Mari Teuter, Asha Balakrishnan, Yuhai Hu, Kelsey Lolatte, Zekyie Korkmaz, Michael Willmann, Jens P Bankstahl, Michael Ott, Tobias L Ross, Frank M Bengel
{"title":"Serial Multitracer PET/CT for Characterization of the Inflammation-Fibrosis Axis in Liver Injury.","authors":"Mari Teuter, Asha Balakrishnan, Yuhai Hu, Kelsey Lolatte, Zekyie Korkmaz, Michael Willmann, Jens P Bankstahl, Michael Ott, Tobias L Ross, Frank M Bengel","doi":"10.2967/jnumed.126.273298","DOIUrl":"https://doi.org/10.2967/jnumed.126.273298","url":null,"abstract":"<p><p>As the global burden of liver disease is increasing, the interplay between inflammation and fibrosis is emerging as a promising target for antifibrotic hepatic therapies. Such advanced interventions will require biomarker guidance, which is an opportunity for molecular imaging. We tested the feasibility of multiple radiopharmaceuticals to characterize disease progression and regression in a mouse model of fibrotic liver injury. <b>Methods:</b> C57BL/6N mice (<i>n</i> = 31) received intraperitoneally injected carbon tetrachloride (CCl<sub>4</sub>) along with serial PET/CT at baseline, in the prefibrotic inflammatory phase (3 wk of CCl<sub>4</sub>), in the fibrosis phase (6 wk of CCl<sub>4</sub>), and in the regression phase (3 wk after termination of CCl<sub>4</sub>). PET/CT included the metabolic marker [<sup>18</sup>F]FDG; the leukocyte marker [<sup>68</sup>Ga]Ga-pentixafor (chemokine [C-X-C motif] receptor 4 ligand); 2 fibroblast activation protein (FAP) markers, [<sup>68</sup>Ga]Ga-MHLL2 and [<sup>68</sup>Ga]Ga-FAP inhibitor (FAPI)-46; and the α<sub>v</sub>β<sub>6</sub>-integrin ligand [<sup>68</sup>Ga]Ga-trivehexin. Correlative measurements included serum biomarkers, in vitro cell assays, and tissue analyses. <b>Results:</b> CCl<sub>4</sub> administration led to elevation of liver transaminases, which was reversible in the regression phase. This was associated with gross morphologic changes, histologic macrophage-monocyte infiltration, and increased collagen deposition. Hepatic [<sup>18</sup>F]FDG uptake increased in the prefibrosis phase (<i>P</i> = 0.005) and the fibrosis phase (<i>P</i> = 0.049) compared with baseline. [<sup>68</sup>Ga]Ga-pentixafor reached its peak in the prefibrosis phase (<i>P</i> = 0.003), consistent with the abundance of CD68-positive cells observed upon histology. Although α<sub>v</sub>β<sub>6</sub>-integrin, as a marker of profibrotic activity, was elevated as expected in the fibrosis phase (<i>P</i> = 0.038), we found a surprising reduction of uptake of both FAP tracers in the prefibrosis phase ([<sup>68</sup>Ga]Ga-MHLL2, <i>P</i> = 0.001; [<sup>68</sup>Ga]Ga-FAPI-46, <i>P</i> = 0.001) and the fibrosis phase ([<sup>68</sup>Ga]Ga-MHLL2, <i>P</i> < 0.001; [<sup>68</sup>Ga]Ga-FAPI-46, <i>P</i> = 0.001), despite histologic proof of FAP-positive stellate cells. In vitro cell assays showed a fast cellular efflux of FAP tracers, potentially limiting specific accumulation in FAP-expressing injured tissue. <b>Conclusion:</b> Activation of the inflammation-fibrosis axis by liver injury is associated with stimulated hepatic glucose utilization. Chemokine receptor 4 targeting specifically identifies hepatic tissue inflammation, whereas α<sub>v</sub>β<sub>6</sub>-integrin identifies fibrotic activity. This supports the feasibility of targeted molecular imaging to characterize hepatic response to injury and provides a foundation for image guidance of antifibrotic therapies. The value of FAP ligands was limited in our model","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043061","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}
Halil Kömek, Esra Arslan, Canan Can, Elife Akgün, Rıdvan Kılıç, Uğur Yücetaş, Nadiye Akdeniz, Tevfik Fikret Çermik, Zuhat Urakçı, Tünkut Doğanca, Murat Bardakçı, Ömer Yeprem, Ali Rıza Kural
{"title":"From Metabolism to Molecular Phenotype: Carbonic Anhydrase IX-Targeted [<sup>68</sup>Ga]Ga-DPI-4452 PET/CT in Renal Cell Carcinoma: A Prospective Multicenter Comparison with [<sup>18</sup>F]FDG PET/CT.","authors":"Halil Kömek, Esra Arslan, Canan Can, Elife Akgün, Rıdvan Kılıç, Uğur Yücetaş, Nadiye Akdeniz, Tevfik Fikret Çermik, Zuhat Urakçı, Tünkut Doğanca, Murat Bardakçı, Ömer Yeprem, Ali Rıza Kural","doi":"10.2967/jnumed.126.273011","DOIUrl":"https://doi.org/10.2967/jnumed.126.273011","url":null,"abstract":"<p><p>The objective of this study was to prospectively compare the diagnostic performance, lesion detection capability, and clinical staging impact of [<sup>68</sup>Ga]Ga-DPI-4452 PET/CT with that of [<sup>18</sup>F]FDG PET/CT in renal cell carcinoma (RCC) using a multicenter design. <b>Methods:</b> Sixty-eight patients with RCC were prospectively enrolled, including patients with newly diagnosed primary tumors, patients under active surveillance or ongoing systemic treatment, and patients with suspected recurrent or metastatic disease. Both PET/CT scans were performed within the same week. The primary endpoint was patient-based diagnostic accuracy; secondary endpoints included lesion detection rate, SUV<sub>max</sub>, maximum tumor-to-background ratio, clinical management impact, and adverse events. <b>Results:</b> The median age was 59.5 y; 52 patients (76.5%) were men. Overall diagnostic accuracy was 92.6% for [<sup>68</sup>Ga]Ga-DPI-4452 PET/CT versus 80.9% for [<sup>18</sup>F]FDG PET/CT (<i>P</i> = 0.1435). In the clear cell RCC (ccRCC) subgroup (<i>n</i> = 56), accuracy was 98.2% versus 76.8%, respectively (<i>P</i> = 0.0034). [<sup>68</sup>Ga]Ga-DPI-4452 detected 90.9% of all lesions (97.9% in ccRCC), compared with 56.7% (47.1% in ccRCC) for [<sup>18</sup>F]FDG. Median SUV<sub>max</sub> was 19.7 versus 4.3, and median of the maximum tumor-to-background ratio was 19.8 versus 2.1 for [<sup>68</sup>Ga]Ga-DPI-4452 versus [<sup>18</sup>F]FDG (both <i>P</i> < 0.001). In the ccRCC subgroup, [<sup>68</sup>Ga]Ga-DPI-4452 led to clinical management changes in 21 patients (37.5%), compared with 1 patient (1.8%) for [<sup>18</sup>F]FDG. No adverse events were observed. <b>Conclusion:</b> [<sup>68</sup>Ga]Ga-DPI-4452 PET/CT provides superior lesion detection, tumor-to-background contrast, and diagnostic accuracy compared with [<sup>18</sup>F]FDG PET/CT in ccRCC, reflecting direct visualization and targeting of the von Hippel-Lindau, hypoxia-inducible factor, and carbonic anhydrase IX axis. With its rapid pharmacokinetic profile and theranostic potential, [<sup>68</sup>Ga]Ga-DPI-4452 may represent a new molecular imaging standard in ccRCC.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993409","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}
Esmail Jafari, Malik E Juweid, Alireza Raeisi, Atena Najdian, Seyed Javad Rekabpour, Majid Assadi
{"title":"From Bench to Bedside: A Critical Appraisal of Somatostatin Receptor Antagonists in the Theranostic Management of Neuroendocrine Neoplasms.","authors":"Esmail Jafari, Malik E Juweid, Alireza Raeisi, Atena Najdian, Seyed Javad Rekabpour, Majid Assadi","doi":"10.2967/jnumed.126.272687","DOIUrl":"https://doi.org/10.2967/jnumed.126.272687","url":null,"abstract":"<p><p>Neuroendocrine neoplasms are increasingly assessed using somatostatin receptor (SSTR) antagonists as an alternative to conventional agonists in molecular imaging and targeted radiopharmaceutical therapy. Radiolabeled SSTR antagonists, such as [<sup>68</sup>Ga]Ga-NODAGA-JR11 and [<sup>68</sup>Ga]Ga-NODAGA-LM3, have demonstrated higher tumor-to-background ratios and enhanced lesion detection in several studies, particularly in hepatic metastases. Therapeutically, radiolabeled antagonists such as [<sup>177</sup>Lu]Lu-DOTA-LM3 and [<sup>177</sup>Lu]Lu-DOTA-JR11 have shown promising tumor uptake and dosimetry profiles, including in patients with progressive disease after prior therapies. However, current evidence is largely derived from early-phase and heterogeneous studies. Increased hematologic toxicity and the absence of prospective evidence demonstrating a survival benefit remain key limitations. This review provides a critical synthesis of the available data, highlighting both the potential advantages and the unresolved challenges of SSTR antagonist-based imaging and therapy in neuroendocrine neoplasms.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993390","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}
Marianna Tosato, Janke Kleynhans, Michiel van de Voorde, Chiara Favaretto, Charlene Harriswangler, Ivis Chaple, Simona Mastroianni, Valeriia Starovoitova, Rebecca Hoerres, Andrew Burgoyne, Aruna Korde, Jean-François Gestin, Nicholas P van der Meulen, Mattia Asti, Ulli Köster, Caterina F Ramogida, Valery Radchenko
{"title":"Beta Atlas: Charting Global Production of Nonconventional β<sup>-</sup>-Emitters for Targeted Radiopharmaceutical Therapy-Part 1.","authors":"Marianna Tosato, Janke Kleynhans, Michiel van de Voorde, Chiara Favaretto, Charlene Harriswangler, Ivis Chaple, Simona Mastroianni, Valeriia Starovoitova, Rebecca Hoerres, Andrew Burgoyne, Aruna Korde, Jean-François Gestin, Nicholas P van der Meulen, Mattia Asti, Ulli Köster, Caterina F Ramogida, Valery Radchenko","doi":"10.2967/jnumed.126.272648","DOIUrl":"https://doi.org/10.2967/jnumed.126.272648","url":null,"abstract":"<p><p>β-minus particle (β<sup>-</sup>)-emitting radionuclides have long been central to targeted radiopharmaceutical therapy. Interest in expanding their repertoire beyond conventional options has grown over time, as the need for radionuclides with different emission profiles and theranostic potential becomes increasingly clear. Nonetheless, their clinical translation remains limited by production constraints, inconsistent clinical evidence supporting their use. By reporting the state of the art in nonconventional β<sup>-</sup>-radionuclide production, the current global landscape of production centers and reviewing current clinical evaluations, this β-atlas provides a critical overview of how these radionuclides may influence the future of targeted radiopharmaceutical therapy. This perspective is intended to support researchers, clinicians, and industry in recognizing both the opportunities and the constraints associated with integrating alternative β<sup>-</sup>-emitters into clinical practice. Ultimately, this β-atlas aims to serve as a strategic resource to foster collaboration and guide investment toward more reliable and scalable supply chains of nonconventional β<sup>-</sup>-emitters, thereby strengthening the foundation for future innovation in β<sup>-</sup>-based therapy. This review focuses on β<sup>-</sup>-emitters that have already progressed to clinical evaluation, including <sup>67</sup>Cu, <sup>153</sup>Sm, <sup>161</sup>Tb, <sup>166</sup>Ho, <sup>186</sup>Re, and <sup>188</sup>Re.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993377","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":"Recurrence: A Patient's Perspective on How Nuclear Medicine Creates Hope Through Clarity.","authors":"Michael Crosby","doi":"10.2967/jnumed.126.273683","DOIUrl":"https://doi.org/10.2967/jnumed.126.273683","url":null,"abstract":"","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993380","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}
Paul J Roach, Dale L Bailey, Geoffrey M Currie, Erin E Grady, Linda B Haramati, Michel LeBlanc, Alexander C W Lee, Pierre-Yves Le Roux, Darlene F Metter, Pierre-Yves Salaun, Barry A Siegel
{"title":"Executive Summary: SNMMI/EANM/ACNM/ANZSNM Procedure Standard/Procedure Guideline for Ventilation-Perfusion Pulmonary Scintigraphy.","authors":"Paul J Roach, Dale L Bailey, Geoffrey M Currie, Erin E Grady, Linda B Haramati, Michel LeBlanc, Alexander C W Lee, Pierre-Yves Le Roux, Darlene F Metter, Pierre-Yves Salaun, Barry A Siegel","doi":"10.2967/jnumed.126.273689","DOIUrl":"https://doi.org/10.2967/jnumed.126.273689","url":null,"abstract":"","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993371","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":"Are Urooncologists Onboard?","authors":"Boris Hadaschik, Oliver Sartor","doi":"10.2967/jnumed.125.269608","DOIUrl":"https://doi.org/10.2967/jnumed.125.269608","url":null,"abstract":"<p><p>Theranostics, particularly PSMA-targeted imaging and radiopharmaceutical therapy, is rapidly transforming the field of urooncology. This article reviews the clinical integration of PSMA PET/CT in diagnosis, treatment planning, and patient selection for <sup>177</sup>Lu-PSMA-617 therapy, which has demonstrated survival benefits and favorable safety profiles in metastatic castration-resistant prostate cancer. As evidence expands into earlier disease stages, PSMA radiopharmaceutical therapy is emerging as a key systemic treatment modality. The article emphasizes the importance of multidisciplinary care and the evolving role of nuclear medicine as both a diagnostic and a therapeutic partner. It also highlights current challenges and regional disparities in access, encouraging thoughtful, patient-centered adaptation of theranostic advances.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":"67 Suppl 2","pages":"3S-4S"},"PeriodicalIF":9.1,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946422","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}
Ruonan Li, Eleftherios Papalanis, Maryam Oroujeni, Ekaterina Bezverkhniaia, Mark Konijnenberg, Anna Orlova, Per-Åke Nygren, Torbjörn Gräslund, Vladimir Tolmachev
{"title":"Targeted RPT of CEACAM5-Expressing Human Xenografts Using an Albumin-Binding Domain-Fused C9 Affibody: Proof-of-Principle Study.","authors":"Ruonan Li, Eleftherios Papalanis, Maryam Oroujeni, Ekaterina Bezverkhniaia, Mark Konijnenberg, Anna Orlova, Per-Åke Nygren, Torbjörn Gräslund, Vladimir Tolmachev","doi":"10.2967/jnumed.126.272854","DOIUrl":"https://doi.org/10.2967/jnumed.126.272854","url":null,"abstract":"<p><p>The carcinoembryonic antigen cell adhesion molecule 5 (CEACAM5) is highly overexpressed in carcinomas of different origins. Affibody molecules are non-immunoglobulin-based affinity proteins capable of in vivo recognition of cancer-associated targets. Affibody C9 was previously generated to bind selectively to CEACAM5. In an earlier in vivo study, C9 was engineered as a dimer, and the effects on the biodistribution from the addition of an N- or C-terminal-fused albumin-binding domain (ABD<sub>035</sub>) were investigated using <sup>99m</sup>Tc labeling. The variant ABD<sub>035</sub>-C9-C9 with N-terminal ABD<sub>035</sub> placement (20,296 Da; affinities of 2.5 and 1.9 nM to CEACAM5 and albumin, respectively) was found to provide the most favorable biodistribution for the delivery of cytotoxic payloads. In this study, we tested the hypothesis that ABD<sub>035</sub>-C9-C9 labeled with a cytotoxic radionuclide would be suitable for targeted radiopharmaceutical therapy (RPT). <b>Methods:</b> ABD<sub>035</sub>-C9-C9, labeled with the β-emitting radionuclide <sup>177</sup>Lu via DOTA or DOTAGA chelators, was evaluated. CEACAM5-positive (BxPC3, LS174T) and CEACAM5-negative (HT-29) cell lines were used to assess binding specificity, kinetics, and internalization in vitro. The biodistribution of [<sup>177</sup>Lu]Lu-ABD<sub>035</sub>-C9-C9-DOTA and [<sup>177</sup>Lu]Lu-ABD<sub>035</sub>-C9-C9-DOTAGA was compared in BALB/c <i>nu/nu</i> mice with BxPC3 xenografts. The biodistribution of [<sup>177</sup>Lu]Lu-ABD<sub>035</sub>-C9-C9-DOTA was measured for dosimetry calculation. Modeling was performed to maximize tumor control probability. The effect of a single injection of 12 MBq of [<sup>177</sup>Lu]Lu-ABD<sub>035</sub>-C9-C9-DOTA on the growth of BxPC3 xenografts was evaluated. <b>Results:</b> In vitro, both [<sup>177</sup>Lu]Lu-ABD<sub>035</sub>-C9-C9-DOTA and [<sup>177</sup>Lu]Lu-ABD<sub>035</sub>-C9-C9-DOTAGA constructs demonstrated saturable, CEACAM5-dependent binding, with a minor difference in internalization rate (∼40% internalization after 24 h). In vivo, [<sup>177</sup>Lu]Lu-ABD<sub>035</sub>-C9-C9-DOTA showed significantly lower kidney uptake than the DOTAGA-conjugated variant. [<sup>177</sup>Lu]Lu-ABD<sub>035</sub>-C9-C9-DOTA demonstrated a significantly reduced renal uptake (14-fold, 4 h postinjection) and an increased uptake in BxPC3 xenografts (3.6-fold) compared with a [<sup>177</sup>Lu]Lu-C9-C9-DOTA reference construct without ABD<sub>035</sub> This experimental RPT study demonstrated a significant increase in the survival of tumor-bearing mice and mild, transient toxicity. <b>Conclusion:</b> ABD<sub>035</sub>-C9-C9-DOTA is a promising candidate for the development of targeted RPT of CEACAM5-expressing tumors.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932244","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}
Cornelis P van Stee, Bram van Leer, João Pinto Pereira, Katalin Tamasi, François Jamar, Riemer H J A Slart, Andor W J M Glaudemans, Maarten W N Nijsten, Mélanie Dechamps, Hildegard S Franke, Xavier Wittebole, Olivier Gheysens, Janesh Pillay
{"title":"Visualizing Persistent Inflammation and Occult Infections in Nonrecovering ICU Patients with [<sup>18</sup>F]FDG PET/CT: VIPER Study Protocol.","authors":"Cornelis P van Stee, Bram van Leer, João Pinto Pereira, Katalin Tamasi, François Jamar, Riemer H J A Slart, Andor W J M Glaudemans, Maarten W N Nijsten, Mélanie Dechamps, Hildegard S Franke, Xavier Wittebole, Olivier Gheysens, Janesh Pillay","doi":"10.2967/jnumed.126.272736","DOIUrl":"https://doi.org/10.2967/jnumed.126.272736","url":null,"abstract":"<p><p>The use of [<sup>18</sup>F]FDG PET/CT for detection of infectious and inflammatory foci in patients admitted to the intensive care unit (ICU) has gained interest as previous retrospective studies have shown promising results. [<sup>18</sup>F]FDG PET/CT in these studies was predominantly performed in patients with prolonged organ failure. These patients often acquire an immune dysregulated state, resulting in infectious complications impairing organ recovery. Early detection of infectious or inflammatory foci in this population may improve outcomes and reduce health care costs. We aim to explore the value of [<sup>18</sup>F]FDG PET in comparison to contrast-enhanced CT (ceCT) for the detection of infectious and inflammatory foci in patients with persistent critical illness. In addition, we will assess the influence of imaging findings on therapy changes after the scans and the relation between circulating biomarkers and [<sup>18</sup>F]FDG PET/CT findings. <b>Methods:</b> This study protocol describes a prospective, dual-center, international, head-to-head diagnostic comparison observational cohort study. Patients admitted to the ICU for at least 7 d with organ failure and persistently increased inflammatory parameters are eligible for inclusion. After inclusion, [<sup>18</sup>F]FDG PET/CT and ceCT will be performed simultaneously between day 8 and day 15 of ICU admission. For the primary endpoint, masked and standardized assessment of the scans will be ensured by exchanging the scans cross-over between both institutions. Primary outcome will be the incidence of findings for both imaging modalities, categorizing the results as PET-positive/CT-positive, PET-negative/CT-positive, PET-positive/CT-negative, or PET-negative/CT-negative. Direct clinical availability of the scans will allow for integration into decision-making. Therapy changes within 48 h after imaging will be recorded. Additionally, a questionnaire on the expected therapy plan and known or suspected foci is completed by the attending physician before the imaging procedure to better assess the impact of imaging on decision-making. Blood samples are taken on the day of inclusion and imaging. <b>Conclusion:</b> This first large prospective study will explore the application of [<sup>18</sup>F]FDG PET/CT compared with ceCT to image infectious and inflammatory foci in persistent critically ill patients. This study may help define the role of [<sup>18</sup>F]FDG PET/CT imaging in the ICU environment, supporting clinicians with an additional diagnostic tool for patient management.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932225","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}
Hidehiro Iida, Henrik B W Larsson, Ian Law, Hiroshi Fukuda, Pirjo Nuutila
{"title":"Regional Blood Flow Assessment in Total-Body Organs with Improved Temporal Resolution Using Long-Axial-Field-of-View PET.","authors":"Hidehiro Iida, Henrik B W Larsson, Ian Law, Hiroshi Fukuda, Pirjo Nuutila","doi":"10.2967/jnumed.125.270159","DOIUrl":"https://doi.org/10.2967/jnumed.125.270159","url":null,"abstract":"","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932294","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}