Journal of nuclear medicine : official publication, Society of Nuclear Medicine最新文献

{"title":"Renal Medullary Carcinoma: Utility of [¹⁸F]FDG PET/CT in Evaluating Extent of Disease and Impact on Treatment Management.","authors":"Simone Krebs, Ahmed E Salem, Nghi C Nguyen, Rahul A Sheth, Jose A Karam, Najat C Daw, Chad Tang, Nizar M Tannir, Pavlos Msaouel, Devaki Shilpa Surasi","doi":"10.2967/jnumed.126.272258","DOIUrl":"10.2967/jnumed.126.272258","url":null,"abstract":"<p><p>The value of [¹⁸F]FDG PET/CT imaging in the management of <i>SMARCB1</i>-deficient renal medullary carcinoma (RMC), a rare and aggressive type of kidney cancer, has not been established. We sought to determine the utility of [¹⁸F]FDG PET/CT findings for the evaluation of disease burden and treatment planning in patients with RMC. <b>Methods:</b> Using an institutional database, we identified patients with RMC who underwent [¹⁸F]FDG PET/CT scans as part of clinical care between 2016 and 2025. When available, baseline [¹⁸F]FDG PET/CT images were used; otherwise, the earliest available follow-up scan performed because of concern of recurrence or progression was included. For all scans, sites of abnormal [¹⁸F]FDG uptake were assessed, the SUV_max of the most avid site was quantified, and tumor-to-normal tissue ratios (TNRs) were calculated. PET/CT findings were compared with anatomic imaging (CT/MRI-based) performed within 30 d. Instances in which PET/CT findings altered treatment were recorded. <b>Results:</b> On PET, 48 of 49 patients had clearly [¹⁸F]FDG-avid disease. The single patient without [¹⁸F]FDG-avid lesions also lacked evidence of disease on anatomic imaging. Of the 23 patients who received a baseline PET/CT scan for staging purposes, 15 had intact renal primary tumors, and all tumors were [¹⁸F]FDG-avid (median SUV_max, 13.4; range, 9.5-23.5; median TNR blood, 10.7; range, 4.2-16.6). Ten patients were imaged during therapy, and 16 underwent imaging after progression or before the start of a new treatment. Forty-three patients had [¹⁸F]FDG-avid nodal metastatic disease (median SUV_max, 8.9; range, 1.8-27.0). Extranodal disease was observed in 36 patients, most commonly in the lungs (<i>n</i> = 24; median SUV_max, 5.8; range, 1.7-17.5) and bones (<i>n</i> = 19; median SUV_max,10.7; range, 3.7-24.8). In 31 patients, [¹⁸F]FDG PET/CT identified additional lesions not detected on anatomic imaging, predominantly involving bones (<i>n</i> = 18), lymph nodes (<i>n</i> = 13), and soft tissues (<i>n</i> = 11). These additional findings led to a change in clinical management for 10 (21%) of 48 patients with active disease. In contrast, no lesions were identified on anatomic imaging that were not apparent on PET/CT scans. <b>Conclusion:</b> RMC is a highly [¹⁸F]FDG-avid malignancy. [¹⁸F]FDG PET frequently detects additional metastatic sites missed by conventional anatomic imaging, facilitating disease extent assessment and optimizing treatment strategy in patients with RMC.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":"1372-1378"},"PeriodicalIF":9.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonsteroidal ¹⁸F-Labeled PET Tracer for Imaging Androgen Receptors.","authors":"Vilma I J Jallinoja, Joo Sun Mun, Alexandra Campanella, Aahna Sasson, Teja M Kalidindi, Giovanna Caxeiro, Darren R Veach, Serge Lyashchenko, Heiko Schöder, Naga Vara Kishore Pillarsetty","doi":"10.2967/jnumed.125.271531","DOIUrl":"10.2967/jnumed.125.271531","url":null,"abstract":"<p><p>Androgen receptor (AR) signaling is the key driver of prostate cancer. Thus, standard-of-care treatments focus on androgen-deprivation therapy followed by AR signaling inhibitors. Even when initially responsive, patients eventually develop resistance to therapies targeting AR signaling, leading to disease progression. To study lesion-to-lesion AR occupancy, the radiofluorinated analog of the endogenous androgen [¹⁸F]16β-fluoro-5α-dihydrotestosterone ([¹⁸F]FDHT) has been investigated as a potential AR imaging agent. In the literature, [¹⁸F]FDHT demonstrates slow clearance from healthy tissue, poor plasma stability in vivo, and nonapplicability in mouse studies. To overcome these limitations, we explored nonsteroidal selective androgen receptor modulator (SARM)-based pharmacophores as potential PET tracers. Here, we describe the performance of a ¹⁸F-radiolabeled AR tracer, [¹⁸F]F-SARM3. <b>Methods:</b> [¹⁸F]F-SARM3 was synthesized via 1-step copper-catalyzed radiofluorination, and its AR affinity (half-maximal inhibitory concentration [IC₅₀]) and biological activity (half-maximal effective concentration [EC₅₀]) were studied in various prostate cancer cell lines. The tracer's stability in vitro was also evaluated. [¹⁸F]F-SARM3 was evaluated in LNCaP and 22Rv1 (AR-positive) tumor-bearing male mice to assess its AR specificity and clearance profile, and its performance was compared with that of [¹⁸F]FDHT. <b>Results:</b> [¹⁸F]F-SARM3 was synthesized with a radiochemical yield and purity of 2.7 ± 1.4% and 97.9 ± 2.3%, respectively. In in vitro cell-binding assays, [¹⁸F]F-SARM3 demonstrated high affinity for ARs, similar to that of dihydrotestosterone (IC₅₀, 20.2 ± 14.6 nM vs. 9.6 ± 4.0 nM, respectively, in 22Rv1 cells). [¹⁸F]F-SARM3 functions as a partial AR agonist, with an EC₅₀ of 15.0 ± 12.0 nM. Furthermore, [¹⁸F]F-SARM3 is highly stable in phosphate-buffered saline and mouse blood (98.5% ± 1.2% and 98.6% ± 1.5% intact, respectively). The tracer's in vivo specificity was confirmed with the observed uptake in tumors and prostate glands of castrated mice, where uptake was blockable. In vivo specificity was not observed with [¹⁸F]FDHT. <b>Conclusion:</b> We developed a first-in-class SARM-based AR tracer that displays high affinity and selectivity for AR in vitro and in vivo. This represents a suitable PET tracer to image AR status in rodent models and provides a strong rationale for clinical translation of [¹⁸F]F-SARM3 as a high-affinity AR agonist PET imaging agent.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":"1379-1384"},"PeriodicalIF":9.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Widespread Prostate Cancer Osseous Metastases: Negative on ¹⁸F-Piflufolastat PET but Positive on ¹⁸F-Fluciclovine PET.","authors":"Gary A Ulaner, Richard Lam","doi":"10.2967/jnumed.125.272001","DOIUrl":"10.2967/jnumed.125.272001","url":null,"abstract":"","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":"1510-1511"},"PeriodicalIF":9.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward Personalized Radiopharmaceutical Therapy: Radiobiologic Insights Compared with External-Beam Radiotherapy.","authors":"Sébastien Penninckx, Wendy Delbart, Magdalena Mileva, Mutaz Kassas, Hugo Levillain, Carlos Artigas, Patrick Flamen, Ioannis Karfis","doi":"10.2967/jnumed.125.271564","DOIUrl":"10.2967/jnumed.125.271564","url":null,"abstract":"<p><p>Radiopharmaceutical therapy differs from external-beam radiation therapy through systemic delivery, a heterogeneous dose distribution, and a low dose rate, challenging conventional radiobiology and dose-effect relationships. These features complicate dose constraints and support dosimetry-guided strategies. Integrating personalized dosimetry into clinical trials is key to optimizing efficacy and limiting toxicity. We emphasize the need for radiopharmaceutical therapy-specific models and trial designs incorporating spatial heterogeneity, radiosensitivity, and patient-specific factors to improve the therapeutic index.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":"1350-1357"},"PeriodicalIF":9.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Industry-Academic Collaboration in Nuclear Medicine: Proceedings from the 2024 CMIIT Industry Partners Circle.","authors":"Dustin Osborne, Cathy S Cutler, Ivis F Chaple, Patrícia M Ribeiro Pereira, Todd E Peterson, Kiran K Solingapuram Sai, Jiaqiong Wang, Peter J H Scott, Delphine L Chen","doi":"10.2967/jnumed.126.272619","DOIUrl":"10.2967/jnumed.126.272619","url":null,"abstract":"<p><p>Advancing and streamlining the development pipeline and translation of theranostic radiopharmaceuticals for application in nuclear medicine necessitates continued cross-sector collaboration among key stakeholders from the Society of Nuclear Medicine and Molecular Imaging (SNMMI), industry partners, and academics to ensure continued growth and innovation and clinical translation. One mechanism the SNMMI has for such dialogue is its biennial Industry Partners Circle (IPC). After the success of prior IPCs, the Center for Molecular Imaging, Innovation, and Translation (CMIIT) hosted the latest IPC in January 2024. The goals of the 2024 CMIIT IPC were to address 4 key priorities that have emerged for the translational community: grow the workforce pipeline, improve academia/industry collaborations to support career development, facilitate radiopharmaceutical clinical trials, and overcome barriers in developing α-therapies. The IPC was attended by SNMMI staff and leadership, members of the CMIIT board of directors, key stakeholders from academia, and industry representatives from a broad range of biopharmaceutical companies and equipment manufacturers. This article summarizes the discussions that were conveyed at the 2024 CMIIT IPC.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":"1365-1368"},"PeriodicalIF":9.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Imaging of Mechanisms of Impaired Cardiac Repair After Macrophage Depletion in Mice: A Longitudinal Multitracer Imaging Study.","authors":"Annika Hess, Maja Strunk, Michael Willmann, Tobias L Ross, Frank M Bengel, James T Thackeray","doi":"10.2967/jnumed.125.271856","DOIUrl":"10.2967/jnumed.125.271856","url":null,"abstract":"<p><p>Macrophage depletion before myocardial infarction (MI) in mice disrupts the inflammatory healing response and leads to left ventricular thrombus formation and tissue calcification. Here, we aimed to determine the effect of clodronate-loaded liposome-mediated macrophage depletion on C-C chemokine receptor 2 (CCR2)-expressing immune cells after MI in male and female mice. Further, we sought to discern the relationship of clodronate liposomes with thrombus calcification and functional outcome using multitracer imaging. <b>Methods:</b> Male and female C57BL/6N mice underwent 60-min ischemia/reperfusion MI or sham surgery after a single or repeated injection of clodronate liposomes for macrophage depletion or injection with liposomes containing phosphate-buffered saline. Macrophage depletion was verified in peripheral blood. PET imaging was performed to assess infarct CCR2 signal at 2 or 4 d after MI and fibroblast activation protein expression at 7 d after MI. Microcalcification was assessed by ¹⁸F-NaF PET/CT over 4 wk. Cardiac function was assessed at 6 wk by MRI. Histopathology validated inflammation and calcification in the heart. <b>Results:</b> Macrophage depletion significantly increased susceptibility to early death after MI, especially in male mice. Molecular imaging revealed an early increase in cardiac CCR2 content after MI compared with sham, which persisted despite macrophage depletion. Histology verified reduced CD68 cell content but sustained CCR2 signal that partially overlapped CD11c, a marker of dendritic cells among other cell types. Ly6G-positive cell content increased in the myocardium of macrophage-depleted mice after MI but did not overlap with CCR2. All macrophage-depleted male mice and 64% of macrophage-depleted female mice developed a dense intracavity thrombus overlying endocardial damage, with gradual microcalcification starting from 2 wk and reaching a maximum at 4 wk after MI. Macrophage depletion did not impact infarct size or contractile function at 6 wk after MI in surviving mice. <b>Conclusion:</b> Macrophage depletion before MI elevated the risk of acute death, particularly in male mice. A persistent CCR2 PET signal suggested that non-CD68-positive immune cells contribute to tracer substrate and altered proportions of other immune cell subtypes during healing. These findings suggest that extreme antiinflammatory interventions after MI may have unintended consequences for scar formation and remodeling, which may be monitored by molecular imaging.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":"1460-1468"},"PeriodicalIF":9.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":"67 9","pages":"1511"},"PeriodicalIF":9.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeted Radiopharmaceutical Therapy: Advances, Investment Dynamics, and Future Directions-Part 2.","authors":"Catello Somma, Richard Zimmermann, Germo Gericke, Ken Herrmann","doi":"10.2967/jnumed.125.270945","DOIUrl":"10.2967/jnumed.125.270945","url":null,"abstract":"<p><p>Radiopharmaceutical therapy is rapidly expanding, propelled by scientific and investment momentum. This paper analyzes the evolving dynamics of clinical innovation, infrastructure build-out, and financial investment that are shaping the competitive landscape. Platform validation, theranostic integration, and novel α-emitting isotopes are redefining early-stage development and investor interest. Although lead assets remain the primary driver of mergers and acquisitions, scalable manufacturing and supply security increasingly influence deal rationale. Distinct business models are emerging between vertically integrated players and network-based collaborators, each with distinct capital and operational trade-offs. Clinical adoption hinges on improved access to imaging, adaptive trial designs, and evolving reimbursement frameworks. Developers and investors must navigate a complex but rapidly maturing radiopharmaceutical therapy field, focusing on differentiation and manufacturing readiness to align with regulatory and payer expectations.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":"1358-1364"},"PeriodicalIF":9.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translational Theranostics in Glioblastoma: FAPI-46 as a Precision Medicine Tool.","authors":"Pauline Jeanjean, Abir Swaidan, Christopher Tse, Samantha Kwock, Iveta Fajnorova, Rachel Dove, Ines Camille Azrour, Sarah Taylor, Begonya Comin-Anduix, David A Nathanson, Giuseppe Carlucci, Jérémie Calais, Johannes Czernin, Élie Besserer-Offroy, Christine E Mona","doi":"10.2967/jnumed.125.271759","DOIUrl":"10.2967/jnumed.125.271759","url":null,"abstract":"<p><p>Glioblastoma represents the most lethal form of brain cancer, characterized by a 5-y survival rate of approximately 4%. Fibroblast activation protein (FAP), expressed within both the tumor microenvironment and glioblastoma cells, has been identified as a promising therapeutic target. This study explores the potential of FAP-targeted molecular probes as theranostic agents for glioblastoma. <b>Methods:</b> Human U-87 MG and murine SB28 glioblastoma-derived cell lines were used to establish immunodeficient and immunocompetent models, respectively. FAP inhibitor (FAPI)-46 was radiolabeled with ⁶⁸Ga for imaging and ²²⁵Ac or ¹⁷⁷Lu for therapy. Tumor uptake, therapeutic efficacy, immunomodulatory effects, and survival were evaluated for FAPI-46 alone or in combination with temozolomide in preclinical studies. [⁶⁸Ga]Ga-FAPI-46 tumor uptake was also evaluated in patients. <b>Results:</b> In subcutaneous xenografts, [⁶⁸Ga]Ga-FAPI-46 exhibited high tumor uptake with minimal background signal. In the immunocompromised model, a single dose of [²²⁵Ac]Ac-FAPI-46 combined with temozolomide was sufficient to increase median survival, whereas in the immunocompetent model, 3 consecutive daily doses were required to achieve a significant survival benefit. [¹⁷⁷Lu]Lu-FAPI-46 demonstrated lower therapeutic efficacy, as a monotherapy or in combination with temozolomide, than did [²²⁵Ac]Ac-FAPI-46. Immunomodulatory effects, assessed via flow cytometry, were insufficient to overcome the immunologically \"cold\" glioblastoma tumor microenvironment. In orthotopic xenografts and patients, [⁶⁸Ga]Ga-FAPI-46 showed low uptake, indicating limited blood-brain barrier penetration and resulting in tumor concentrations likely too low for therapeutic efficacy. <b>Conclusion:</b> FAPI-46 demonstrates significant potential as a theranostic agent for glioblastoma in peripheral models. However, its inability to cross the blood-brain barrier in orthotopic models highlights the need for future studies to improve its clinical applicability.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":"1452-1459"},"PeriodicalIF":9.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148165746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Following Medical Artificial Intelligence Advice Can Mitigate Malpractice Liability: Cross-National Insights from a Randomized Trial.","authors":"Alessandro Tacconelli, Jakob Merane, Aileen Nielsen, Kevin Tobia, Björn Hackanson, Alexander Stremitzer","doi":"10.2967/jnumed.126.272292","DOIUrl":"10.2967/jnumed.126.272292","url":null,"abstract":"<p><p>Artificial intelligence (AI) increasingly influences clinical decision-making, yet its recommendations may diverge from standard care. Although malpractice concerns are thought to discourage physicians from following AI advice, experimental evidence from the United States suggests the opposite: lay jurors are more likely to hold physicians liable when they reject AI recommendations. Whether this pattern extends to systems in which court-appointed experts, not lay jurors, determine liability remains unknown. <b>Methods:</b> To examine how physicians and laypeople in expert-based and lay-juror legal systems evaluate physicians' acceptance or rejection of AI recommendations, particularly when those recommendations deviate from standard care, we designed a randomized vignette study: a 2 × 2 factorial design varying the AI recommendation (standard vs. nonstandard care) and a fictional physician's decision (accept vs. reject). The study was conducted online in 2023 among nationally representative samples of U.S. and German adults and from 2023 to 2024 among German physicians. In total, 387 German physicians, 2291 U.S. adults, and 2283 German adults participated; those not completing the survey or failing attention checks were excluded per preregistered criteria. Participants were randomly assigned to 1 of 4 vignettes, varying the AI recommendation (standard vs. nonstandard care) and physician's decision (accept vs. reject). The reasonableness of the fictional physician's decision was measured, rated by participants on a Likert scale. <b>Results:</b> Analysis, following preregistered exclusion criteria, included 248 German physicians, 1202 U.S. adults, and 1358 German adults. Physicians accepting standard-care AI recommendations were rated more reasonable than those rejecting them (U.S. laypeople: <i>t</i> = 5.36; 95% CI, 0.45-0.97; <i>P</i> < 0.001; German physicians: <i>t</i> = 2.47; 95% CI, 0.14-1.30; <i>P</i> = 0.02; German laypeople: <i>t</i> = 4.14; 95% CI, 0.27-0.76; <i>P</i> < 0.001). Ratings of physicians accepting versus rejecting AI nonstandard-care recommendations were statistically equivalent. Equivalence was tested at an α-value of 0.05 using a two 1-sided tests procedure, reported with 90% CIs per standard convention (U.S. laypeople: <i>t</i> = -4.90; 90% CI, -0.1 to 0.36; <i>P</i> < 0.001; German physicians: <i>t</i> = -1.76; 90% CI, -0.12 to 0.67; <i>P</i> = 0.04; German laypeople: <i>t</i> = 5.35; 90% CI, -0.35 to 0.06; <i>P</i> < 0.001). <b>Conclusion:</b> Across the United States and Germany, samples representative of lay jurors and court-appointed experts viewed accepting standard-care AI advice as more reasonable, whereas accepting or rejecting nonstandard-care AI advice was judged similarly. Contrary to predictions, malpractice liability regimes do not necessarily pose a barrier to AI use in precision medicine.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":"1474-1480"},"PeriodicalIF":9.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}