Gokce Belge Bilgin, Brian J Burkett, Cem Bilgin, Jacob J Orme, Daniel S Childs, Miguel Muniz Rincon, Ahmad S Abdelrazek, Derek R Johnson, Geoffrey B Johnson, Eugene D Kwon, Oliver Sartor, Ayse Tuba Kendi
{"title":"Neurologic Symptoms After <sup>177</sup>Lu-Prostate-Specific-Membrane Antigen-617 Therapy: A Single-Center Experience.","authors":"Gokce Belge Bilgin, Brian J Burkett, Cem Bilgin, Jacob J Orme, Daniel S Childs, Miguel Muniz Rincon, Ahmad S Abdelrazek, Derek R Johnson, Geoffrey B Johnson, Eugene D Kwon, Oliver Sartor, Ayse Tuba Kendi","doi":"10.2967/jnumed.124.267643","DOIUrl":"10.2967/jnumed.124.267643","url":null,"abstract":"<p><p>Treatment with <sup>177</sup>Lu-prostate-specific membrane antigen (PSMA)-617 (<sup>177</sup>Lu-vipivotide tetraxetan [Pluvicto]) prolongs both progression-free and overall survival in advanced PSMA-positive metastatic castration-resistant prostate cancer. Data examining specifically neurologic symptoms after <sup>177</sup>Lu-PSMA-617 treatment are scarce. In this study, we aimed to review the neurologic findings in a large cohort of metastatic castration-resistant prostate cancer patients undergoing <sup>177</sup>Lu-PSMA-617 therapy. <b>Methods:</b> The clinical records and imaging data of patients who received their initial dose of <sup>177</sup>Lu-PSMA-617 between March 2022 and November 2022 were retrospectively reviewed. All patients presenting for medical evaluation, regardless of specific specialty appointments, with new or worsening neurologic symptoms were included in the study. <b>Results:</b> A total of 185 patients underwent <sup>177</sup>Lu-PSMA-617 therapy. The median age was 70 y (range, 58-90 y). The mean follow-up time was 12.04 ± 2.87 mo. Fifty-five new or worsening neurologic symptoms were observed in 50 patients (27%, 50/185). Of these, 27 (11.9%, 27/185) reported altered taste. Eleven patients (6%, 11/185) experienced dizziness with no other clear etiology; 2 of these patients were admitted to the emergency department (ED). Paresthesia symptoms were reported in 6 patients (3.2%, 6/185). Five patients (2.7%, 5/185) reported headaches, 3 of these patients were admitted to the ED because of the severity of the symptoms. Two patients (1.08%, 2/185) presented with extremity weakness. Two patients (1.08%, 2/185) had an ischemic stroke and were admitted to the ED. One patient (0.05%, 1/185) exhibited gait disturbances. In total, 7 patients (3.78%, 7/185) were admitted to the ED because of neurologic symptoms. None of the patients discontinued or failed to complete the <sup>177</sup>Lu-PSMA-617 therapy because of neurologic symptoms. <b>Conclusion:</b> After <sup>177</sup>Lu-PSMA-617 treatment, the most common neurologic symptoms were dysgeusia and dizziness. In this study, our follow-up period and population size might not have been sufficient to detect delayed or uncommon neurologic symptoms. In patients without neurologic symptoms or central nervous system metastases before treatment, we found the development of severe neurologic problems to be rare and unlikely to require discontinuation of treatment.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":"1402-1408"},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141877008","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}
Jan J Duin, Hilda A de Barros, Pim J van Leeuwen, Henk G van der Poel
{"title":"Reply: Considerations Surrounding the Sentinel Lymph Node in Prostate Cancer and Unanswered Questions.","authors":"Jan J Duin, Hilda A de Barros, Pim J van Leeuwen, Henk G van der Poel","doi":"10.2967/jnumed.124.267658","DOIUrl":"10.2967/jnumed.124.267658","url":null,"abstract":"","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":"1497"},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763626","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}
John Nikitas, Angela Castellanos Rieger, Andrea Farolfi, Ameen Seyedroudbari, Amar U Kishan, Nicholas G Nickols, Michael L Steinberg, Luca F Valle, Matthew Rettig, Johannes Czernin, Jeremie Calais
{"title":"Prostate-Specific Membrane Antigen PET/CT-Guided, Metastasis-Directed Radiotherapy for Oligometastatic Castration-Resistant Prostate Cancer.","authors":"John Nikitas, Angela Castellanos Rieger, Andrea Farolfi, Ameen Seyedroudbari, Amar U Kishan, Nicholas G Nickols, Michael L Steinberg, Luca F Valle, Matthew Rettig, Johannes Czernin, Jeremie Calais","doi":"10.2967/jnumed.124.267922","DOIUrl":"10.2967/jnumed.124.267922","url":null,"abstract":"<p><p>Systemic treatments for metastatic castration-resistant prostate cancer (mCRPC) include androgen deprivation therapy, androgen receptor pathway inhibitors, chemotherapy, and radiopharmaceuticals, all of which have associated toxicity. Prostate-specific membrane antigen (PSMA) PET/CT allows for higher sensitivity in detecting metastatic disease than is possible with conventional imaging. We hypothesized that PSMA PET/CT-guided, metastasis-directed radiotherapy may offer durable disease control with low toxicity rates in patients with mCRPC who have a limited number of metastases. <b>Methods:</b> We retrospectively screened 5 prospective PSMA PET/CT studies for patients with mCRPC who had up to 5 sites of oligorecurrent or oligoprogressive disease on PSMA PET/CT and subsequently received definitive-intent, metastasis-directed radiotherapy to all new or progressing sites with concurrent androgen deprivation therapy. Progression-free survival, freedom from new lines of systemic therapy, and overall survival (OS) were calculated from the start of metastasis-directed radiotherapy using Kaplan-Meier analysis. Biochemical response was defined as at least a 50% decrease in prostate-specific antigen 6 mo after the start of treatment. Toxicity was graded using the Common Terminology Criteria for Adverse Events, version 5. <b>Results:</b> Twenty-four patients met the inclusion criteria with a median follow-up of 33.8 mo (interquartile range, 27.6-45.1 mo). Between October 2017 and April 2023, 11 patients (45.8%) had 1 treated site, 10 patients (41.7%) had 2, and 3 patients (12.5%) had 3. Five sites were prostate or prostate bed, 15 were nodal, 19 were osseous, and 1 was visceral. Seventeen patients (70.8%) continued their preexisting systemic therapy, whereas 7 (29.2%) started a new systemic therapy. Median progression-free survival was 16.4 mo (95% CI, 9.8-23.0 mo). The biochemical response rate was 66.7%. Median freedom from a new line of systemic therapy was 29.0 mo (95% CI, 7.6-50.4 mo). Median OS was not reached. The 2- and 4-y OS rates were 91.1% (95% CI, 79.3%-100%) and 68.8% (95% CI, 45.1%-92.5%), respectively. Grade 2 and grade 3 or higher toxicity rates were 4.2% and 0%, respectively. <b>Conclusion:</b> PSMA PET/CT-guided, metastasis-directed radiotherapy appears to offer durable disease control with low toxicity rates for oligometastatic castration-resistant prostate cancer. Further prospective studies are needed to compare metastasis-directed radiotherapy with systemic therapy versus systemic therapy alone and PSMA PET/CT-guided versus conventional imaging-guided radiotherapy.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":"1387-1394"},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141877010","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}
Robel K Gebre, Alexis Moscoso Rial, Sheelakumari Raghavan, Heather J Wiste, Fiona Heeman, Alejandro Costoya-Sánchez, Christopher G Schwarz, Anthony J Spychalla, Val J Lowe, Jonathan Graff-Radford, David S Knopman, Ronald C Petersen, Michael Schöll, Melissa E Murray, Clifford R Jack, Prashanthi Vemuri
{"title":"Advancing Tau PET Quantification in Alzheimer Disease with Machine Learning: Introducing THETA, a Novel Tau Summary Measure.","authors":"Robel K Gebre, Alexis Moscoso Rial, Sheelakumari Raghavan, Heather J Wiste, Fiona Heeman, Alejandro Costoya-Sánchez, Christopher G Schwarz, Anthony J Spychalla, Val J Lowe, Jonathan Graff-Radford, David S Knopman, Ronald C Petersen, Michael Schöll, Melissa E Murray, Clifford R Jack, Prashanthi Vemuri","doi":"10.2967/jnumed.123.267273","DOIUrl":"10.2967/jnumed.123.267273","url":null,"abstract":"<p><p>Alzheimer disease (AD) exhibits spatially heterogeneous 3- or 4-repeat tau deposition across participants. Our overall goal was to develop an automated method to quantify the heterogeneous burden of tau deposition into a single number that would be clinically useful. <b>Methods:</b> We used tau PET scans from 3 independent cohorts: the Mayo Clinic Study of Aging and Alzheimer's Disease Research Center (Mayo, <i>n</i> = 1,290), the Alzheimer's Disease Neuroimaging Initiative (ADNI, <i>n</i> = 831), and the Open Access Series of Imaging Studies (OASIS-3, <i>n</i> = 430). A machine learning binary classification model was trained on Mayo data and validated on ADNI and OASIS-3 with the goal of predicting visual tau positivity (as determined by 3 raters following Food and Drug Administration criteria for <sup>18</sup>F-flortaucipir). The machine learning model used region-specific SUV ratios scaled to cerebellar crus uptake. We estimated feature contributions based on an artificial intelligence-explainable method (Shapley additive explanations) and formulated a global tau summary measure, Tau Heterogeneity Evaluation in Alzheimer's Disease (THETA) score, using SUV ratios and Shapley additive explanations for each participant. We compared the performance of THETA with that of commonly used meta-regions of interest (ROIs) using the Mini-Mental State Examination, the Clinical Dementia Rating-Sum of Boxes, clinical diagnosis, and histopathologic staging. <b>Results:</b> The model achieved a balanced accuracy of 95% on the Mayo test set and at least 87% on the validation sets. It classified tau-positive and -negative participants with an AUC of 1.00, 0.96, and 0.94 on the Mayo, ADNI, and OASIS-3 cohorts, respectively. Across all cohorts, THETA showed a better correlation with the Mini-Mental State Examination and the Clinical Dementia Rating-Sum of Boxes (ρ ≥ 0.45, <i>P</i> < 0.05) than did meta-ROIs (ρ < 0.44, <i>P</i> < 0.05) and discriminated between participants who were cognitively unimpaired and those who had mild cognitive impairment with an effect size of 10.09, compared with an effect size of 3.08 for meta-ROIs. <b>Conclusion:</b> Our proposed approach identifies positive tau PET scans and provides a quantitative summary measure, THETA, that effectively captures heterogeneous tau deposition observed in AD. The application of THETA for quantifying tau PET in AD exhibits great potential.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":"1473-1480"},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763621","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}
Medhat M Osman, Amir Iravani, Catherine Mitchell, Rodney J Hicks, Elisa Perry, Michael S Hofman
{"title":"<sup>18</sup>F-DCFPyL PSMA PET/CT Tracheobronchial Uptake in Patients with Prostate Cancer: Incidence and Etiology.","authors":"Medhat M Osman, Amir Iravani, Catherine Mitchell, Rodney J Hicks, Elisa Perry, Michael S Hofman","doi":"10.2967/jnumed.124.267772","DOIUrl":"10.2967/jnumed.124.267772","url":null,"abstract":"<p><p>We evaluated the incidence and potential etiology of tracheobronchial uptake in patients being evaluated by <sup>18</sup>F-DCFPyL PET/CT for prostate cancer (PCa). <b>Methods:</b> The study included a consecutive 100 PCa patients referred for <sup>18</sup>F-DCFPyL PET/CT. The PET/CT scans were retrospectively reviewed. The presence or absence of physiologic tracheobronchial uptake on PET/CT was recorded. To further evaluate tracheal prostate-specific membrane antigen (PSMA) expression, immunohistochemistry was performed on tracheal samples taken from 2 men who had surgical resection of lung cancer. <b>Results:</b> Tracheal uptake was present in 31 of 100 patients (31%). When tracheal uptake was present, the SUV<sub>max</sub> was significantly higher in the left main bronchus (mean, 2.7) than in the right (mean, 2.3) (<i>P</i> < 0.001). Histopathologic testing of tracheobronchial samples showed PSMA expression in bronchial submucosal glands. <b>Conclusion:</b> In PCa patients undergoing <sup>18</sup>F-DCFPyL PET/CT, tracheobronchial uptake occurred in 31% of patients. This is attributed to normal physiologic PSMA expression in bronchial submucosal glands.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":"1383-1386"},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141877006","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}
Sofia H L Frost, Johnnie J Orozco, Tom A Bäck, Brian W Miller, Erlinda B Santos, Aimee Kenoyer, Sue E Knoblaugh, Donald K Hamlin, D Scott Wilbur, Brenda M Sandmaier
{"title":"<sup>211</sup>At-Labeled Anti-CD45 Antibody as a Nonmyeloablative Conditioning for Canine DLA-Haploidentical Stem Cell Transplantation.","authors":"Sofia H L Frost, Johnnie J Orozco, Tom A Bäck, Brian W Miller, Erlinda B Santos, Aimee Kenoyer, Sue E Knoblaugh, Donald K Hamlin, D Scott Wilbur, Brenda M Sandmaier","doi":"10.2967/jnumed.124.267540","DOIUrl":"10.2967/jnumed.124.267540","url":null,"abstract":"<p><p>The α-emitter <sup>211</sup>At deposits a high amount of energy within a few cell diameters, resulting in irreparable DNA double-strand breaks while minimizing off-target toxicity. We investigated the use of the <sup>211</sup>At-labeled anti-CD45 monoclonal antibody (mAb) <sup>211</sup>At-CD45-B10 as a nonmyeloablative conditioning regimen for dog-leukocyte-antigen-haploidentical hematopoietic cell transplantation. <b>Methods:</b> Seventeen healthy dogs were injected with either a 0.50 (<i>n</i> = 14) or 0.75 (<i>n</i> = 3) mg/kg dose of anti-CD45 mAb labeled with <sup>211</sup>At (8.436-23.199 MBq [0.228-0.627 mCi/kg]) on day -3. Peripheral blood stem cells from dog-leukocyte-antigen-haploidentical donors were given on day 0. Peripheral blood chimerism was calculated by polymerase chain reaction assays, and blood clearance of the radioimmunoconjugate was studied using enzyme-linked immunosorbent assay and radioactivity measurements of serial blood samples. <b>Results:</b> All dogs achieved donor chimerism by day 28 (range, 27%-100%). The hematopoietic engraftment rate was 100%, though engraftment durability was variable. No difference in absorbed dose to blood was seen for the 2 mAb dosing levels studied. Neutropenia (0-29 cells/μL), lymphocytopenia (36-130 cells/μL), and thrombocytopenia (1.5-9 × 10<sup>3</sup>/μL) with prompt recovery were observed. The main adverse nonhematologic event related to <sup>211</sup>At-CD45-B10 was mild reversible transaminitis. Graft-versus-host disease was not seen. Twelve of the 17 dogs survived over 30 d, with donor chimerism ranging from 3% to 99%. <b>Conclusion:</b> The results suggest that nonmyeloablative conditioning with <sup>211</sup>At-CD45-B10 could be used in haploidentical hematopoietic cell transplantation though with variable engraftment.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":"1443-1449"},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141725322","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}
Sherrington Li, Andrew Nguyen, William Counter, Nikeith C John, Jeremiah De Leon, George Hruby, Anthony M Joshua, Phillip Stricker, Megan Crumbaker, Narjess Ayati, Lyn Chan, Zahra Sabahi, Mina Swiha, Andrew Kneebone, Keith Wong, Victor Liu, Shikha Sharma, Shikha Agrawal, Louise M Emmett
{"title":"Utility of <sup>64</sup>Cu-Sarcophagine-Bombesin PET/CT in Men with Biochemically Recurrent Prostate Cancer and Negative or Equivocal Findings on <sup>68</sup>Ga-PSMA-11 PET/CT.","authors":"Sherrington Li, Andrew Nguyen, William Counter, Nikeith C John, Jeremiah De Leon, George Hruby, Anthony M Joshua, Phillip Stricker, Megan Crumbaker, Narjess Ayati, Lyn Chan, Zahra Sabahi, Mina Swiha, Andrew Kneebone, Keith Wong, Victor Liu, Shikha Sharma, Shikha Agrawal, Louise M Emmett","doi":"10.2967/jnumed.124.267881","DOIUrl":"10.2967/jnumed.124.267881","url":null,"abstract":"<p><p>Despite a high detection rate of <sup>68</sup>Ga-prostate-specific membrane antigen (PSMA) PET/CT in biochemical recurrence (BCR) of prostate cancer, a significant proportion of men have negative <sup>68</sup>Ga-PSMA-11 PET/CT results. Gastrin-releasing peptide receptor, targeted by the copper-chelated bombesin analog <sup>64</sup>Cu-sarcophagine-bombesin (SAR-BBN) PET/CT, is also overexpressed in prostate cancer. In this prospective imaging study, we investigate the detection rate of <sup>64</sup>Cu-SAR-BBN PET/CT in patients with BCR and negative or equivocal <sup>68</sup>Ga-PSMA-11 PET/CT results. <b>Methods:</b> Men with confirmed adenocarcinoma of the prostate, prior definitive therapy, and BCR (defined as a prostate-specific antigen [PSA] level > 0.2 ng/mL) with negative or equivocal <sup>68</sup>Ga-PSMA-11 PET/CT results within 3 mo were eligible for enrollment. <sup>64</sup>Cu-SAR-BBN PET/CT scans were acquired at 1 and 3 h after administration of 200 MBq of <sup>64</sup>Cu-SAR-BBN, with further delayed imaging undertaken optionally at 24 h. PSA (ng/mL) was determined at baseline. All PET (PSMA and bombesin) scans were assessed visually. Images were read with masking of the clinical results by 2 experienced nuclear medicine specialists, with a third reader in cases of discordance. Accuracy was defined using a standard of truth that included biopsy confirmation, confirmatory imaging, or response to targeted treatment. <b>Results:</b> Twenty-five patients were enrolled. Prior definitive therapy was radical prostatectomy (<i>n</i> = 24, 96%) or radiotherapy (<i>n</i> = 1, 4%). The median time since definitive therapy was 7 y (interquartile range [IQR], 4-11 y), and the Gleason score was 7 or less (<i>n</i> = 15, 60%), 8 (<i>n</i> = 3, 12%), or 9 (<i>n</i> = 7, 28%). The median PSA was 0.69 ng/mL (IQR, 0.28-2.45 ng/mL). Baseline PSMA PET scans were negative in 19 patients (76%) and equivocal in 6 (24%). <sup>64</sup>Cu-SAR-BBN PET-avid disease was identified in 44% (11/25): 12% (3/25) with local recurrence, 20% (5/25) with pelvic node metastases, and 12% (3/25) with distant metastases. The κ-score between readers was 0.49 (95% CI, 0.16-0.82). Patients were followed up for a median of 10 mo (IQR, 9-12 mo). Bombesin PET/CT results were true-positive in 5 of 25 patients (20%), false-positive in 2 of 25 (8%), false-negative in 7 of 25 (28%), and unverified in 11 of 25 (44%). <b>Conclusion:</b> <sup>64</sup>Cu-SAR-BBN PET/CT demonstrated sites of disease recurrence in 44% of BCR cases with negative or equivocal <sup>68</sup>Ga-PSMA-11 PET/CT results. Further evaluation to confirm diagnostic benefit is warranted.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":"1371-1375"},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141877012","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":"Unrealistic Data Augmentation Improves the Robustness of Deep Learning-Based Classification of Dopamine Transporter SPECT Against Variability Between Sites and Between Cameras.","authors":"Thomas Buddenkotte, Ralph Buchert","doi":"10.2967/jnumed.124.267570","DOIUrl":"10.2967/jnumed.124.267570","url":null,"abstract":"<p><p>We propose strongly unrealistic data augmentation to improve the robustness of convolutional neural networks (CNNs) for automatic classification of dopamine transporter SPECT against the variability between sites and between cameras. <b>Methods:</b> A CNN was trained on a homogeneous dataset comprising 1,100 <sup>123</sup>I-labeled 2β-carbomethoxy-3β-(4-iodophenyl)-<i>N</i>-(3-fluoropropyl)nortropane SPECT images using strongly unrealistic data augmentation based on gaussian blurring and additive noise. Strongly unrealistic data augmentation was compared with no augmentation and intensity-based nnU-Net augmentation on 2 independent datasets with lower (<i>n</i> = 645) and considerably higher (<i>n</i> = 640) spatial resolution. <b>Results:</b> The CNN trained with strongly unrealistic augmentation achieved an overall accuracy of 0.989 (95% CI, 0.978-0.996) and 0.975 (95% CI, 0.960-0.986) in the independent test datasets, which was better than that without (0.960, 95% CI, 0.942-0.974; 0.953, 95% CI, 0.934-0.968) and with nnU-Net augmentation (0.972, 95% CI, 0.956-0.983; 0.950, 95% CI, 0.930-0.966) (all McNemar <i>P</i> < 0.001). <b>Conclusion:</b> Strongly unrealistic data augmentation results in better generalization of CNN-based classification of <sup>123</sup>I-labeled 2β-carbomethoxy-3β-(4-iodophenyl)-<i>N</i>-(3-fluoropropyl)nortropane SPECT images to unseen acquisition settings. We hypothesize that this can be transferred to other nuclear imaging applications.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":"1463-1466"},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763630","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}
Akram Al-Ibraheem, Ahmed Abdlkadir, Dhuha Al-Adhami, Ken Herrmann
{"title":"[<sup>177</sup>Lu]Lu-DOTATATE May Resensitize Neuroendocrine Tumors to Hormonal Therapy: Initial Clinical Experience in Renal Carcinoid.","authors":"Akram Al-Ibraheem, Ahmed Abdlkadir, Dhuha Al-Adhami, Ken Herrmann","doi":"10.2967/jnumed.124.267497","DOIUrl":"10.2967/jnumed.124.267497","url":null,"abstract":"","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":"1494"},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961211","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":"Reply: The Potential Value of Functional Adrenal Imaging in Primary Aldosterone.","authors":"Xiang Li, Li Huo","doi":"10.2967/jnumed.124.268001","DOIUrl":"10.2967/jnumed.124.268001","url":null,"abstract":"","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":"1495-1496"},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763627","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}