Annals of Nuclear Medicine最新文献

{"title":"Extended single-dose toxicity study of [²¹¹At]meta-astatobenzylguanidine in normal mice in preparation for the first-in-human clinical trial of targeted alpha therapy for pheochromocytoma and paraganglioma.","authors":"Taiki Joho, Songji Zhao, Ken-Ichi Nishijima, Naoyuki Ukon, Saki Shimoyama, Atsushi Yamashita, Komei Washino, Tatsuya Higashi, Masao Kobayakawa, Tohru Shiga, Kazuhiro Takahashi, Hiroshi Ito","doi":"10.1007/s12149-025-02065-0","DOIUrl":"https://doi.org/10.1007/s12149-025-02065-0","url":null,"abstract":"<p><strong>Objective: </strong>Targeted alpha-particle therapy (TAT) is promising with a greater therapeutic effect than conventional beta radionuclide therapy. To develop human clinical trials of [²¹¹At]meta-astatobenzylguanidine ([²¹¹At]MABG), we have conducted an extended single-dose toxicity study of [²¹¹At]MABG in normal mice in consultation with the Pharmaceuticals and Medical Devices Agency (PMDA). We are currently working for human clinical trials of [²¹¹At]MABG. After consultation with the Pharmaceuticals and Medical Devices Agency, we conducted a single-dose toxicity study of [²¹¹At]MABG in normal mice in preparation for a human clinical trial of [²¹¹At]MABG.</p><p><strong>Methods: </strong>[²¹¹At]MABG was manufactured at Fukushima Medical University, where doses of 16, 48, and 80 MBq/kg were administered to BALB/cCrSlc mice (90 males and 90 females, 9 weeks old). The mice were observed and weighed every day for 14 days after [²¹¹At]MABG administration, as well as at any time between 14 and 35 days after [²¹¹At]MABG administration. At the end of the observation period, necropsy, blood examination, organ weighing, and histopathological examinations were performed. Statistical analyses of body weight, blood test results, and organ weights were performed to compare the data between the control and treatment groups.</p><p><strong>Results: </strong>In the 80-MBq/kg-administered group of females, two mice were emergently euthanized on day 8 because of the deterioration of their general condition. One mouse died spontaneously on day 9. Except for the two emergently euthanized mice and one mouse that died, both males and females showed volume-dependent deterioration in body weight, general condition, necropsy findings, blood test results, organ weights, and histopathological findings, but all except for genital organ weights showed a recovery trend after 35 days.</p><p><strong>Conclusions: </strong>The extended single-dose toxicity study of [²¹¹At]MABG conducted under the reliability criteria showed the toxicity of [²¹¹At]MABG to hematopoietic cells, gastrointestinal mucosa, adrenal glands, and genital organs, especially at the dose of 80 MBq/kg. Under the conditions of this study, the approximate lethal dose of [²¹¹At]MABG exceeds 80 MBq/kg, so the severely toxic dose in 10% of the animals was estimated to be 80 MBq/kg or greater.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324336","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":"Assessment of reduced ¹⁸F-FDG dosage in pediatric PET/MR imaging through randomized down-sampling.","authors":"Xiaoyue Tan, Yongrong Zhou, Qing Zhang, Hui Yuan, Xinchao Yao, Chang Sun, Entao Liu, Lei Jiang","doi":"10.1007/s12149-025-02066-z","DOIUrl":"https://doi.org/10.1007/s12149-025-02066-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to explore the feasibility of reduced ¹⁸F-FDG dosage in pediatric PET/MR imaging through randomized down-sampling.</p><p><strong>Methods: </strong>Forty-four pediatric patients (26 males, 18 females; median: 11 years [range, 1-17]) underwent ¹⁸F-FDG PET/MR examinations were retrospectively enrolled. PET data were reconstructed into 6 groups with different simulated doses using randomly down-sampling: full dose (2.96 MBq/kg), 1/2 dose, 1/3 dose, 1/4 dose, 1/10 dose, and 1/20 dose. Subjective visual analysis of image quality was evaluated using a 5-point Likert scale. Quantitative parameters of lesions and blood pool and liver background were analyzed. The full dose group was served as a reference.</p><p><strong>Results: </strong>Subjective image quality of 1/2 dose, 1/3 dose and 1/4 dose images was clinically acceptable (score ≥ 3), and all FDG-avid lesions could be identified in these three groups like full-dose group. SUVmax and standard deviation (SD) of blood pool and liver increased as the dose reduced, while no significant difference in SUVmean of blood pool and liver was found in 1/2-1/20 dose groups when compared to the full dose group. Besides, a significant difference was observed in SUVmax and SD of lesion and lesion-to-background ratio between 1/2-1/20 dose and full dose groups (p < 0.05).</p><p><strong>Conclusion: </strong>Further reduction in administered ¹⁸F-FDG activities is feasible in pediatric PET/MR scan. Clinically acceptable image quality could be achieved using a low dose of 0.74 MBq/kg.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315795","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":"A comparative study of dual-layer spectral CT and 18F-FDG-PET/CT multi-quantitative parameters in the diagnosis of sentinel lymph nodes in breast cancer.","authors":"Xin He, Jihui Li, Lingxiao Wang, Yuyang Xie, Ruting Zhang, Ling Yang","doi":"10.1007/s12149-025-02074-z","DOIUrl":"https://doi.org/10.1007/s12149-025-02074-z","url":null,"abstract":"<p><strong>Objective: </strong>To compare the diagnostic efficacy of dual-layer spectral computed tomography (DSCT) and 18-F fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in preoperative identification of metastatic sentinel lymph nodes (SLNs) in patients with breast cancer.</p><p><strong>Methods: </strong>This retrospective study analyzed 97 patients who underwent DSCT and 107 patients who underwent 18F-FDG-PET/CT, classified by pathology into SLN-positive group and SLN-negative group. Quantitative measurements included: (1) DSCT parameters (normalized iodine concentration[nIC], effective atomic number [Zeff], the slope of the spectral Hounsfield unit curve [λHU] in both arterial and venous phases) and (2) the maximum standardized uptake value (SUVmax) of 18F-FDG PET/CT. Statistical analysis involved group comparisons, logistic regression for independent predictors, and receiver-operating characteristic (ROC) curve analysis (area under the curve [AUC], sensitivity, and specificity).</p><p><strong>Results: </strong>The results showed that SUVmax and spectral parameters, including Zeff in the venous phase, nIC in both arterial and venous phases, and λHU in both arterial and venous phases, were significantly higher in metastatic SLNs compared to non-metastatic SLNs. Logistic regression analysis identified both λHU in the venous phase and SUVmax as independent risk factors for predicting metastatic SLNs. ROC curve analysis indicated that SUVmax had a higher diagnostic efficiency (AUC: 0.905) than the combined spectral parameters (AUC: 0.834). Specifically, SUVmax demonstrated higher specificity (97 vs. 53%) but lower sensitivity (77 vs. 98%) than the spectral parameters.</p><p><strong>Conclusions: </strong>Compared with DSCT, 18F-FDG-PET/CT demonstrated higher specificity in identifying metastatic SLNs in breast cancer patients, but was less sensitive than spectral parameters. Spectral parameters can serve as a noninvasive tool for preoperative identification of metastatic SLNs in breast cancer.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315794","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":"Evaluation of the feasibility of anomaly detection for dose management in PET examinations.","authors":"Yusuke Fukui, Shogo Baba, Kohei Ohashi, Yukihiro Nagatani, Kazumasa Kobashi, Yoshiyuki Watanabe, Harumi Iguchi","doi":"10.1007/s12149-025-02063-2","DOIUrl":"https://doi.org/10.1007/s12149-025-02063-2","url":null,"abstract":"<p><strong>Objective: </strong>Owing to the revision of the Medical Care Act in 2020, managing and recording radiation doses in PET-CT examinations have become mandatory. In this study, we investigated unsupervised anomaly detection methods as a potential solution to minimize input errors in dose recordings.</p><p><strong>Methods: </strong>We analyzed data extracted from our database, including patient body weight, positron emission tomography (PET) dose, and dose length product (DLP). Several anomaly detection models, such as one-class support vector machine (OCSVM), Hotelling's T2 method, multivariate statistical process control (MSPC), isolation forest, and local outlier factor (LOF), were applied and compared. The dataset included 3509 entries for model training and 499 entries for evaluation. Anomalies that could be potential input errors were evaluated using metrics, such as precision, recall, F1 score, receiver operating characteristics-area under the curve (ROC-AUC), and precision-recall-AUC (PR-AUC).</p><p><strong>Results: </strong>We demonstrated that Hotelling's T2 method and MSPC's T² statistic outperformed other models, achieving a recall of 1.0 and AUCs of 1.0, effectively detecting input errors in radiation dose records. Furthermore, our findings suggest that unsupervised anomaly detection can not only identify input errors but also detect excessively high or low radiation doses, contributing to improved dose management in PET-CT examinations.</p><p><strong>Conclusion: </strong>These findings suggest that unsupervised anomaly detection is a promising approach to improve the accuracy of dose management in PET-CT examinations, enhancing patient safety and compliance with regulatory standards.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301055","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":"From planar to SPECT-CT brain perfusion study in brain death determination: our experience from 2010 to 2023.","authors":"Mathieu Charest, Marc-André Bélair","doi":"10.1007/s12149-025-02068-x","DOIUrl":"https://doi.org/10.1007/s12149-025-02068-x","url":null,"abstract":"<p><strong>Purpose: </strong>Radionuclide brain perfusion studies using a lipophilic radiopharmaceutical are recognized as reliable ancillary tests for brain death determination in various clinical guidelines. We aim to share our experience with the SPECT-CT protocol.</p><p><strong>Materials and methods: </strong>All studies performed between 2010 and 2023 were included. Planar, SPECT, and SPECT-CT images were analyzed and categorized as showing normal intracranial perfusion, residual cerebellar activity, definitive absence of intracranial perfusion, or residual intracranial activity. These findings were compared with the final diagnosis for each study, which was based on available clinical information, radiologic, and nuclear medicine images.</p><p><strong>Results: </strong>A total of 117 brain perfusion studies for brain death determination were performed. Of these, 106 (91%) were reported as definitive for the absence of intracranial perfusion and were concordant with the clinical diagnosis of brain death. In the remaining 11 cases, 5 (4%) showed normal brain perfusion, and 6 (5%) demonstrated residual intracranial activity. Among the 5 studies with normal perfusion, all (100%) were correctly identified on planar-only images. Of the 106 patients with a definitive diagnosis of absent brain perfusion, 56.6% (60/106) showed a definitive planar result, 36.8% (39/106) had a probable result, 3.8% (4/106) showed possible intracranial activity, and in 2.8% (3/106), planar images were not performed. A total of 105 studies with tomographic images were analyzed. Of the 4 studies showing residual cerebellar activity, all (100%) were correctly identified on SPECT images. Of the 98 studies with definitive absence of intracranial perfusion, 91.8% (90/98) showed no cerebral activity on tomographic images. The remaining 8.2% (8/98) showed mild cerebral activity. Notably, 5 of these patients underwent SPECT-CT imaging, and were correctly reclassified as having intracranial bleeding, which led to a final diagnosis of absent brain perfusion. For the 53 SPECT-CT studies analyzed, all patients were correctly categorized as either having absent brain perfusion or residual cerebellar perfusion, with no cases of normal perfusion or residual cerebral perfusion observed. Challenging cases are also discussed, including 3 patients who underwent repeat brain perfusion studies after an initial normal or inconclusive report.</p><p><strong>Conclusions: </strong>In this article, we share our experience with brain perfusion studies in brain death determination and the evolution of our protocol over the past decade. SPECT-CT has become our standard protocol, allowing us to confidently categorize patients as having either normal brain perfusion, absent brain perfusion, or residual partial brain perfusion. This approach reflects the clinical need for an unbiased and accurate test of intracranial perfusion.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301056","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":"Diagnosis of cardiac sarcoidosis using glucose metabolic rate from four-dimensional ¹⁸F-FDG PET/CT.","authors":"Yurie Shirai, Michinobu Nagao, Akihiro Inoue, Atsushi Yamamoto, Koichiro Kaneko, Akiko Sakai, Atsushi Suzuki, Junichi Yamaguchi, Shuji Sakai","doi":"10.1007/s12149-025-02070-3","DOIUrl":"https://doi.org/10.1007/s12149-025-02070-3","url":null,"abstract":"<p><strong>Objective: </strong>¹⁸F-Fludeoxyglucose (FDG) PET/CT is an effective tool for detecting active cardiac sarcoidosis (CS), but often has difficulty distinguishing CS lesions from physiological myocardial accumulation. We investigated the potential of the glucose metabolic rate (MR_glc, mg/min/100mL) from four-dimensional FDG PET/CT in distinguishing between CS and physiological accumulation. Additionally, we compared CS delineation between MR_glc and standardized uptake value (SUV).</p><p><strong>Methods: </strong>A total of 192 individuals with CS or suspected CS who underwent four-dimensional FDG PET/CT after 18 h fasting was enrolled. Ultimately, 45 individuals with CS and 14 patients with physiological accumulation, with SUV_mean ≥ 2.7 accumulation in the left ventricular myocardium, were analyzed. The SUV, MR_glc, and the ratio of MR_glc to SUV (MR_glc/SUV) were calculated for each lesion with SUV_mean ≥ 2.7 using data acquired between 30 and 50 min on four-dimensional FDG PET/CT. In the CS group, lesion-to-normal myocardium contrast ratios on MR_glc and SUV images were compared.</p><p><strong>Results: </strong>A total of 127 lesions from 45 individuals with CS and 43 physiological accumulations from 14 individuals were analyzed. The SUV, MR_glc, and MR_glc/SUV for CS lesions were significantly lower than those for physiological accumulations (SUV, 4.26±1.35 vs. 6.06±3.28; MR_glc, 1.91 ± 1.02 vs. 3.78 ± 2.11; MR_glc/SUV, 0.43 ± 0.14 vs. 0.63 ± 0.14; p < 0.0001). Receiver operating characteristic analysis revealed that the ability to discriminate CS lesions from physiological accumulations yielded areas under the curves of 0.656, 0.808, and 0.849; sensitivities of 68, 76, and 73%; and specificities of 61, 72, and 84%, for SUV 4.525, MR_glc 2.41, and MR_glc/SUV 0.518. In the CS group, the contrast ratio of lesions was significantly greater on MR_glc images than on SUV images (6.36 ± 6.17 vs. 2.54 ± 1.03, p < 0.0001).</p><p><strong>Conclusions: </strong>MR_glc from four-dimensional FDG PET/CT is a useful quantitative measure to distinguish CS lesions from physiological accumulation and enables better visualization of CS lesion contrast than SUV.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293233","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 a ¹²³I-meta-iodobenzylguanidine normal database for D-SPECT using Japanese and Italian data.","authors":"Xue Zhang, Kenichi Nakajima, Wanda Acampa, Roberta Assante, Adriana D'Antonio, Koichi Okuda, Kunihiko Yokoyama, Seigo Kinuya","doi":"10.1007/s12149-025-02061-4","DOIUrl":"https://doi.org/10.1007/s12149-025-02061-4","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to develop ¹²³I-meta-iodobenzylguanidine (MIBG) normal databases (NDBs) for D-SPECT that included Japanese and European populations and to validate the ability of combined NDBs to diagnose heart failure (HF).</p><p><strong>Methods: </strong>This study included 55 Japanese and 33 Italian patients without cardiac or neurological diseases associated with Lewy bodies. Single-photon emission computed tomography (SPECT) images were acquired 20 min and 3-4 h after ¹²³I-MIBG injection. We established NDBs for Japanese (Jp-NDB) and Italian (It-NDB) patients, and combined them (JpIt-NDB) using 17-segment polar maps. We also compared the Jp- with the Anger camera NDB established by the Japanese Society of Nuclear Medicine and clinically validated our findings in a cohort of 31 patients with HF.</p><p><strong>Results: </strong>The average uptake in the anterior segments was lower in the It-NDB and differences were more pronounced in males. The JpIt-NDB closely aligned with both the Jp-NDB and It-NDB. Clinical validation indicated that HF was identified more accurately by automated defect scores derived from the JpIt-NDB than visual scores (area under the receiver operating characteristic (ROC) curve (AUC): 0.827 vs. 0.683; P = 0.032). Combining JpIt-NDB-derived scores based on the heart-to-mediastinum ratio (HMR) significantly enhanced diagnostic accuracy (early and late AUCs: 0.960 and 0.952, respectively).</p><p><strong>Conclusions: </strong>The combined JpIt-NDB accurately diagnosed HF in Japanese and European patients, while the defect scores correlated closely to Jp- and It-NDBs. Integrated HMR and NDB defect scores significantly enhanced cardiac assessment precision, which offers promise for future investigations into cardiac innervation imaging.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198078","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":"Dynamic expression of the myocardial sigma-1 receptor after doxorubicin cardiomyopathy using radioiodine-labeled 2-[4-(2-iodophenyl)piperidino]cyclopentanol (OI5 V) imaging.","authors":"Zhuoqing Chen, Hiroshi Wakabayashi, Hiroshi Mori, Tomo Hiromasa, Xue Zhang, Takashi Kozaka, Kazuma Ogawa, Seigo Kinuya, Junichi Taki","doi":"10.1007/s12149-025-02062-3","DOIUrl":"https://doi.org/10.1007/s12149-025-02062-3","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to evaluate the expression of the intensity and distribution of the sigma-1 receptor (σ1R) demonstrated by radiolabeled 2-[4-(2-iodophenyl)piperidino]cyclopentanol (OI5V) in a rat model of doxorubicin-induced cardiotoxicity.</p><p><strong>Methods: </strong>Wistar rats received doxorubicin (DOX; 2 mg/kg/week) as an intraperitoneal injection. Gated ^{99 m}Tc-MIBI SPECT was performed for cardiac function evaluation, and ^{99 m}Tc-DSMA scintigraphy was performed for renal function assessment. Various organs' uptake (%ID/g) of ¹²⁵I-OI5V was estimated in the rats before and at three, five, and seven weeks after the injection.</p><p><strong>Results: </strong>No rats died during DOX injections, until eight weeks. The left ventricular cavity volume increased compared to before DOX injection at five weeks after DOX injection. At seven weeks post-DOX injection, the ejection fraction decreased compared with that before the injection. DMSA scintigraphy revealed that renal function decreased significantly after seven weeks. In the post-mortem tissue counting study, ¹²⁵I-OI5V uptake decreased from five weeks post-injection. After DOX injection, the tracer uptake in the kidney decreased and the tracer uptake in the blood increased.</p><p><strong>Conclusion: </strong>The present study confirmed the expression pattern of σ1R expression after DOX injection. A decrease in σ1R expression detected using ¹²⁵I-OI5V may serve as an earlier marker of DOX-induced cardiotoxicity compared with ejection fraction decline.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172239","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":"Which factors affect treatment success/prognosis in thyroid cancers with pulmonary metastases and what is/how should be the effective cumulative cure/dose as a current approach; a retrospective study.","authors":"Fatih Tamer, Mertcan Güven, Aylin Oral, Bülent Yazici, Ayşegül Akgün","doi":"10.1007/s12149-025-02060-5","DOIUrl":"https://doi.org/10.1007/s12149-025-02060-5","url":null,"abstract":"<p><strong>Objective: </strong>Our primary objective in this study was to analyse clinical-prognostic factors, to evaluate their effects on response to radioactive iodine therapy (RAIT) and survival in pulmonary metastatic differantiated thyroid cancer. Another aim was to evaluate the treatment cycles/doses to achieve effective treatment at the end of the follow-up.</p><p><strong>Methods: </strong>68 patients with pulmonary metastatic differentiated thyroid cancer who met all inclusion criteria were included. Clinical-pathological features and imaging findings of patients were collected and analysed retrospectively.</p><p><strong>Results: </strong>Advanced age (p 0.037, OR 1.045), > 2 cm primary tumor (p: 0.009, OR 8), macronodular pulmonary metastases (p: 0.024, OR 3.7) and non-RAI-avidity (p: 0.045, OR 4.5) were independent factors associated with non-response to RAIT. When cumulative RAIT responses in the first 3 cycles were compared, no significant change was observed until the 3rd cycle (up to a cumulative dose of 21.27 GBq). That is, excluding patients who achieved an excellent response in ≤ 2 cycles, it would be appropriate to administer at least 3 cycles (21.27 GBq) to achieve an indeterminate response, which constitutes another pillar of the good prognostic group.</p><p><strong>Conclusion: </strong>Collectively, it would be appropriate to consider that response and survival to RAIT decrease in advanced age and in the presence of macronodular pulmonary metastases. In addition to this, it was concluded that at least 3 cycles of RAIT (21.27 GBq) may be appropriate in the determination of treatment-resistant cases, in other words, in the determination of cases in which biochemical-structural incomplete response can be obtained during follow-up.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092716","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":"The prognostic value of positron emission tomography/magnetic resonance imaging in predicting survival in patients with adenocarcinoma of the esophagogastric junction.","authors":"Gustav Holm Schæbel, Helle Hjorth Johannesen, Johan Löfgren, Henrik Gutte, Lene Bæksgaard, Michael Patrick Achiam, Mohamed Belmouhand","doi":"10.1007/s12149-025-02058-z","DOIUrl":"https://doi.org/10.1007/s12149-025-02058-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;In recent years, the utility of positron emission tomography/magnetic resonance imaging (PET/MRI) has become increasingly significant in diagnostic settings. This study provides a five-year follow-up on a previous pilot study that demonstrated the feasibility of PET/MRI in predicting the resectability of adenocarcinoma of the esophagogastric junction (AEG). We aimed to evaluate whether this imaging modality could further serve as a prognostic tool for survival in AEG patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 22 patients were included in the initial pilot study, with 17 of them undergoing surgery. All patients underwent three series of neo-adjuvant chemotherapy (NT). This follow-up study retrospectively analyzed the correlation between the apparent diffusion coefficient (ADC) and standard uptake value (SUV) measurements of the primary tumor from the original study with overall survival and recurrence. ADC and SUV values were measured prior to initiation of NT, and again 17-21 days into the first cycle of NT-administration, and the differences between the scans were calculated as ∆SUV&lt;sub&gt;max&lt;/sub&gt;, ∆ADC&lt;sub&gt;b0&lt;/sub&gt;, and ∆ADC&lt;sub&gt;b50&lt;/sub&gt;. Early treatment response was assessed using the Response Evaluation Criteria In Solid Tumors (RECIST). Binary logistic regression was employed to evaluate the predictive values of ADC and SUV parameters, and receiver operating characteristic (ROC) curves were generated to determine sensitivity, specificity, and area under the curve (AUC).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;As of January 7, 2022, 8 of the 22 patients were still alive. The AUC was calculated to assess the association of imaging parameters with long-term survival: ∆SUV&lt;sub&gt;max&lt;/sub&gt;: AUC = 0.74, sensitivity, 87.5%, specificity 62.5% (p = 0.037). ∆ADC&lt;sub&gt;b0&lt;/sub&gt;: AUC = 0.62, sensitivity 85.7%, specificity 57.1% (p = 0.400). ∆ADC&lt;sub&gt;b50&lt;/sub&gt;: AUC = 0.78, sensitivity 78.6%, specificity 85.7% (p = 0.011). Combining all three parameters yielded an AUC of 0.81, with a sensitivity of 78.6% and a specificity of 85.7% (p = 0.002). The results for individual measurements were: SUV&lt;sub&gt;max&lt;/sub&gt;(pre-NT): AUC = 0.56, sensitivity 78.6%, specificity 50% (p = 0.646). SUV&lt;sub&gt;max&lt;/sub&gt;(post-NT): AUC = 0.81, sensitivity 85.7%, specificity 87.5% (p = 0.002). ADC&lt;sub&gt;b0&lt;/sub&gt;(pre-NT): AUC = 0.55, sensitivity 71.4%, specificity 62.5% (p = 0.682). ADC&lt;sub&gt;b0&lt;/sub&gt;(post-NT): AUC = 0.63, sensitivity 78.6%, specificity 57.1% (p = 0.339). ADC&lt;sub&gt;b50&lt;/sub&gt;(pre-NT): AUC = 0.51, sensitivity 85.7%, specificity 37.5% (p = 0.952). ADC&lt;sub&gt;b50&lt;/sub&gt;(post-NT): AUC = 0.63, sensitivity 42.9%, specificity 100% (p = 0.279). No significant correlation was found between RECIST group and survival status (p = 0.15).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our results indicate that PET/MRI is feasible for predicting long-term survival in AEG patients. The highest AUCs were achieved when combining SUV and ADC parameters, and when using post-NT SUV&lt;","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085715","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}