s12149-025-02101-z","DOIUrl":"https://doi.org/10.1007/s12149-025-02101-z","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates the impact of prior PRRT with Lu-177 DOTATATE on the response to TARE in NET patients with liver metastases.</p><p><strong>Methods: </strong>Twenty-one patients who underwent TARE after PRRT between 2015 and 2022 were retrospectively analyzed. Tumor-specific cumulative Lu-177 DOTATATE counts were calculated from SPECT/CT images. Treatment planning was conducted with a standard target dose of 150 Gy to the tumoral tissue. Treatment response was assessed using changes in SUVmax, SUVmean, and somatostatin receptor-expressing tumor volume (SRE-TV) values derived from Ga-68 DOTATATE PET/CT before and 2-4 months after TARE. Lesion size was evaluated using RECIST v1.1 criteria. Dosimetry calculations were performed on Tc-99 m MAA SPECT/CT and Y-90 microsphere PET/MRI using Simplicit90Y™. Statistical analyses included Spearman correlation and Kruskal-Wallis tests.</p><p><strong>Results: </strong>The median age of patients was 56 years (range 36-78 years). PRRT involved a mean cumulative Lu-177 DOTATATE dose of 43.5 ± 13.4 GBq (1175 ± 362 mCi). Post-TARE reductions in SUVmax (38.49 ± 20.46 to 19.94 ± 10.43 g/mL), SUVmean (9.51 ± 5.60 to 5.39 ± 3.64 g/mL), and SRE-TV (217.43 ± 155.87 to 175.62 ± 147.77 cm³) were observed. No significant correlation was found between cumulative Lu-177 DOTATATE counts and changes in SUV parameters, SRE-TV values, or lesion size after TARE. Similarly, no correlation was detected between tumor-to-normal liver activity ratios, calculated using either the partition model or voxel-based dosimetry and cumulative Lu-177 DOTATATE counts.</p><p><strong>Conclusion: </strong>Prior PRRT does not significantly affect TARE response in NET patients with liver metastases. Radioembolization planning should prioritize factors like tumor, target, or healthy liver doses over previous PRRT.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in imaging-based diagnosis, prognosis, and response assessment in cardiac amyloidosis: a comprehensive multimodality review","authors":"Osamu Manabe,&nbsp;Seitaro Oda,&nbsp;Takashi Norikane,&nbsp;Tadao Aikawa,&nbsp;Yuka Otaki,&nbsp;Nagara Tamaki","doi":"10.1007/s12149-025-02092-x","DOIUrl":"10.1007/s12149-025-02092-x","url":null,"abstract":"<div><p>Cardiac amyloidosis, characterized by extracellular deposition of amyloid fibrils within the myocardium, is an increasingly recognized cause of heart failure. With the advent of disease-modifying therapies, imaging has become central to diagnosis, subtype differentiation, prognostication, and treatment monitoring. This review provides a comprehensive update on multimodality imaging in cardiac amyloidosis, emphasizing its clinical utility across the disease continuum. Echocardiography, technetium-labeled bone scintigraphy, amyloid-specific positron emission tomography, cardiac magnetic resonance, and cardiac computed tomography each contribute uniquely to detecting amyloid burden and assessing cardiac function. In addition to outlining a practical diagnostic approach, we highlight emerging imaging biomarkers for monitoring treatment response and predicting clinical outcomes. The integration of these modalities into clinical practice enhances diagnostic accuracy, enables individualized risk stratification, and supports optimized, evidence-based care for patients with cardiac amyloidosis.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"39 10","pages":"1037 - 1052"},"PeriodicalIF":2.5,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12149-025-02092-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of repeated trans-arterial radioembolization with multi-compartment dosimetry.","authors":"Cigdem Soydal, Burak Demir, Mine Araz, Irem Mesci, Emre Can Çelebioğlu, Nuriye Ozlem Kucuk","doi":"10.1007/s12149-025-02094-9","DOIUrl":"https://doi.org/10.1007/s12149-025-02094-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Transarterial radioembolization (TARE) is one of the local treatment options for primary and metastatic liver tumors. However, our knowledge regarding the safety of repeated TARE remains limited. In this study, we aimed to evaluate the safety of repeated transarterial radioembolization with multi-compartment dosimetry.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this retrospective single-center study, we analyzed the data of the patients who were treated with at least two separate sessions of radioembolization with &lt;sup&gt;90&lt;/sup&gt;Y microspheres. Multi-compartment and voxel-wise dosimetry was performed for every treatment session and cumulative whole-liver normal tissue absorbed radiation dose (D&lt;sub&gt;norm&lt;/sub&gt;), V20-V100 values for whole-liver normal tissue were calculated. Toxicity was assessed with Common Terminology Criteria for Adverse Events (CTCAE) grading system for alanine aminotransferase (ALT)/aspartate aminotransferase (AST)/bilirubin levels and International Normalized Ratio (INR) before and after each treatment. In addition, albumin-bilirubin (ALBI) scores, grades, and changes in ALBI score (ΔALBI) were recorded. Difference between the ALBI scores before and after the treatment was compared with Wilcoxon tests, and relationships between ΔALBI and dosimetric variables were compared using linear regression analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 24 patients (6 males, 18 females; median age: 57 years) were included in the analysis. The most common diagnosis was colorectal carcinoma liver metastases (46%). Seventeen patients (71%) underwent two TARE treatments, five (21%) underwent three, and two (8%) underwent four. The median interval between the first and second treatments was 138 days (range: 34-782), and between the second and third treatments was 210 days (range: 72-435). No CTCAE Grade 3 or 4 toxicities were observed. ALBI score analysis revealed no significant changes after the first two treatments, but a significant difference was noted after the third treatment (P = 0.043), with one patient progressing to ALBI Grade 3 with significant hypoalbuminemia. No significant relationship was found between ΔALBI and treatment intervals. ALT/AST elevations were mostly transient and mild, with only one case of Grade 2 hepatotoxicity in each of the first two treatments. In patients treated with glass microspheres in their first two treatments (n = 12), a significant linear correlation was found between cumulative D&lt;sub&gt;norm&lt;/sub&gt; and ΔALBI (R&lt;sup&gt;2&lt;/sup&gt; = 0.512, P = 0.007). Cumulative dose-volume histogram parameters, particularly V30, V40, and V50, showed significant correlations with ΔALBI. However, in patients treated with resin microspheres (n = 6), no statistically significant relationship was observed between cumulative D&lt;sub&gt;norm&lt;/sub&gt; and ΔALBI (P = 0.718).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Repeated TARE with a multi-compartment personalized dosimetric approach appears to be safe for the first two cy","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of an ¹⁸F-FDG PET/CT radiomic nomogram for predicting axillary lymph-node status after neoadjuvant chemotherapy for breast cancer: a multicenter study.","authors":"Yu Li, Kun Chen, Luqiang Jin, Hailin Huang","doi":"10.1007/s12149-025-02099-4","DOIUrl":"https://doi.org/10.1007/s12149-025-02099-4","url":null,"abstract":"<p><strong>Rationale and objective: </strong>To develop and validate the predictive value of ¹⁸F-FDG PET/CT radiomics models based on data preprocessing methods for axillary lymph-node (ALN) status after neoadjuvant chemotherapy (NAC) for breast cancer.</p><p><strong>Materials and methods: </strong>According to the status of ALN after NAC, we divided the breast cancer patients of the three scanners into the pathological complete remission (pCR) and non-pCR groups, respectively. Totally 630 models were obtained based on various data preprocessing, feature filtering, and modeling approaches. On the one hand, different data preprocessing methods were compared to analyze the advantages of different preprocessing methods. On the other hand, the AUC of predicting ALN status was compared among all models, and the model with the best prediction was obtained. Finally, the optimal model is combined with the clinical and the corresponding Nomogram is plotted.</p><p><strong>Results: </strong>The comparison of the data preprocessing modalities revealed that the model prediction of tumor-to-liver ratio (TLR) radiomics was better than origin radiomics (OR), and the effect of Combat and Limma was better than without batch effects. All preprocessing modalities could be used as a potential method that can further optimize the model. The optimal model had a predicted AUC of 0.798 for ALN status after NAC for breast cancer in the test set and an AUC of 0.811 when combined with clinical characteristics.</p><p><strong>Conclusion: </strong>It is necessary to pre-process the data before conducting a study on multicenter data, and the model developed in this way can effectively predict the status of ALN after NAC in breast cancer.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2024 Hisada Prize (Award for Articles in Annals of Nuclear Medicine)","authors":"Kazunari Ishii","doi":"10.1007/s12149-025-02096-7","DOIUrl":"10.1007/s12149-025-02096-7","url":null,"abstract":"","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"39 10","pages":"1025 - 1026"},"PeriodicalIF":2.5,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the diagnostic utility of [⁶⁸Ga]Ga-Pentixafor in solid tumors: a systematic review","authors":"Saad Ruzzeh,&nbsp;Ahmed Saad Abdlkadir,&nbsp;Hasan Al-Alawi,&nbsp;Egesta Lopci,&nbsp;Mike Sathekge,&nbsp;Serin Moghrabi,&nbsp;Shahed Obeidat,&nbsp;Akram Al-Ibraheem","doi":"10.1007/s12149-025-02093-w","DOIUrl":"10.1007/s12149-025-02093-w","url":null,"abstract":"<div><p>The C-X-C motif chemokine receptor 4 (CXCR4) has emerged as a critical molecular imaging target in various malignancies due to its central role in tumor progression, metastasis, and resistance to therapy. Among the imaging modalities developed to exploit this target, [68Ga]Ga-Pentixafor—a positron emission tomography (PET) radiopharmaceutical—has shown potential in diagnostic imaging. However, its diagnostic utility in solid tumors remains relatively underexplored, particularly in comparison to the widely utilized [18F]fluorodeoxyglucose ([18F]FDG) PET/CT. Comprehensive literature search was performed across PubMed, Scopus, Web of Science and Embase, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies included those reporting CXCR4-targeted PET imaging in solid tumors, with data on lesion detection, semiquantitative uptake values including maximum standardized uptake value (SUVmax) and tumor-to-background ratio (TBR). Data extraction focused on study design, patient demographics, tumor types, imaging protocols, and key findings. The quality of included studies was assessed using standardized risk-of-bias tools using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. This systematic review analyzed data from 26 studies, encompassing 831 patients with various solid malignancies to assess the diagnostic utility of [68Ga]Ga-Pentixafor PET/CT. Tracer uptake varied significantly among tumor types, with higher SUVmax values observed in adrenocortical carcinoma, small cell lung cancer, and desmoplastic small round cell tumors, while lower uptake was noted in breast cancer, glioblastoma, and melanoma. Certain malignancies, such as prostate cancer, pleural mesothelioma, and colorectal carcinoma, exhibited minimal or absent CXCR4 expression on PET imaging. A correlation between in vivo PET uptake and histopathologic CXCR4 expression was evident in specific tumor types, though heterogeneity in receptor expression was reported. When compared to [18F]FDG PET/CT, [68Ga]Ga-Pentixafor PET/CT demonstrated lower lesion detectability, highlighting its potential as a theranostic tool for CXCR4-targeted therapies rather than a primary diagnostic modality. [68Ga]Ga-Pentixafor PET/CT represents a promising, yet evolving, tool in oncology. While its diagnostic performance may not rival that of [18F]FDG PET/CT across all tumor types, its theranostic potential underscores its value in the precision medicine landscape.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"39 10","pages":"1053 - 1073"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of ¹⁸F-FDG PET/CT in the follow-up of conjunctival melanoma.","authors":"Huan Ma, Chuangui Li, Qian Zhang, Jiayue Liu, Wei Zhao, Xiaoyi Guo, Nina Zhou, Daxi Xue","doi":"10.1007/s12149-025-02097-6","DOIUrl":"https://doi.org/10.1007/s12149-025-02097-6","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the diagnostic performance of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) in detecting metastatic conjunctival melanoma (CM).</p><p><strong>Methods: </strong>This retrospective study enrolled 67 patients with histopathologically confirmed CM who underwent ¹⁸F-FDG PET/CT for follow-up or suspected recurrence. Parameters including short-axis diameter of lesions, maximum standardized uptake value (SUVmax), the target-to-nontarget (T/NT) ratios of cervical lymph nodes, and bone lesion characterization (osteolytic, osteoblastic, or unchanged) were evaluated. Metastases were confirmed via either histopathology or ≥ 6-month imaging follow-up. Diagnostic sensitivity, specificity, accuracy, and metastatic patterns were analyzed at patient level.</p><p><strong>Results: </strong>A total of 16 patients were confirmed metastasis. The median interval from surgery to metastasis was 20.3 months (range 1-100 months), with 56.3% (9/16) occurring within the first postoperative year. PET/CT detected metastases in 13 patients, missed metastases in 3 patients (2 with small preauricular lymph nodes and 1 with tiny pulmonary metastases), and misdiagnosed 1 patient with parotid benign nodules as metastatic. PET/CT demonstrated a sensitivity of 81.3%, specificity of 98.0%, and accuracy of 94.0%. The most common metastatic sites included lymph nodes (62.5%), bone (37.5%), lung (31.3%), and liver (25.0%), with PET/CT demonstrating detection rates of 95.5%, 100%, 86.7%, and 100%, respectively. PET/CT also identified metastases in rare sites, including the thyroid, cerebellum, adrenal glands, pericardium, pancreas, and subcutaneous/soft tissue. Lymph node metastases in CM predominately occurred in ipsilateral regional nodes (90.1%), with rare bilateral involvement (9.1%). Metastatic lymph nodes in the cervical and submandibular regions showed significantly higher mean SUVmax (11.6 ± 10.5 vs. 2.9 ± 0.9; p = 0.005) and T/NT ratios (6.9 ± 8.2 vs. 3.0 ± 1.0; p = 0.011) compared to inflammatory lymph nodes. SUVmax of metastatic lymph nodes, lung metastases, and liver metastases showed positive correlations with lesion size (p < 0.05 for all). Among metastatic lymph nodes, 53.2% had a short-axis diameter < 10 mm, and 59.1% of bone metastases exhibited no abnormal CT density.</p><p><strong>Conclusion: </strong>¹⁸F-FDG PET/CT provides high diagnostic accuracy in detecting systemic metastases of CM during follow-up assessments, particularly for small lymph nodes, early bone metastases, and uncommon sites.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}