Annals of Nuclear Medicine最新文献

{"title":"A real-world decision tree model based on ¹⁸F-FDG PET/CT Z scores and Mini-Mental State Examination for differentiating mild cognitive impairment from clinically diagnosed Alzheimer disease","authors":"Ayşe Rana Övüt,&nbsp;Reyhan Toyran,&nbsp;Nazlı Gamze Bülbül,&nbsp;Muammer Urhan","doi":"10.1007/s12149-026-02257-2","DOIUrl":"10.1007/s12149-026-02257-2","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the ability of regional metabolic Z scores derived from ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT), medial temporal atrophy (MTA) scores, and Mini-Mental State Examination (MMSE) results to distinguish mild cognitive impairment (MCI) from clinically diagnosed Alzheimer disease (AD), and to develop an interpretable decision-tree model based on these parameters.</p><h3>Methods</h3><p>This retrospective single-center study included 124 patients who underwent ¹⁸F-FDG PET/CT for suspected cognitive impairment between 2023 and 2025. Patients were classified as AD or MCI according to final clinical diagnoses established by experienced neurologists using National Institute on Aging–Alzheimer’s Association criteria. Regional metabolic Z scores were generated with CortexID Suite by comparison with an age-matched healthy normative database. MTA was graded on structural magnetic resonance imaging using the Scheltens scale by two blinded nuclear medicine physicians. MMSE scores were retrieved from clinical records. A random forest algorithm was used to identify discriminative variables, which were then incorporated into a transparent decision-tree classifier. The dataset was divided into a training cohort (<i>n</i> = 100) and a split-sample test cohort (<i>n</i> = 24).</p><h3>Results</h3><p>The final decision tree integrated regional metabolic Z scores and MMSE values in a hierarchical classification structure. In the split-sample test cohort, the model achieved an accuracy of 95.8% and a balanced accuracy of 96.4%, with 100% sensitivity and 92.9% specificity for AD classification. The area under the receiver operating characteristic curve was 0.964 (95% confidence interval, 0.894–1.000).</p><h3>Conclusions</h3><p>An interpretable decision-tree approach integrating quantitative ¹⁸F-FDG PET/CT metrics with cognitive assessment showed promising performance for distinguishing clinically diagnosed AD from MCI in a real-world clinical cohort.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 11","pages":"1405 - 1414"},"PeriodicalIF":2.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148409844","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":"Beyond metastases: a mechanism-based guide to misleading ¹³¹I uptake on whole-body scintigraphy","authors":"Andrija Gregov,&nbsp;Anđela Deak,&nbsp;Lucija Lučev,&nbsp;Alfredo Campennì,&nbsp;Stephan Beintner-Skawran,&nbsp;Luca Giovanella,&nbsp;Murat Tuncel,&nbsp;Urs J. Muehlematter,&nbsp;Martin W. Huellner,&nbsp;Gorana Mirošević,&nbsp;Petra Petranović Ovčariček","doi":"10.1007/s12149-026-02253-6","DOIUrl":"10.1007/s12149-026-02253-6","url":null,"abstract":"<div><p>¹³¹I whole-body scintigraphy (WBS) remains a cornerstone in the follow-up of differentiated thyroid carcinoma (DTC). However, radioiodine uptake is not specific, and many benign conditions can result in focal or diffuse radioiodine activity that mimics metastatic disease. A narrative literature review spanning more than five decades was conducted to identify and categorise reported sites of misleading radioiodine uptake on WBS in patients with DTC. Case reports, case series, original studies, and reviews were analysed with particular emphasis on the underlying mechanisms of uptake. The majority of false-positive findings were attributable to non-tumorous conditions, followed by benign neoplasms and, less frequently, non-thyroidal malignancies. Ectopic thyroid tissue was documented at numerous sites beyond classical thyroglossal duct remnants. Although pathological NIS expression was demonstrated in several non-thyroidal tumors, its presence did not consistently correlate with functional iodide transport. No single imaging feature reliably differentiates non-tumorous radioiodine uptake from true metastatic disease. Accurate interpretation, therefore, requires integration of clinical history, biochemical findings, and complementary imaging, particularly single-photon emission computed tomography/computed tomography (SPECT/CT). A mechanism-based approach to unexpected radioiodine uptake offers a practical strategy to reduce false-positive interpretations and avoid unnecessary diagnostic procedures.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 11","pages":"1292 - 1310"},"PeriodicalIF":2.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148409849","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 68Ga-PSMA and 18F-FDG PET/CT in Metastatic Castration-Resistant Prostate Cancer Treated with 177Lu-EB-PSMA","authors":"Xingting Chen,&nbsp;Yumeng Peng,&nbsp;Qingming Zheng,&nbsp;Yuxin Lai,&nbsp;Hongfei Cheng,&nbsp;Zhaohui Zhu,&nbsp;Guochang Wang,&nbsp;Jie Zang","doi":"10.1007/s12149-026-02250-9","DOIUrl":"10.1007/s12149-026-02250-9","url":null,"abstract":"<div><h3>Background</h3><p>We aimed to explore the value of prostate-specific membrane antigen (PSMA) and ¹⁸F-FDG PET/CT in efficacy evaluation and prognosis analysis for patients with metastatic castration-resistant prostate cancer (mCRPC) who underwent Lutetium-177-labeled Evans blue-modified PSMA (¹⁷⁷Lu-EB-PSMA) therapy.</p><h3>Methods</h3><p>This study retrospectively enrolled 35 mCRPC patients who received ¹⁷⁷Lu-EB-PSMA therapy between January 2019 and April 2022, with follow-up data until December 2024. The correlation and predictive value of parameters derived from ⁶⁸Ga-PSMA and ¹⁸F-FDG PET/CT with prostate-specific antigen (PSA) response rate, PSA progression-free survival (PSA-PFS), and overall survival (OS) were explored.</p><h3>Results</h3><p>Among the 35 patients, 27 and 15 received 2 and 3 cycles of ¹⁷⁷Lu-EB-PSMA therapy, respectively. The best PSA response rate was 54.3% (19/35 patients), the median PSA-PFS was 4.8 months (95% confidence interval [CI] 4.2–7.2), and the median OS was 13.9 months (95% CI 11.5–17.3). Multivariable analysis demonstrated that baseline PSMA-positive tumor volume (hazard ratio [HR], 1.223 [95% CI, 1.065–1.404]; <i>P</i> = 0.011) was an independent prognostic factors of PSA-PFS and higher baseline total lesion PSMA for OS (HR, 1.180 [95% CI, 1.065–1.390]; <i>P</i> = 0.015). The newly emerged lesions after the first cycle of therapy on ⁶⁸Ga-PSMA PET/CT (NELs_1−PSMA) were identified as an early on-treatment progression indicator associated with worse outcomes in exploratory analyses (For PSA-PFS, HR, 6.419 [95% CI, 1.880–19.437]; <i>P</i> = 0.001; For OS, HR, 3.976 [95% CI, 2.015–9.433]; <i>P</i> = 0.001) .</p><h3>Conclusion</h3><p>⁶⁸Ga-PSMA PET/CT may provide valuable information for predicting long-term outcomes in patients undergoing ¹⁷⁷Lu-EB-PSMA therapy. These findings are hypothesis-generating; the potential role warrants prospective validation in larger, independent cohorts.</p><h3>Trial registration</h3><p>ClinicalTrials.gov, NCT03780075, Registered 19 December 2019, retrospectively registered, https://clinicaltrials.gov/study/NCT03780075;</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 11","pages":"1339 - 1349"},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359093","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":"Atomic degradation: chemical design strategies and immunotherapeutic mechanisms of radio-PROTACs","authors":"Tuğba Ören Varol,&nbsp;Mehmet Varol","doi":"10.1007/s12149-026-02254-5","DOIUrl":"10.1007/s12149-026-02254-5","url":null,"abstract":"<div><p>Convergence of Proteolysis Targeting Chimeras (PROTACs) and Targeted Alpha Therapy (TAT) is proposed here as a novel pharmacological frontier in precision oncology, aimed at overcoming mutually exclusive resistance mechanisms of each parent modality. While PROTACs provide catalytic ablation of oncoproteins, their efficacy is often limited by E3 ligase alterations. Conversely, TAT deliver high-LET radiation but lack intrinsic signaling modulation. This study critically examines the design of Radio-PROTACs, heterotrifunctional constructs that integrate a macrocyclic chelator within the linker region of a degrader. We postulate a “Hot Linker” strategy to balance chelation stability with the entropic requirements for ternary complex formation. A synchronized “Inflict-and-Disarm” mechanism is proposed: (i) Genomic Ablation via high-LET radiation, and (ii) Proteome Editing to degrade DDR proteins (e.g., RAD51, BRD4), thereby sensitizing cells to radioactive decay. Furthermore, we explore the potential for Radio-PROTACs to remodel tumor microenvironment by amplifying radiation-induced cGAS-STING activation while simultaneously degrading checkpoint proteins to overcome immune resistance. Despite the compelling therapeutic rationale, significant translational bottlenecks remain, including the permeability paradox, recoil effects, and the unvalidated temporal synchronization between degradation kinetics and isotopic decay. This work provides a stage-gated preclinical roadmap defining the essential experiments required to transition Radio-PROTACs from theoretical concept to therapeutic reality.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 11","pages":"1277 - 1291"},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359065","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":"Impact of biguanide therapy on hepatic 18F-fluorodeoxyglucose-positron emission tomography quantitative parameters in patients with diabetes: a dynamic positron emission tomography study","authors":"Akiko Tomiyama,&nbsp;Yu Iwabuchi,&nbsp;Kai Tonda,&nbsp;Yoshiki Owaki,&nbsp;Arashi Fujita,&nbsp;Ryosuke Sakurai,&nbsp;Atsushi Shimizu,&nbsp;Maho Kurihara,&nbsp;Kogo Togo,&nbsp;Yuki Iwaita,&nbsp;Takehiro Nakahara,&nbsp;Tohru Shiga,&nbsp;Yoshitake Yamada,&nbsp;Masahiro Jinzaki","doi":"10.1007/s12149-026-02251-8","DOIUrl":"10.1007/s12149-026-02251-8","url":null,"abstract":"<div><h3>Objective</h3><p>Previous studies have shown that patient characteristics, such as fasting blood glucose, can modulate hepatic ¹⁸F-fluorodeoxyglucose (FDG) uptake; however, the drug-specific effects of different antidiabetic agents on hepatic and whole-body FDG distribution remain poorly understood. Therefore, in this study, we aimed to evaluate the impact of biguanide therapy, as well as insulin and other antidiabetic medications, on hepatic FDG uptake and dynamic positron emission tomography (PET) kinetic parameters [the static mean standardized uptake value normalized by lean body mass (SULmean), dynamic metabolic rate of glucose (Ki), and the FDG distribution volume (DV)] in patients with diabetes, using a multiparametric dynamic FDG-PET/computed tomography (CT) protocol.</p><h3>Methods</h3><p>This retrospective study included 107 patients with diabetes who underwent dynamic whole-body FDG-PET/CT after a 4-h fast and drug withdrawal between January 2022 and May 2025. Patients with hepatic structural abnormalities or artifacts were excluded. PET kinetic parameters (SULmean, Ki, and DV) were measured in the liver and analyzed for associations with clinical variables, including biguanide and insulin therapy, via multivariate regression.</p><h3>Results</h3><p>Among the 107 patients included, 44 and 9 received biguanide and insulin, respectively. Multivariate regression showed that biguanide therapy, but not insulin use or other clinical variables, was significantly associated with increased hepatic SULmean (p = 0.037). No clinical variables were significantly associated with Ki or DV in the corresponding models. These findings suggest that biguanide therapy elevates static hepatic FDG uptake, whereas hepatic glucose metabolic dynamics, as assessed by Ki and DV, did not show significant alterations associated with the antidiabetic medications evaluated in our cohort under standard pre-scan preparation.</p><h3>Conclusions</h3><p>Our study demonstrates that biguanide therapy increases static hepatic FDG accumulation without interfering with the underlying glucose metabolic dynamics (Ki and DV). The observed increase in SULmean is numerically significant but visually minimal; thus, its impact on routine diagnostic interpretation is likely minimal.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 11","pages":"1350 - 1358"},"PeriodicalIF":2.4,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343732","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":"Dual-time-point 68Ga-FAPI PET/CT in gastrointestinal malignancies: head-to-head comparison with 18 F-FDG for lesion detection and patient-level assessment","authors":"Hasan Pala,&nbsp;Murat Tuncel,&nbsp;Suayib Yalcin,&nbsp;Erdem Karabulut,&nbsp;Nezih Akkapulu,&nbsp;Timucin Erol,&nbsp;Omer Ugur","doi":"10.1007/s12149-026-02249-2","DOIUrl":"10.1007/s12149-026-02249-2","url":null,"abstract":"<div><h3>Objectives</h3><p>To compare the diagnostic performance of 18 F-Fluorodeoxyglucose (FDG) and 68Ga-fibroblast activation protein inhibitor (FAPI) positron emission tomography/computed tomography (PET/CT) in gastrointestinal malignancies, with particular emphasis on lesion detection, peritoneal disease assessment, and the potential added value of dual-time-point FAPI imaging.</p><h3>Methods</h3><p>Thirty-eight patients with histologically confirmed gastrointestinal cancers who underwent both FDG and FAPI PET/CT within a 4-week interval were retrospectively analyzed. FAPI PET/CT images were acquired at 10 and 60 min after tracer injection. Patient-level analyses (staging/restaging accuracy, impact on management) and lesion-based analyses (detection rate, characterization, maximum standardized uptake value [SUVmax] dynamics, lesion size) were evaluated against follow-up data as the reference standard.</p><h3>Results</h3><p>FAPI PET/CT demonstrated superior agreement with the reference standard compared with FDG PET/CT for staging and restaging (κ = 0.91 vs. 0.32). On lesion-based analysis, FAPI showed markedly higher detection rate for malignant lesions (86% vs. 34%) and fewer indeterminate findings. Median peritoneal carcinomatosis index score and the number of detected malignant lesions per patient were significantly higher with FAPI PET/CT (<i>p</i> &lt; 0.001). Dual-time-point FAPI imaging revealed a significant increase in SUVmax from early to later time points in malignant lesions, whereas benign lesions showed no significant change. Larger lesions (&gt; 10 mm) demonstrated more pronounced delayed uptake, and greater early-to-delayed SUVmax increases were independently associated with malignancy, suggesting a potential role for dynamic uptake patterns in lesion characterization.</p><h3>Conclusions</h3><p>Dual-time-point 68Ga-FAPI PET/CT demonstrated superior lesion detectability compared with FDG PET/CT in gastrointestinal malignancies and may help reduce diagnostic uncertainty. These findings suggest that dual-time-point FAPI imaging may provide incremental value for lesion characterization and support its complementary role in oncologic imaging.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 11","pages":"1326 - 1338"},"PeriodicalIF":2.4,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12149-026-02249-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315251","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":"Bloodpool SPECT/CT offers enhanced sensitivity for the diagnosis of frozen shoulder","authors":"Maxence Gambiez,&nbsp;Emmanuel David,&nbsp;Claire Leplont,&nbsp;Charles-Louis Buee,&nbsp;Marc-Etienne Meyer,&nbsp;David Morland,&nbsp;Antoine Girard","doi":"10.1007/s12149-026-02246-5","DOIUrl":"10.1007/s12149-026-02246-5","url":null,"abstract":"<div><h3>Objective</h3><p>Adhesive capsulitis (frozen shoulder) is a common condition characterized by pain and progressive restriction of shoulder mobility, often requiring imaging for differential diagnosis. While bone scintigraphy is occasionally performed, the diagnostic potential of bloodpool SPECT/CT has never been evaluated.</p><h3>Methods</h3><p>We retrospectively analyzed 18 affected shoulders in 17 patients who underwent standardized bone scintigraphy with both bloodpool and late-phase SPECT/CT. Uptake was visually assessed in four predefined capsular regions.</p><h3>Results</h3><p>Bloodpool SPECT/CT revealed increased uptake in the rotator cuff interval in 100% of pathological shoulders, followed by the axillary recess (72%), anterior joint capsule (67%), and posterior joint capsule (44%). Late-phase diffuse uptake was present in 78% of cases. In three pathological shoulders, uptake in the rotator cuff interval was the only abnormality at the bloodpool phase.</p><h3>Conclusion</h3><p>This study suggests that increased uptake in the rotator cuff interval on bloodpool SPECT/CT may be associated with adhesive capsulitis and could represent a sensitive imaging pattern. Further prospective studies are required to determine the diagnostic value of blood-pool SPECT/CT in patients with shoulder pain.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 10","pages":"1262 - 1268"},"PeriodicalIF":2.4,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12149-026-02246-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293356","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":"Adsorption treatment of 177Lu radioactive wastewater with 177mLu impurity: batch versus column methods","authors":"Rintaro Sato,&nbsp;Noriaki Miyaji,&nbsp;Koki Hasegawa,&nbsp;Yuma Ihara,&nbsp;Shigenori Yabe,&nbsp;Katsuyuki Kikori,&nbsp;Naochika Akiya,&nbsp;Kaito Wachi,&nbsp;Akemi Minami,&nbsp;Kosuke Yamashita,&nbsp;Tensho Yamao,&nbsp;Takashi Ohba,&nbsp;Kenta Miwa,&nbsp;Noboru Oriuchi","doi":"10.1007/s12149-026-02247-4","DOIUrl":"10.1007/s12149-026-02247-4","url":null,"abstract":"<div><h3>Objective</h3><p>The rapid global expansion of targeted radionuclide therapy using ¹⁷⁷Lu-labeled radiopharmaceuticals has increased the need for effective and regulatory-compliant management of radioactive wastewater. However, long-lived impurities, such as ^177mLu, which emit high-energy γ-ray emissions complicate wastewater treatment and compliance with discharge regulations. This study aimed to determine an optimal method to treat wastewater contaminated with ¹⁷⁷Lu and ^177mLu.</p><h3>Methods</h3><p>Radioactive wastewater samples were collected from a storage tank in a targeted radionuclide therapy ward. The adsorption efficiency of various adsorbents, including Chelex resin, Bondesil-C18 and granular activated carbon, was assessed using both batch and column methods. Adsorption efficiency was measured as counts at 208 keV using a high-purity germanium detector.</p><h3>Results</h3><p>The adsorption efficiency of Chelex resin and Bondesil-C18 in 100 mL of radioactive wastewater, was below 25%, whereas that of granular activated carbon was 85.9%. The adsorption efficiency of batch and column methods increased with adsorbent mass and processing time. The column method with small amounts of granular activated carbon achieved 60%–70% adsorption efficiency within ~ 7 min in a single-pass operation.</p><h3>Conclusion</h3><p>Adsorption treatment using granular activated carbon was effective for the removal of ¹⁷⁷Lu and ^177mLu from radioactive wastewater. Column method may support the management of radioactive wastewater contaminated with ¹⁷⁷Lu and other radionuclides in clinical settings.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 11","pages":"1319 - 1325"},"PeriodicalIF":2.4,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270091","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":"Detection ability of model observer for diagnosis of active cardiac sarcoidosis on 18F-FDG-PET","authors":"Junichiro Naoi,&nbsp;Kentaro Takanami,&nbsp;Keisuke Kiso,&nbsp;Miho Shidahara,&nbsp;Hayato Odagiri,&nbsp;Daisuke Sakai,&nbsp;Takashi Noda,&nbsp;Satoshi Yasuda,&nbsp;Kei Takase","doi":"10.1007/s12149-026-02248-3","DOIUrl":"10.1007/s12149-026-02248-3","url":null,"abstract":"<div><h3>Objective</h3><p>Sarcoidosis is an inflammatory granulomatous disease of unknown cause, and cardiac sarcoidosis (CS) is the main cause of death in patients with sarcoidosis. Cardiac ¹⁸F-Fluorodeoxyglucose (FDG)-positron emission tomography (PET) is used to detect active CS, based on the patterns of ¹⁸F-FDG uptake in the myocardium. In this study, we investigated the ability of a model observer, Channelized Hoteling Observer (CHO), in differentiating the active CS pattern, in comparison with the diagnosis by the expert cardiac nuclear medicine (NM) physician as a reference standard.</p><h3>Methods</h3><p>This retrospective study included 223 patients who underwent ¹⁸F-FDG PET scans because they were clinically suspected of having CS. One expert cardiac NM physician and one oncology NM physician classified the cardiac ¹⁸F-FDG uptake into four patterns (focal, focal on diffuse, diffuse, none) for all PET images. The oncology NM physician additionally determined the confidence scale of CS expressed as a percentage (0-100). The focal and focal on diffuse patterns were defined as CS patterns. In CHO, 80 subjects (CS: 40, non-CS: 40) were used for training data sets, and 143 subjects (CS: 66, non-CS: 77) were used for evaluation data sets of objective CS discrimination ability, respectively. The confidence scale of CS by CHO was also output as a percentage (0-100). Finally, ROC analysis was used to compare discrimination ability between the oncology NM physician and CHO by refereeing the classification of the cardiac NM physician as a standard.</p><h3>Results</h3><p>The match rate of classified subject numbers between the two physicians was moderate (Kappa coefficient of 0.57). In comparison with the judgment of the expert cardiac NM physician, the area under the ROC curve of oncology NM medicine and that of CHO were 0.73 and 0.78, respectively.</p><h3>Conclusions</h3><p>The detection ability of CHO in CS pattern of myocardial ¹⁸F-FDG uptake was almost equivalent to that of the oncology NM physician when the diagnosis by the cardiac expert NM physician was defined as a reference standard. Even though the reference standard is not made by Japanese Circulation Society guidelines, the model observer has a potential alternative for assessing the discrimination ability of ¹⁸F-FDG uptake patterns of CS.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 11","pages":"1311 - 1318"},"PeriodicalIF":2.4,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12149-026-02248-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257070","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":"Comparison of automated bone scan indexes in patients with prostate cancer: aBSI and BONENAVI","authors":"Takeshi Matsumura,&nbsp;Kenichi Nakajima,&nbsp;Atsushi Mizokami,&nbsp;Hiroshi Wakabayashi,&nbsp;Jens Richter,&nbsp;Seigo Kinuya","doi":"10.1007/s12149-026-02244-7","DOIUrl":"10.1007/s12149-026-02244-7","url":null,"abstract":"<div><h3>Objective</h3><p>Bone scan indexes (BSIs) are frequently applied in Japan, Europe and the USA. The BONENAVI (Japan) and aBSI (Europe and USA) software programs were developed based on different training and validation datasets to calculate BSIs. However, whether they are compatible has not been systematically determined. We compared BSIs generated by these programs in a patient cohort to clarify correlations between them.</p><h3>Methods</h3><p>We retrospectively analyzed 339 scintigraphic data from 34 patients (mean age, 69.9 ± 9.1 [48–89] y) with prostate cancer who underwent whole-body bone scintigraphy to evaluate metastatic bone disease. Anterior and posterior whole-body scans with ^99mTc-methylene-diphosphonate (MDP) were processed then BSIs were computed by aBSI and BONENAVI. Systematic differences between aBSI and BONENAVI were evaluated using Pearson’s correlation coefficients and Bland–Altman analysis. We also categorized BSIs during follow-up as decreased, unchanged, or increased, and evaluated agreement between longitudinal changes.</p><h3>Results</h3><p>The mean number of bone scans per patient was 10.0 ± 6.8 (1−26), and longitudinal changes in BSIs were evaluated using 305 pairs of follow-up studies. The automatic BSIs from aBSI and BONENAVI were 3.23% ± 3.47% and 2.91% ± 2.84%, respectively. Both strongly correlated (<i>r</i> = 0.947, <i>p</i> &lt; 0.001). Bland–Altman plots revealed that aBSI tended to yield slightly higher BSIs (mean difference, + 0.31% (95% CI, 0.19−0.44, <i>p</i> &lt; 0.001). A subgroup analysis of BSIs &gt; 7% revealed higher automatic BSIs from aBSI than BONENAVI (mean difference, + 1.57%; 95% CI, 0.99−2.15; <i>p</i> &lt; 0.001). The rate of longitudinal changes in BSI during follow-up substantially agreed (78.7% vs. 76.4% with respective thresholds of ± 0.5% and ± 0.3% (κ = 0.63, Cramer’s V = 0.65, <i>p</i> &lt; 0.0001 for both).</p><h3>Conclusion</h3><p>The aBSI and BONENAVI BSIs computed by the software programs strongly correlated and longitudinal changes during follow-up studies generally concurred. However, BSIs from aBSI tended to be higher among patients with an increased disease burden compared with BONENAVI. Clinicians and investigators should be aware of these differences when interpreting or comparing results among software programs.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 10","pages":"1253 - 1261"},"PeriodicalIF":2.4,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12149-026-02244-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203284","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}