Annals of Nuclear Medicine最新文献

{"title":"[¹⁸F]FDG PET/CT role in FUO among patients with end-stage renal disease on renal replacement therapy.","authors":"Domenico Albano, Chong Jiang, Francesco Bertagna","doi":"10.1007/s12149-026-02277-y","DOIUrl":"https://doi.org/10.1007/s12149-026-02277-y","url":null,"abstract":"<p><strong>Objective: </strong>End-stage renal disease (ESRD) patients undergoing renal replacement therapy (RRT) are at increased risk of infections, inflammatory disorders, and malignancies because of immune dysfunction, repeated vascular access procedures, and immunosuppressive therapy after kidney transplantation. Fever of unknown origin (FUO) is particularly challenging to investigate in this population, and evidence regarding the role of [18 F]FDG PET/CT remains limited. This study evaluated the diagnostic performance, clinical impact, and predictors of positive [18 F]FDG PET/CT findings in ESRD patients with FUO.</p><p><strong>Methods: </strong>This retrospective single-center study included ESRD patients receiving hemodialysis, peritoneal dialysis, or kidney transplantation who underwent [18 F]FDG PET/CT for FUO between 2014 and 2021. PET/CT findings were compared with the final diagnosis established by microbiological, histopathological, imaging, laboratory, and follow-up data. Sensitivity, specificity, predictive values, likelihood ratios, and diagnostic accuracy were calculated. Clinical impact was assessed according to the influence of PET/CT on diagnostic and therapeutic management.</p><p><strong>Results: </strong>Eighty-seven patients were retrospectively included, 53 (61%) on hemodialysis, 27 (31%) on peritoneal dialysis, and 7 (8%) after kidney transplantation. [18 F]FDG PET/CT was positive in 57 cases (65%). Final diagnoses included infectious diseases in 36 patients, non-infectious inflammatory diseases in 20, malignancies in 10, while no diagnosis was established in 21. The most common infectious causes were catheter-related bloodstream infection, infective endocarditis, spondylodiscitis, pneumonia, and vascular graft infection; large-vessel vasculitis was the predominant inflammatory disease, and lymphoma the most frequent malignancy. PET/CT achieved a sensitivity of 77%, specificity of 71%, positive predictive value of 89.5%, negative predictive value of 50%, and overall accuracy of 76%. Elevated C-reactive protein, erythrocyte sedimentation rate, neutrophil-to-lymphocyte ratio, and longer hospitalization independently predicted positive PET/CT findings. PET/CT influenced clinical management in 66 patients (76%) by guiding targeted therapy, invasive diagnostic procedures, additional investigations, or avoiding unnecessary interventions after negative examinations.</p><p><strong>Conclusion: </strong>[18 F]FDG PET/CT demonstrates good diagnostic accuracy and substantial clinical impact in ESRD patients with FUO receiving RRT. These findings support the early integration of PET/CT into the diagnostic work-up of this high-risk population, particularly in patients with elevated inflammatory biomarkers.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838964","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":"Regional differences in ¹⁸F-flutemetamol accumulation between amyloid-positive and -negative brains using high-resolution dedicated head PET scanner.","authors":"Yasuyuki Kojita, Kazunari Ishii, Takahiro Yamada, Kohei Hanaoka, Hayato Kaida, Atsushi K Kono, Kazushi Hanada, Kazumasa Saigoh, Mamoru Hashimoto, Takashi Kato, Akinori Nakamura","doi":"10.1007/s12149-026-02272-3","DOIUrl":"https://doi.org/10.1007/s12149-026-02272-3","url":null,"abstract":"<p><strong>Objective: </strong>To investigate regional ¹⁸F-flutemetamol accumulation differences between amyloid-positive (Aβ⁺) and amyloid-negative (Aβ⁻) brains, particularly in cerebral white matter, using a dedicated head PET (dhPET) scanner.</p><p><strong>Methods: </strong>This retrospective study included 38 consecutive participants who underwent ¹⁸F-flutemetamol PET using a high-resolution dhPET scanner (SET-5002, Shimadzu). Participants were classified as Aβ⁺ or Aβ⁻ based on cortical uptake patterns. Voxels of interest were anatomically defined using OpenMAP-T1, an MRI-based automated brain parcellation software, and merged into 33 regions for SUVR calculation. SUVRs were calculated using the Centiloid whole cerebellar VOIs as the reference region. Group comparisons were assessed using two-way repeated-measures ANOVA, followed by Mann-Whitney U tests with false discovery rate correction. Age and MMSE were compared using nonparametric tests, and gender using Fisher's exact test.</p><p><strong>Results: </strong>The Aβ⁺ (n = 25) and Aβ⁻ (n = 13) groups did not differ in age, gender, or MMSE. ANOVA revealed significant effects of group, VOI, and group×VOI interaction (all p < 0.001). After FDR correction, SUVRs were significantly higher in the Aβ⁺ group across widespread cortical gray matter, cerebral white matter, and subcortical structures, as well as in the choroid plexus and cerebellar gray matter (all q < 0.05). No significant differences were observed in cerebellar white matter, cerebellar peduncle, or brainstem regions.</p><p><strong>Conclusion: </strong>High-resolution dhPET revealed significantly higher SUVRs in Aβ⁺ compared with Aβ⁻ subjects in supratentorial structures, including cerebral white matter, and in cerebellar gray matter.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148824282","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":"Evolving trends in yttrium-90 radioembolization research: a comprehensive bibliometric study.","authors":"Tao Pan, Yuhang Wang, Hongmin Li, Hui Zhang, Lin Zhang, Hang Yang, Meiying Huang, Xianchun Zeng, Xiaofei Hu","doi":"10.1007/s12149-026-02273-2","DOIUrl":"https://doi.org/10.1007/s12149-026-02273-2","url":null,"abstract":"<p><strong>Objective: </strong>Yttrium-90 (Y-90) radioembolization has become a key therapeutic option for liver malignancies and is expanding into extrahepatic applications. This study aims to provide a Y-90-focused, field-wide bibliometric map that links global research trends to practice-defining contexts and explicitly contrasts glass versus resin microspheres and primary versus metastatic liver disease.</p><p><strong>Materials and methods: </strong>The Web of Science Core Collection was queried for articles and reviews from 2005 to 12 July 2024. CiteSpace, VOSviewer, and Bibliometrix were employed to visualize annual output, co-authorship and institutional networks, reference co-citation backbones, and keyword clusters and bursts. Studies were narratively classified by microsphere type (glass vs resin) and disease context (hepatocellular carcinoma vs metastatic liver cancers).</p><p><strong>Results: </strong>The study analyzed 2,002 publications, revealing an annual growth rate of 8%. Scientific production and collaboration were concentrated in North America and Western Europe. The co-citation core was dominated by foundational hepatocellular carcinoma outcomes and international recommendations. In sub analyses, glass microsphere literature was clustered with hepatocellular carcinoma, and segmentectomy; resin microsphere literature was concentrated in colorectal liver metastases within randomized or combination regimens. Primary-disease corpora were shown to emphasize survival and transplant pathways, whereas metastatic corpora focused on local control within multimodality care.</p><p><strong>Conclusion: </strong>This analysis underscores the significant growth and thematic shifts in Y-90 research, while highlighting gaps such as the need for randomized trials and long-term outcome studies. Addressing these gaps will advance Y-90 radioembolization and enhance patient care through innovation and collaboration.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787033","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":"Intra-patient comparison of tracer uptake and biodistribution of [⁶⁸Ga]Ga-FAPI-46 and [¹⁸F]AlF-FAPI-74.","authors":"Anne-Leen Deleu, Benjamin Bondue, Ayça Arçay Öztürk, Carlos Artigas, Simon Lacroix, Sigrid Vercauteren, Clémentine Marin, Bruno Vanderlinden, Loubna Taraji, Philomène Lavis, Samuel De Bontridder, Zéna Wimana, Patrick Flamen","doi":"10.1007/s12149-026-02271-4","DOIUrl":"https://doi.org/10.1007/s12149-026-02271-4","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the tracer uptake and biodistribution of [⁶⁸Ga]Ga-FAPI-46 and [¹⁸F]AlF-FAPI-74 in an intra-patient study design.</p><p><strong>Methods: </strong>This substudy of a large prospective trial included five patients with fibrotic lung disease who underwent both [⁶⁸Ga]Ga-FAPI-46 and [¹⁸F]AlF-FAPI-74 PET/CT. Imaging was performed 60 min post-injection using EARL2-compliant reconstructions. Spherical volumes of interest were placed in normal organs, background tissues (blood pool, liver, and skeletal muscle) and reactive tissue uptake foci. SUVmean and SUVmax were calculated and the means were compared using paired t-tests.</p><p><strong>Results: </strong>Visual analysis showed similar overall biodistribution for both tracers, with higher apparent vascular and intestinal activity on [¹⁸F]AlF-FAPI-74 PET/CT compared with [⁶⁸Ga]Ga-FAPI-46 PET/CT. Quantitatively, [¹⁸F]AlF-FAPI-74 demonstrated significantly higher SUVmean and SUVmax in the blood pool region (p = 0.01 and p = 0.03, respectively). SUVmean was also significantly higher in the spleen (p = 0.01) and jejunum (p = 0.02) for [¹⁸F]AlF-FAPI-74 compared with [⁶⁸Ga]Ga-FAPI-46. No significant differences between both radiopharmaceuticals were observed in other normal organs or reactive tissue foci.</p><p><strong>Conclusion: </strong>At 1 h post-injection, [¹⁸F]AlF-FAPI-74 shows higher blood pool, splenic, and small bowel activity but otherwise similar normal-organ and reactive tissue uptake compared with [⁶⁸Ga]Ga-FAPI-46. Although both tracers exhibit low physiological background uptake, these biodistribution differences should be considered when interpreting FAPI PET images and when comparing quantitative metrics across studies using different FAPI tracers.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786946","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":"Baseline ¹⁸F-FDG PET/CT-derived heterogeneity index predicts poor pathological response after neoadjuvant chemoradiotherapy in locally advanced rectal cancer.","authors":"Yiğithan Okar, Ömer Faruk Şahin, Seval Erhamamcı, Duygu Yörük Atik, Ceren Uğurlu, Elif Kelkit, Rukiye Karabudak, Ayşe Mavi Karakullukçu","doi":"10.1007/s12149-026-02270-5","DOIUrl":"https://doi.org/10.1007/s12149-026-02270-5","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether baseline ¹⁸F-FDG PET/CT-derived volumetric and heterogeneity parameters can predict Ryan 3 poor pathological response after neoadjuvant chemoradiotherapy in locally advanced rectal cancer (LARC).</p><p><strong>Methods: </strong>This retrospective single-center study included 48 patients with histopathologically confirmed LARC who underwent baseline ¹⁸F-FDG PET/CT before neoadjuvant chemoradiotherapy followed by curative-intent low anterior resection. PET-derived SUVmax, SUVmean, metabolic tumor volume (MTV), total lesion glycolysis (TLG), and a linear regression-derived heterogeneity index (HI) were calculated from the primary tumor. HI was derived from MTV values measured at 40%, 60%, and 80% of SUVmax thresholds. Patients were classified as Ryan 3 poor/non-response or Ryan 0-2 response according to surgical pathology. ROC analysis, logistic regression, and bootstrap internal validation were performed.</p><p><strong>Results: </strong>Sixteen patients had Ryan 3 poor pathological response and 32 had Ryan 0-2 response. MTV, TLG, HI, and clinical/radiological T stage were significantly higher in Ryan 3 patients, whereas age, sex, CEA, clinical/radiological N stage, SUVmax, and SUVmean did not differ significantly between response groups. SUVmax and SUVmean showed no significant discriminatory value. HI showed the numerically highest AUC (0.760; bootstrapped 95% CI, 0.586-0.899), with predictive performance comparable to MTV (AUC 0.749) and TLG (AUC 0.748). In restricted T-stage-adjusted models, HI, MTV, and TLG remained independently associated with Ryan 3 poor response. Bootstrap optimism-corrected AUCs were 0.847, 0.842, and 0.813 for HI + T stage, MTV + T stage, and TLG + T stage models, respectively.</p><p><strong>Conclusion: </strong>Baseline ¹⁸F-FDG PET/CT-derived HI, MTV, and TLG may help identify LARC patients at risk for Ryan 3 poor pathological response. The workstation-calculable HI may provide complementary information for pretreatment risk stratification.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786981","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":"Progress in the application of ¹⁷⁷Lu- and ²²⁵Ac-targeted radionuclide therapy in pancreatic ductal adenocarcinoma.","authors":"Tao Jiang, Zunyu Xiao","doi":"10.1007/s12149-026-02268-z","DOIUrl":"https://doi.org/10.1007/s12149-026-02268-z","url":null,"abstract":"<p><p>Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies, characterized by the limited efficacy of current therapies and an urgent need for novel treatment strategies. Targeted radionuclide therapy (TRT) enables the selective delivery of radionuclides to tumor sites via specific ligands, integrating molecular targeting with cytotoxic radiation. Among these radionuclides, ¹⁷⁷Lu, a β-emitter with moderate energy and suitable tissue penetration, offers a distinct advantage in theranostics, whereas ²²⁵Ac, an α-emitter with high linear energy transfer (LET) and an ultrashort path length, demonstrates superior efficacy against hypoxic and treatment-resistant tumor cells. Although no TRT agents have yet been approved for PDAC, multiple emerging targets are under active investigation, with several candidates entering early-phase clinical trials. This review systematically summarizes recent advances in ¹⁷⁷Lu- and ²²⁵Ac-labeled radiopharmaceuticals for PDAC, comparing their physicochemical properties, biological effects, and translational potential. Future perspectives for TRT development are also discussed to facilitate its clinical application in PDAC.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757250","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":"Recent advances in PSMA therapy - from beta to alpha","authors":"Adrien Holzgreve,&nbsp;Sophie C. Siegmund,&nbsp;Liam Widjaja,&nbsp;Rudolf A. Werner","doi":"10.1007/s12149-026-02269-y","DOIUrl":"10.1007/s12149-026-02269-y","url":null,"abstract":"","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 10","pages":"1153 - 1160"},"PeriodicalIF":2.4,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12149-026-02269-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757661","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":"Differential performance of statistical versus machine learning methods in partial volume correction in oncologic F18-FDG PET/CT scanning","authors":"Hanan K. Metwally,&nbsp;Hesham A. Gawaad,&nbsp;Magdy M. Khalil","doi":"10.1007/s12149-026-02255-4","DOIUrl":"10.1007/s12149-026-02255-4","url":null,"abstract":"<div><p>Partial volume effects (PVE) in positron emission tomography (PET) imaging introduce quantification inaccuracies, particularly in small or heterogeneous lesions, necessitating precise correction methodologies. This study systematically evaluates the performance of statistical versus machine learning approaches in partial volume correction (PVC) across multiple PET reconstruction algorithms, including TrueX, TrueX + TOF, and Iterative + TOF. Phantom experiments were conducted across a broad range of lesion-to-background contrast ratios and lesion sizes to derive and validate exponential recovery coefficient (RC) fitting models. Additionally, advanced machine learning algorithms, including Random Forest, Support Vector Regression, and Gradient Boosting, were implemented to enhance PVC accuracy. The results demonstrate that Iterative + TOF reconstruction yielded the most consistent RC estimates, while machine learning-based PVC significantly outperformed traditional exponential fitting in minimizing residual errors. Among the machine learning models, Random Forest exhibited the lowest root mean square error (RMSE) and highest coefficient of determination (R²), indicating superior predictive accuracy and robustness. These findings underscore the potential of machine learning-driven PVC methodologies for standardizing PET quantification, thereby improving lesion characterization, therapy response assessment, and multi-center data harmonization.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 11","pages":"1370 - 1394"},"PeriodicalIF":2.4,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629374","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":"No-carrier-added ¹⁷⁷Lu production eliminates persistent urine radioactivity: implications for safe expansion of targeted radionuclide therapy.","authors":"Junichi Tsuchiya, Takumi Narita, Tatsuhiko Anzai, Shoji Koyama, Keisuke Takino, Hirofumi Yamada, Kota Yokoyama, Daisuke Asano, Eriko Katsuta, Keiichi Akahoshi, Daisuke Ban, Ukihide Tateishi","doi":"10.1007/s12149-026-02267-0","DOIUrl":"https://doi.org/10.1007/s12149-026-02267-0","url":null,"abstract":"<p><strong>Objective: </strong>¹⁷⁷Lu is an approved radionuclide for targeted radionuclide therapy (TRT), first established with ¹⁷⁷Lu-DOTATATE for neuroendocrine tumors, and subsequently with PSMA-targeted therapy. The widespread adoption of these therapies is expected to substantially increase radioactive waste generation. The long-lived isomer ¹⁷⁷ᵐLu, present as an impurity in ¹⁷⁷Lu preparations, may significantly affect the long-term radioactivity of urine waste. We aimed to quantify and compare the radioactivity of urine waste from real-world patients undergoing ¹⁷⁷Lu-TRT, with and without ¹⁷⁷ᵐLu impurities, to inform waste management strategies.</p><p><strong>Methods: </strong>Radioactivity was measured in two components: vials and patient urine waste. Six vials produced by the direct production process (containing ¹⁷⁷ᵐLu impurities) and six by the no-carrier-added (n.c.a.) process (without ¹⁷⁷ᵐLu impurities) were measured using a dose calibrator. Urine waste from real-world patients treated with ¹⁷⁷Lu-DOTATATE (7.4 GBq per infusion, four infusions at 8-week intervals) was collected from a room under special safety measures for radionuclide therapy using a portable toilet system (Wrappon^®), stored under refrigerated conditions, and measured using a NaI scintillator at 1 m. Measurements were performed at multiple time points up to 120 days post-treatment. A log-linear mixed-effects model was used for statistical analysis (R version 4.5.2).</p><p><strong>Results: </strong>Vials and urine waste from the direct production route retained measurable radioactivity beyond 120 days. In contrast, those from the non-carrier-added route reached background levels by day 73.5 and day 77.0, respectively (both p < 0.05).</p><p><strong>Conclusion: </strong>No-carrier-added ¹⁷⁷Lu production, which eliminates ¹⁷⁷ᵐLu impurities, significantly reduces the long-term radioactive burden of urine waste and supports the safe expansion of targeted radionuclide therapy.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597926","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":"Quantitative Imaging Evaluation of Structural and Densitometric Changes in Major Salivary Glands After 177Lu PSMA Radioligand Therapy.","authors":"Nihat Köylüce, Fadime Demir","doi":"10.1007/s12149-026-02266-1","DOIUrl":"https://doi.org/10.1007/s12149-026-02266-1","url":null,"abstract":"<p><strong>Objective: </strong>Prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) provides a survival advantage in metastatic castration-resistant prostate cancer (mCRPC). However, the physiologically high PSMA-ligand uptake in salivary glands makes these organs susceptible to radiation damage. The aim of this study is to examine the changes occurring in salivary glands after PSMA-RLT and to evaluate their relationship with treatment-related parameters, including cumulative administered activity and number of RLT cycles.</p><p><strong>Method: </strong>The study included 68 mCRPC patients who received 177Lu PSMA-617 treatment. Volume, surface area, density, and PSMA uptake levels were calculated for the parotid and submandibular glands in pre- and post-treatment imaging. Treatment-related changes and their associations with baseline imaging parameters, treatment timing, cumulative administered activity, and number of RLT cycles were statistically analyzed.</p><p><strong>Findings: </strong>After RLT, parotid glands showed significant decreases in SUVmean, volume, surface area, and PSMA total activity (all p < 0.001), whereas parotid density remained stable. Submandibular glands also demonstrated significant reductions in SUVmean, volume, surface area, PSMA total activity, and CT-derived density (all p < 0.001). In the exploratory correlation analyses, the number of RLT cycles and cumulative administered activity showed weak nominal positive associations with parotid density change; however, these associations did not remain statistically significant after Benjamini-Hochberg false discovery rate correction. BMI was not significantly associated with glandular SUVmean, HU measurements, or post-treatment glandular changes after correction for multiple testing.</p><p><strong>Conclusion: </strong>PSMA-targeted RLT was associated with significant imaging-detectable structural alterations and reductions in PET-derived glandular activity in the major salivary glands. CT-derived density significantly decreased in the submandibular glands, whereas parotid density remained stable. No baseline imaging-, BMI-, time-, or administered activity-related parameter remained significantly associated with post-treatment glandular changes after correction for multiple testing.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590238","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}