Annals of Nuclear Medicine最新文献

{"title":"Straightforward PET phantom preparation using 68Gallium diluted with acid","authors":"Tensho Yamao,&nbsp;Kenta Miwa,&nbsp;Koki Hasegawa,&nbsp;Noriaki Miyaji,&nbsp;Naochika Akiya,&nbsp;Kaito Wachi,&nbsp;Naoyuki Ukon,&nbsp;Taiki Joho,&nbsp;Tohru Shiga,&nbsp;Hiroshi Ito","doi":"10.1007/s12149-026-02245-6","DOIUrl":"10.1007/s12149-026-02245-6","url":null,"abstract":"<div><h3>Objective</h3><p>The present study aimed to establish a user-friendly practical way to prepare phantoms for routine quantitative ⁶⁸Gallium (Ga) PET.</p><h3>Methods</h3><p>We produced gallium ions in 0.05 M HCl from a ⁶⁸Ge/⁶⁸Ga generator and prepared a phantom in five ways. We directly diluted [⁶⁸Ga]Ga³⁺ in water (i), neutralized [⁶⁸ Ga]Ga³⁺ in NaOH then diluted it with water (ii), labeled prostate-specific membrane antigen (PSMA)-617 with [⁶⁸Ga]Ga³⁺ then added it to water (iii), and directly added [⁶⁸Ga]Ga³⁺ to 0.05 M HCl (iv) and 0.1 M citric acid (v). A cylindrical phantom was scanned for 60 min in list mode, and images were reconstructed into consecutive 5-min frames. Temporal changes in spatial uniformity and image noise were evaluated based on the standard deviations (SD) of inter-ROI differences, coefficients of variation (CV), SUV_mean, and the fraction of pixels outside the SUV range of 0.95–1.05.</p><h3>Results</h3><p>The visible distribution of activity in the phantom prepared using method (ii) was not uniform with peripheral accumulation, and spatial uniformity progressively deteriorated over time. The SD increased from 0.0206 to 0.0361 at 5 and 60 min, respectively. In contrast, the phantoms prepared using the other four methods yielded visually homogeneous images and the methods (iii), (iv), and (v) maintained relatively stable SDs throughout image acquisition. The CV increased modestly over time under all conditions, and was consistent with decreasing count statistics, whereas SUV_mean remained stable with only small deviations from unity. Pixel-wise analysis showed higher fractions of pixels outside SUV 0.95–1.05 for methods (i) and (ii).</p><h3>Conclusions</h3><p>Diluting [⁶⁸Ga]Ga³⁺ with 0.05 M HCl or 0.1 M citric acid enabled reliable preparation of a uniform phantom with spatial uniformity comparable to that of radiolabeling. Direct dilution in water showed no apparent peripheral accumulation on visual assessment, but quantitative analyses suggested less stable uniformity than acidic dilution. These approaches are practical for quality assurance and cross-calibration in quantitative ⁶⁸Ga PET.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 10","pages":"1269 - 1276"},"PeriodicalIF":2.4,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203305","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":"Assessing metabolic progression in temporal lobe epilepsy: biological and methodological considerations","authors":"Giampiero Giovacchini,&nbsp;Shubhi Agrawal,&nbsp;Andrea Marciano,&nbsp;William H. Theodore","doi":"10.1007/s12149-026-02243-8","DOIUrl":"10.1007/s12149-026-02243-8","url":null,"abstract":"<div><h3>Background</h3><p>Magnetic resonance (MR) and [¹⁸F]fluorodeoxyglucose (FDG) positron emission tomography (PET) studies suggested that temporal lobe epilepsy (TLE) might be a progressive disease with mesial temporal regions being the most vulnerable to epileptic seizures. However, the biasing effect of brain atrophy and mesial temporal sclerosis (MTS) has not been assessed. We assessed the relationship between epilepsy duration and cerebral glucose metabolism (CMRglu) before and after partial volume correction (PVC).</p><h3>Methods</h3><p>We used PET with FDG in 22 TLE patients to quantify absolute and normalized CMRglu values. An automated, MR-segmentation-based PVC algorithm was applied.</p><h3>Results</h3><p>PVC increased CMRglu variability. Normalization of regional absolute CMRglu values to global gray matter reduced variability. There was no significant relationship between absolute CMRglu values and epilepsy duration. A significant negative relationship was found between normalized CMRglu values in parahippocampus and hippocampus that persisted after PVC only in parahippocampus. A significant positive relationship between CMRglu asymmetry indices (AIs) and epilepsy duration was found in hippocampus before, but not after PVC. In patients with MTS, before PVC a statistical trend between epilepsy duration and AI was obtained for hippocampus, superior temporal cortex, and amygdala. After PVC, statistical significance was attained in amygdala.</p><h3>Conclusion</h3><p>Ipsilateral mesial temporal regions are one of the areas most sensitive to epileptic seizures. Assessment of metabolic progression is affected by methodological factors, such as brain atrophy (and the correction thereof) and data variability. Normalized CMRglu values and AIs have greater statistical power than absolute CMRglu values implying no need for quantitative PET studies.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 10","pages":"1245 - 1252"},"PeriodicalIF":2.4,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203885","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":"Efficacy and safety of peptide receptor radionuclide therapy in advanced foregut and hindgut neuroendocrine tumors: a real-world experience from a single institution","authors":"Piyush Aggarwal,&nbsp;Ashwani Sood,&nbsp;Divya Khosla,&nbsp;Rakesh Kapoor,&nbsp;Gaurav Prakash,&nbsp;Divya Dahiya,&nbsp;Sanjay Kumar Bhadada,&nbsp;Rama Walia,&nbsp;Rajesh Gupta,&nbsp;Bhagwant Rai Mittal","doi":"10.1007/s12149-026-02241-w","DOIUrl":"10.1007/s12149-026-02241-w","url":null,"abstract":"<div><h3>Objective</h3><p>Foregut and hindgut neuroendocrine tumors (NETs) contribute significantly to the global NET burden especially in Asian population; however, these cohorts are sparse and underrepresented in current trials assessing peptide receptor radionuclide therapy (PRRT) in gastroenteropancreatic (GEP) NETs. This single-centre study evaluates the efficacy and safety of PRRT in advanced foregut and hindgut NETs.</p><h3>Methods</h3><p>Retrospective data evaluation of consecutive patients with biopsy-proven metastatic foregut (gastric, lung and thymic NETs) and hindgut NETs (colorectal, anal and sacral NETs) who underwent PRRT from 2014 to 2024 at a tertiary care hospital was done. Up to four cycles of ¹⁷⁷Lu-DOTATATE (7.4 GBq/cycle) were administered intravenously every 6–8 weeks along with nephroprotection. Interim and end-of-treatment ⁶⁸Ga-DOTANOC PET/CT scans were acquired for response evaluation, based on RECIST v1.1. Objective response rate (ORR), disease control rate (DCR), best biochemical response, toxicity profile, quality-of-life scores, progression-free survival (PFS) and overall survival (OS) were assessed.</p><h3>Results</h3><p>Thirty-four patients (median age-56 yrs) with foregut (<i>n</i> = 16) and hindgut (<i>n</i> = 18) NETs received a total of 111 cycles (range 1–4) of ¹⁷⁷Lu-DOTATATE (median cumulative activity 26.5 GBq). The best ORR and DCR were 45% and 80%, median PFS was 29.7 months (95% CI, 20.3–39.1), and the 1- and 5-year OS rates were 93.8% (95% CI, 85.4–100) &amp; 53.6% (95% CI, 28.6–78.6), respectively, after a median follow-up of 45.3 months. Grade 3 adverse events were observed in only five patients.</p><h3>Conclusion</h3><p>PRRT appears to be safe and effective treatment modality in advanced foregut and hindgut NETs. More prospective trials are required to validate these findings in larger cohorts.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 10","pages":"1229 - 1236"},"PeriodicalIF":2.4,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148134","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":"Local aggressiveness and prognostic prediction in desmoid-type fibromatosis: insights from 18F-FDG PET/CT","authors":"Yan Cui,&nbsp;Min Wang,&nbsp;Yitong Liu,&nbsp;Yang Liu,&nbsp;Yufei Song,&nbsp;Shizhen Zhai,&nbsp;Nan Li","doi":"10.1007/s12149-026-02221-0","DOIUrl":"10.1007/s12149-026-02221-0","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the value of ¹⁸F-FDG PET/CT in assessing the local aggressiveness of desmoid-type fibromatosis (DF) and in predicting prognosis of DF.</p><h3>Methods</h3><p>We retrospectively analyzed ¹⁸F-FDG PET/CT of DF lesions in participants. Clinical data and ¹⁸F-FDG PET/CT imaging features were collected and analyzed. The diagnostic performance of ¹⁸F-FDG PET/CT versus contrast-enhanced MRI (CE-MRI) for assessing peritumoral invasion was compared using reference of pathology. Lesions were followed up to record progressive disease (PD) and postoperative recurrence (POR), and event-free survival (EFS) was determined. Univariate and multivariate Cox regression analyses were performed to identify independent predictors of PD or POR.</p><h3>Results</h3><p>Fifty-five lesions from 44 participants were included. ¹⁸F-FDG PET/CT showed higher accuracy and sensitivity than CE-MRI for assessing peritumoral invasion, with no statistically significant differences in paired comparisons. Notably, pathology in one case demonstrated tumor invasion of the lymph node capsules. Furthermore, DF lesions with PD or POR had significantly higher maximum standardized uptake value (SUV_max) and target-to-background ratio (TBR). SUV_max, TBR and irregular lesion morphology were identified as independent predictors of PD or POR. The AUC for SUV_max was 0.79 (95% CI: 0.64–0.95), with sensitivity, specificity, and overall accuracy of 78.6% (11/14), 82.9% (34/41), and 81.8% (45/55), respectively. Kaplan-Meier survival analysis revealed that SUV_max&gt; 5.0 was associated with significantly shorter EFS (692.4 [427.5-957.3] days vs. 2419.9 [1989.5-2850.3] days).</p><h3>Conclusion</h3><p>¹⁸F-FDG PET/CT showed numerically higher sensitivity and accuracy than CE-MRI for assessing peritumoral invasion of DF lesions, though with lower specificity. SUV_max, TBR, and lesion morphology were independent predictors of PD or POR.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 9","pages":"1043 - 1052"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136332","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":"Utility of preoperative [¹⁸F]FDG PET/CT for CT-guided biopsy planning of large tumors: target adjustment and malignant yield with hotspot targeting","authors":"Fumiyasu Tsushima,&nbsp;Taiki Koshiishi,&nbsp;Tomohiro Shintaku,&nbsp;Sho Maruyama,&nbsp;Shinya Kakehata,&nbsp;Hiroyuki Miura,&nbsp;Shingo Kakeda","doi":"10.1007/s12149-026-02242-9","DOIUrl":"10.1007/s12149-026-02242-9","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the clinical utility of preoperative [¹⁸F]FDG PET/CT for CT-guided biopsy planning of large tumors, including predictors of PET/CT-informed target adjustment and malignant yield with FDG hotspot targeting in very large tumors.</p><h3>Methods</h3><p>In this retrospective single-center study (January 2015–December 2025), we analyzed 82 patients who underwent pre-biopsy [¹⁸F]FDG PET/CT at our institution within 90 days. Target adjustment was retrospectively adjudicated as the presence of a spatial difference between the contrast-enhanced CT-based target and the PET/CT-informed target selected after considering intratumoral FDG uptake. ROC analysis was used to evaluate whether tumor size predicted target adjustment and to determine the optimal cutoff. Multivariable logistic regression included age, sex, tumor size, PET system (analog vs. digital), ΔSUV, lesion location (chest vs. other), and lymphoma (vs. other). In tumors ≥ 52 mm, malignant yield was compared between hotspot (highest uptake) and non-hotspot targeting.</p><h3>Results</h3><p>Target adjustment was performed in 28/82 cases (34.1%). Interobserver agreement was 89% with Cohen’s κ = 0.74 (95% CI, 0.58–0.89). Tumor size predicted target adjustment (AUC 0.847; 95% CI 0.761–0.934), and the Youden-optimal cutoff was 52 mm (sensitivity 0.82, specificity 0.81). Target adjustment rates were 5/49 (10.2%) for &lt; 52 mm and 23/33 (69.7%) for ≥ 52 mm (<i>p</i> &lt; 0.001). In multivariable analysis, tumor size (per 10 mm) was independently associated with target adjustment (OR 2.33; 95% CI 1.56–3.50; <i>p</i> &lt; 0.001), while female sex was inversely associated (OR 0.20; 95% CI 0.04–0.96; <i>p</i> = 0.045). Lymphoma showed a trend toward an inverse association that did not reach statistical significance (OR 0.11; 95% CI 0.01–1.11; <i>p</i> = 0.062). The multivariable model showed good discrimination (AUC 0.90; 95% CI 0.82–0.98; DeLong). Among tumors ≥ 52 mm, malignant pathology was obtained in 14/14 cases (100%) with hotspot targeting versus 5/9 (55.6%) with non-hotspot targeting (<i>p</i> = 0.014).</p><h3>Conclusions</h3><p>Preoperative [¹⁸F]FDG PET/CT supports CT-guided biopsy planning of large tumors by identifying cases likely to require target adjustment and was associated with higher malignant yield when the FDG hotspot was targeted in tumors ≥ 52 mm.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 10","pages":"1237 - 1244"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136390","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":"Energy spectrum-based correction of washout rates in dual-isotope 123I-BMIPP/201Tl imaging","authors":"Kenichi Nakajima,&nbsp;Shotoku Makida,&nbsp;Masato Okamura,&nbsp;Masa-aki Kawashiri,&nbsp;Takayuki Shibutani","doi":"10.1007/s12149-026-02235-8","DOIUrl":"10.1007/s12149-026-02235-8","url":null,"abstract":"<div><h3>Background</h3><p>Myocardial metabolism and perfusion in patients with ischemic heart disease or cardiomyopathy can be simultaneously assessed using ¹²³I-β-methyl-iodophenyl-pentadecanoic acid (BMIPP) and ²⁰¹Thallium (Tl) dual-isotope images. However, cross-contaminated counts between these tracers complicate quantitative analyses, particularly of ¹²³I-BMIPP washout rates (WRs). We developed a simplified method to determine WRs corrected for energy spectral crosstalk from dual-isotope images.</p><h3>Methods</h3><p>Our correction method was based on fixed energy-spectrum spill-in ratios (iRatio for ¹²³I and tRatio for ²⁰¹Tl) that were empirically determined from phantom and patient datasets. These ratios were applied to separate ¹²³I and ²⁰¹Tl counts in 38 studies of 36 patients with ischemic heart disease using dual-energy planar and single-photon emission computed tomography (SPECT) images. We calculated WRs before and after correction using early and late anterior planar images, as well as mean tomographic counts derived from polar maps. Thresholds of 5% (planar) and 10% (SPECT) were used to assess classification agreement between corrected and uncorrected WRs.</p><h3>Results</h3><p>The range of iRatios was 0.57–0.73 and that of tRatios was 0.10–0.12. Higher iRatio values were associated with greater body-weight patients, whereas tRatios were relatively stable regardless of body weight. The corrected ¹²³I-BMIPP WR depends primarily on tRatio and, by formulation, is not directly affected by iRatio. Using a fixed tRatio of 0.12, the correction method revealed strong correlations between corrected and uncorrected WRs for planar imaging (R² = 0.969, <i>p</i> &lt; 0.0001) and SPECT (R² = 0.964, <i>p</i> &lt; 0.0001). Corrected ¹²³I-BMIPP WRs were comparable to uncorrected values for both planar imaging (mean difference, − 1.4%) and SPECT (mean difference, 0.8%). Among the 38 studies, classification of tentative normal versus abnormal WRs remained concordant in 35 (92%) planar studies and 36 (95%) SPECT studies.</p><h3>Conclusion</h3><p>Our simplified energy spectrum–based method demonstrated that correction of ¹²³I-BMIPP WRs is feasible under dual-isotope conditions. Although uncorrected WRs may provide approximate estimates, correction is important for reliable quantitative use of dual-isotope datasets, where spectral cross-talk limits accuracy. The proposed model-based approach improves the robustness and interpretability of WR assessment and enables practical, standardized quantitation.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 10","pages":"1197 - 1209"},"PeriodicalIF":2.4,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12149-026-02235-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148100934","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":"FDG-PET/CT Parameters for distinguishing high and low microsatellite instability in colorectal cancer: A systematic review and Meta-analysis","authors":"Nima Broomand Lomer,&nbsp;Sajjad Sadeghpour,&nbsp;Drew A. Torigian","doi":"10.1007/s12149-026-02240-x","DOIUrl":"10.1007/s12149-026-02240-x","url":null,"abstract":"<div><p>Microsatellite instability (MSI) is a key prognostic biomarker in colorectal cancer (CRC), guiding immunotherapy planning. MSI testing requires invasive and costly tissue sampling. ¹⁸F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) offers noninvasive metabolic profiling and may capture MSI-associated heterogeneity. This study evaluated the utility of PET-derived parameters for distinguishing high MSI (MSI-H) from low MSI (MSI-L) CRC. Following PRISMA guidelines, PubMed, Embase, Scopus, and Web of Science were searched through October 2025. Included studies reported mean and standard deviation for either of SUVmax, SUVmean, MTV, TLG for MSI groups. Random-effects models generated pooled standardized mean differences (SMDs). Heterogeneity was evaluated using I², with subgroup analysis and meta-regression exploring its sources. Publication bias was assessed using Begg’s test and trim-and-fill. Ten studies (1,579 patients; 246 MSI-H) were included. SUVmax (SMD: 0.22; 95% CI: -0.02 to 0.46) and SUVmean (SMD: 0.39; 95% CI: -0.01 to 0.80) showed no significant differences. Volumetric measures demonstrated significant discriminatory power: MTV (SMD: 0.67; 95% CI: 0.41 to 0.93; I²=0%) and TLG (SMD: 0.37; 95% CI: 0.13 to 0.60; I²=0%). MTV showed the highest diagnostic performance (AUC up to 0.805). Studies using polymerase chain reaction showed larger SUVmax SMD than those using immunohistochemistry (<i>p</i> = 0.03). A marginal inverse association was found between SUVmax SMD and proportion of high-grade tumor (<i>p</i> = 0.09). Publication bias was detected for SUVmax (<i>p</i> = 0.02). Volumetric PET parameters, particularly MTV, showed relatively higher performance than intensity-based metrics for distinguishing MSI status in CRC; however, given the limited evidence and moderate diagnostic accuracy, they should be considered adjunctive imaging biomarkers and not a replacement for tissue-based assessment.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 10","pages":"1161 - 1173"},"PeriodicalIF":2.4,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148052077","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 role of 18 F-FDG PET/CT SUVmax values in evaluating treatment response in hormone receptor–positive metastatic breast cancer patients receiving CDK4/6 inhibitor therapy","authors":"Rahime Dilara Özbek,&nbsp;Aydın Aytekin,&nbsp;Enes Yerdes,&nbsp;Umut Elboga","doi":"10.1007/s12149-026-02233-w","DOIUrl":"10.1007/s12149-026-02233-w","url":null,"abstract":"<div><h3>Objective</h3><p>Metastatic breast cancer is a disease with poor prognosis. For many years, it has been treated with endocrine therapy; however, due to the promising results of CDK 4/6 inhibitors, their combination with endocrine therapy has recently become an essential component of metastatic breast cancer treatment. Although no standardized approach exists for evaluating the response to CDK 4/6 inhibitors, assessment with 18 F-FDG PET/CT may be possible. In this study, we aimed to assess the treatment response using 18 F-FDG PET/CT SUVmax values in hormone receptor–positive metastatic breast cancer patients receiving CDK 4/6 inhibitors.</p><h3>Methods</h3><p>Our study was designed as a single-center, retrospective analysis including 94 patients (93 females, 1 male). The mean age at diagnosis was 55 years. The most commonly used treatment combination was ribociclib + letrozole (45.7%). Neutropenia was the most frequent adverse event associated with CDK 4/6 inhibitors (35.5% of patients), followed by fatigue (25.8%) and nausea (19.4%).</p><h3>Results</h3><p>The mean highest SUVmax value (primary tumor + metastases) before CDK4/6 inhibitor treatment was 11.20, which decreased to 7.32 after treatment initiation (<i>p</i> = 0.001). Patients with a marked absolute reduction in SUVmax (AUC: 0.769, <i>p</i> = 0.001, cut-off: 3.35) had longer progression-free survival (PFS) compared with those without a reduction (28.92 months vs. 14.47 months). The difference between pre- and post-treatment SUVmax values was significantly associated with both Clinical Benefit Rate (CBR) and Objective Response Rate (ORR) (<i>p</i> = 0.001).</p><h3>Conclusion</h3><p>Early changes in 18 F-FDG PET/CT SUVmax values can serve as a valuable predictive marker for treatment response and survival in patients with metastatic breast cancer treated with CDK 4/6 inhibitors.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 10","pages":"1188 - 1196"},"PeriodicalIF":2.4,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148052040","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":"Patterns of positron emission mammography uptake by benign and malignant breast lesions: radiopathological correlation with malignant histopathological subtypes, histological grades, and molecular subtypes","authors":"MennatAllah Mohamed Hanafy,&nbsp;Rasha Mohamed Kamal,&nbsp;Sara Hassan Shams Alden Khater,&nbsp;Marina Mammdouh Gabrah Kirollus,&nbsp;Amr Farouk Ibrahim Moustafa","doi":"10.1007/s12149-026-02234-9","DOIUrl":"10.1007/s12149-026-02234-9","url":null,"abstract":"<div><h3>Purpose</h3><p>In the new era of nuclear breast imaging, differentiating benign from malignant uptake in the breast is essential in guiding clinical management. Accordingly, we aimed to assess the pattern of PEM uptake in benign and malignant breast lesions and to investigate its correlation with different histopathological subtypes, histological tumor grades, and molecular subtypes.</p><h3>Methods</h3><p>This was a prospective study comprised of 337 women with 465 breast lesions, of whom 128 patients had bilateral breast lesions. All patients performed Positron Emission Mammography (PEM) from March 2022 to February 2024. Any abnormality was evaluated qualitatively (mass and non-mass enhancement ) and quantitatively ( PUVmax and LTB ratio). The PEM readings were correlated with final pathology to differentiate benign from malignant lesions, and receiver operating characteristic (ROC) curve analysis was performed to assess the discriminant ability of PUVmax and LTB ratio in distinguishing histopathological groups, histological grades, and molecular subtypes.</p><h3>Results</h3><p>According to the final pathology, 330 (71%) lesions were malignant, and 135 (29%) were benign. The ROC curve analysis showed cutoff values of 1.92 and 3.145 for PUVmax and the LTB ratio, respectively, to discriminate between benign and malignant breast lesions. Significant differences in PUVmax and LTB ratio were detected between benign lesions and histopathological types, grades, and molecular malignant subtypes. The cutoff values for PUVmax and LTB ratio from benign were 1.81 and 3.165 for Ductal carcinoma in situ, 2.09 and 3.55 for invasive duct carcinoma (IDC) 1.62 and 2.8 for invasive lobular carcinoma,1.92 &amp; 3.165 for grade I, 1.935 &amp; 3.145 for grade II &amp; III tumors, 1.92 and 3.145 for luminal molecular subtype, 1.95 and 3.45 for HER 2 subtype, and 2.28 and 4.27 for the triple-negative subtype respectively. The lesions with irregular shapes, uncircumscribed margins, and segmental non-mass distribution have higher PUVmax and LTB ratios.</p><h3>Conclusions</h3><p>PEM is a valuable imaging modality for distinguishing between benign and malignant breast lesions. PEM may enable stratification of malignant lesions by histopathological subtype, tumour grade, and molecular subtypes. The highest metabolic activity was observed in invasive duct carcinoma, grade III, and the triple-negative molecular subtype. Overall, PEM can provide in vivo evaluation of breast lesion metabolic activity, leading to better lesion characterization and individualized patient management. However, due to methodological constraints, subgroup sample size, and radiation exposure, PEM should be regarded as an adjunct to sonomammography rather than a primary screening imaging modality.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 10","pages":"1174 - 1187"},"PeriodicalIF":2.4,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148012927","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":"Target-anchored platform concentration and uneven developmental consolidation in systemic solid-tumor radioligand therapy: a retrospective Trialtrove-based analysis","authors":"Yue Chang","doi":"10.1007/s12149-026-02225-w","DOIUrl":"10.1007/s12149-026-02225-w","url":null,"abstract":"<div><h3>Objective</h3><p>Radioligand therapy (RLT) has expanded rapidly across oncology, yet it remains unclear whether this expansion reflects broad multi-target maturation or continued concentration within a limited number of clinically deployable target-defined platforms. We hypothesized that contemporary systemic solid-tumor RLT development remains concentrated in a small number of more consolidated platforms rather than representing diffuse multi-target maturation.</p><h3>Methods</h3><p>This retrospective trial-level observational analysis used a prespecified Trialtrove export generated on March 23, 2026, restricted to Therapeutic Area = Oncology and Mechanism of Action = Radioemitter, with observational studies excluded. The raw export yielded 1341 oncology radioemitter trial records. Row-level platform-consistency curation excluded residual hematologic records, locoregional or intracavitary radiotherapies, non-targeted bone-seeking radiopharmaceuticals, and diagnostic-only studies, yielding a broad solid-tumor radioemitter universe of 558 trials. Additional exclusion of systemic radioligand records without a stably identifiable molecular target in the export fields produced a target-anchored systemic RLT universe of 513 trials. Future/planned records beyond 2025 were excluded from the historical main-text figure universe, leaving 462 trials. All eligible trials were included regardless of current status or achieved study phase; phase was used only as a descriptive grouping variable. Developmental consolidation was assessed descriptively across disease niche coherence, radionuclide strategy, scaffold architecture, and progression beyond early-phase exploration.</p><h3>Results</h3><p>PSMA (<i>n</i> = 179) and somatostatin receptor (SSTR; <i>n</i> = 128) together accounted for 307 of 462 historical trials (66.5%). Disease positioning remained strongly target-centered, with PSMA overwhelmingly prostate-focused and SSTR concentrated in neuroendocrine tumors. PSMA and SSTR showed marked Lu-177 predominance, whereas newer target families were more radionuclide-heterogeneous. SSTR was almost entirely peptide-based, whereas PSMA spanned small-molecule/ligand, peptide, and antibody/engineered-protein formats. Phase 2 or later development was reached by 44.7% of PSMA trials and 52.3% of SSTR trials, but by only 11.1% of FAP trials, none of GRPR trials, 30.0% of CAIX trials, and 16.4% of trials in the broader other-target group.</p><h3>Conclusions</h3><p>Current systemic solid-tumor RLT development is characterized less by broad multi-target maturation than by marked platform concentration with uneven developmental consolidation. In this descriptive framework, trial growth alone is insufficient to indicate platform maturity; more informative is whether a target can sustain a coherent disease niche, a workable radionuclide strategy, a deployable carrier format, and advancement beyond early-phase exploration.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 9","pages":"1138 - 1145"},"PeriodicalIF":2.4,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148012962","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}