PURPOSEWe previously proposed that a probability-based sympathetic 123I-meta-iodobenzylguanidine (mIBG) index (SMILe) could distinguish the presence or absence of Lewy body disease (LBD) based on findings at a single center. However, whether the model would be useful in the real world remained uncertain. Therefore, we updated and evaluated its performance at five Japanese and three European institutions.METHODSWe compared data from 967 patients with suspected LBD with 62 controls from a normal database (NDB). Of 815 patients with guideline-based diagnoses, 483 had LBD (Parkinson disease [PD] or dementia with Lewy bodies [DLB]) and 332 did not have LBD. Heart-to-mediastinum (H/M) ratios were standardized using a phantom-based method. Logistic regression models included early and late H/M ratios, age, sex, and comorbidities. We assessed diagnostic performance using ROC analysis and cross-validation.RESULTSThe updated model discriminated LBD from other diseases (AUC for early and late H/M, 0.880 0.899, respectively). Age correction of H/M ratios based on the NDB did not improve accuracy. Median early H/M ratios [SMILe probability] were 3.09 [12.8%] for NDB, 2.57 [37.5%] for Alzheimer disease, 1.76 [84.7%] for PD, and 1.62 [89.0%] for DLB, with significantly lower H/M ratios and higher probabilities in PD and DLB compared with controls (p < 0.0001). Late-phase imaging added value mainly in intermediate borderline (30%-70%) situations. Coronary artery disease attenuated the diagnostic performance of SMILe.CONCLUSIONThe probability-based 123I-mIBG model reliably differentiated LBD from other diseases. Standardization among sites supports global applicability and reflects real-world clinical practice.
{"title":"Multicenter development and validation of a probability-based model to diagnose Lewy body disease using ¹²³I-meta-iodobenzylguanidine.","authors":"Kenichi Nakajima,Junji Komatsu,Takeshi Matsumura,Satoshi Orimo,Mitsuhiro Yoshita,Viviana Frantellizzi,Maria Silvia De Feo,Gemma Greenfinch,Alan Thomas,Roberta Assante,Wanda Acampa,Naoki Shirasaki,Kunihiko Yokoyama,Hiroshi Wakabayashi,Moeko Noguchi-Shinohara,Kenjiro Ono,Seigo Kinuya","doi":"10.1007/s00259-025-07706-0","DOIUrl":"https://doi.org/10.1007/s00259-025-07706-0","url":null,"abstract":"PURPOSEWe previously proposed that a probability-based sympathetic 123I-meta-iodobenzylguanidine (mIBG) index (SMILe) could distinguish the presence or absence of Lewy body disease (LBD) based on findings at a single center. However, whether the model would be useful in the real world remained uncertain. Therefore, we updated and evaluated its performance at five Japanese and three European institutions.METHODSWe compared data from 967 patients with suspected LBD with 62 controls from a normal database (NDB). Of 815 patients with guideline-based diagnoses, 483 had LBD (Parkinson disease [PD] or dementia with Lewy bodies [DLB]) and 332 did not have LBD. Heart-to-mediastinum (H/M) ratios were standardized using a phantom-based method. Logistic regression models included early and late H/M ratios, age, sex, and comorbidities. We assessed diagnostic performance using ROC analysis and cross-validation.RESULTSThe updated model discriminated LBD from other diseases (AUC for early and late H/M, 0.880 0.899, respectively). Age correction of H/M ratios based on the NDB did not improve accuracy. Median early H/M ratios [SMILe probability] were 3.09 [12.8%] for NDB, 2.57 [37.5%] for Alzheimer disease, 1.76 [84.7%] for PD, and 1.62 [89.0%] for DLB, with significantly lower H/M ratios and higher probabilities in PD and DLB compared with controls (p < 0.0001). Late-phase imaging added value mainly in intermediate borderline (30%-70%) situations. Coronary artery disease attenuated the diagnostic performance of SMILe.CONCLUSIONThe probability-based 123I-mIBG model reliably differentiated LBD from other diseases. Standardization among sites supports global applicability and reflects real-world clinical practice.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"10 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145961408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-14DOI: 10.1007/s00259-025-07742-w
A El Ghalbouni,T J Snijders,N Tolboom,A J A T Braat
{"title":"Near complete response recurrent glioblastoma after treatment with [131I]-Iodofalan.","authors":"A El Ghalbouni,T J Snijders,N Tolboom,A J A T Braat","doi":"10.1007/s00259-025-07742-w","DOIUrl":"https://doi.org/10.1007/s00259-025-07742-w","url":null,"abstract":"","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"4 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145961410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-13DOI: 10.1007/s00259-025-07712-2
Magdalena Sophie Späth, Helmut Dittmann, Richard Spallek, Eduardo Calderón, Jonas Mück, Andreas Brendlin, Steffen Rausch, Christian la Fougère, Nils F. Trautwein
{"title":"PET-imaging derived prognostic factors for prostate cancer patients with visceral metastases receiving [177Lu]Lu-PSMA radiopharmaceutical therapy (RPT)","authors":"Magdalena Sophie Späth, Helmut Dittmann, Richard Spallek, Eduardo Calderón, Jonas Mück, Andreas Brendlin, Steffen Rausch, Christian la Fougère, Nils F. Trautwein","doi":"10.1007/s00259-025-07712-2","DOIUrl":"https://doi.org/10.1007/s00259-025-07712-2","url":null,"abstract":"","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"46 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145955126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-12DOI: 10.1007/s00259-025-07736-8
Otto M Henriksen,Oriol P Calvo,Frederik J Bruun,Marie Bruun,Steen G Hasselbalch,Kristian S Frederiksen,Adam E Hansen,Ian Law,Ulrich Lindberg
PURPOSETo assess the quantitative and visual concordance of multiple post-labelling delay (multi-PLD) arterial spin labelling (ASL) MRI cerebral blood flow (CBF) measurements and [18F]-fluoro-deoxyglucose (FDG) PET in a mixed memory clinic population.METHODSHybrid [18F]FDG PET/MRI including multi-PLD pseudo continuous ASL from 96 memory clinic patients and 38 elderly controls were analysed along with ASL data from 12 healthy young volunteers. ASL image interpretability, concordance with [18F]FDG PET, and value of Z-score maps were rated visually. Regional associations of CBF with [18F]FDG uptake ratio (SUVr) were investigated by univariate regression and mixed linear models. Also influences of age, disease stage and vascular pathology on ASL interpretability and concordance, and whole cortex spatial coefficient of variation (sCOV) were analysed.RESULTSASL CBF maps were non-comparable to [18F]FDG PET, i.e. uninterpretable or discordant, in 53% of patients, 37% of elderly controls, and 8% of young controls. Only 14% of patient ASL MRI scans were concordant with [18F]FDG PET. Z-score maps were mainly of value in partially concordant scans. Increasing sCOV was strongly associated both with disease severity and with decreasing ASL interpretability and concordance, and allowed for identification of uninterpretable scans with 95% sensitivity and 90% specificity. Whole cortex CBF and [18F]FDG SUVr values showed similar distribution across groups, but low to moderate regional associations.CONCLUSIONSMulti-PLD ASL provided quantitative CBF measurements correlating with disease severity, but poor image quality and low regional concordance in head-to-head comparison with [18F]FDG PET imaging restricts the clinical use in memory clinic patients.
{"title":"Simultaneous multiple post-labelling delay ASL MRI and [18F]FDG PET in a mixed memory clinic population and healthy controls.","authors":"Otto M Henriksen,Oriol P Calvo,Frederik J Bruun,Marie Bruun,Steen G Hasselbalch,Kristian S Frederiksen,Adam E Hansen,Ian Law,Ulrich Lindberg","doi":"10.1007/s00259-025-07736-8","DOIUrl":"https://doi.org/10.1007/s00259-025-07736-8","url":null,"abstract":"PURPOSETo assess the quantitative and visual concordance of multiple post-labelling delay (multi-PLD) arterial spin labelling (ASL) MRI cerebral blood flow (CBF) measurements and [18F]-fluoro-deoxyglucose (FDG) PET in a mixed memory clinic population.METHODSHybrid [18F]FDG PET/MRI including multi-PLD pseudo continuous ASL from 96 memory clinic patients and 38 elderly controls were analysed along with ASL data from 12 healthy young volunteers. ASL image interpretability, concordance with [18F]FDG PET, and value of Z-score maps were rated visually. Regional associations of CBF with [18F]FDG uptake ratio (SUVr) were investigated by univariate regression and mixed linear models. Also influences of age, disease stage and vascular pathology on ASL interpretability and concordance, and whole cortex spatial coefficient of variation (sCOV) were analysed.RESULTSASL CBF maps were non-comparable to [18F]FDG PET, i.e. uninterpretable or discordant, in 53% of patients, 37% of elderly controls, and 8% of young controls. Only 14% of patient ASL MRI scans were concordant with [18F]FDG PET. Z-score maps were mainly of value in partially concordant scans. Increasing sCOV was strongly associated both with disease severity and with decreasing ASL interpretability and concordance, and allowed for identification of uninterpretable scans with 95% sensitivity and 90% specificity. Whole cortex CBF and [18F]FDG SUVr values showed similar distribution across groups, but low to moderate regional associations.CONCLUSIONSMulti-PLD ASL provided quantitative CBF measurements correlating with disease severity, but poor image quality and low regional concordance in head-to-head comparison with [18F]FDG PET imaging restricts the clinical use in memory clinic patients.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"15 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-12DOI: 10.1007/s00259-025-07758-2
Luigi Mansi
{"title":"Kalevi Kairemo. Prostate cancer from a nuclear oncology perspective. A personal journey. Springer Nature Switzerland AG 2025, ISBN: 978-3-031-90336-6","authors":"Luigi Mansi","doi":"10.1007/s00259-025-07758-2","DOIUrl":"https://doi.org/10.1007/s00259-025-07758-2","url":null,"abstract":"","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"9 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145955132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-10DOI: 10.1007/s00259-025-07722-0
Phyo H. Khaing, Mark G. MacAskill, Jianfei Xiao, Shichao Liu, Zhuqin Gu, Xiaohiu Sun, Tao Xu, Norman Koglin, Andrew W. Stephens, David E. Newby, Yihui Guan, Holly McErlain, Andrew Sutherland, Gilles D. Tamagnan, Fang Xie, Adriana Alexandre S. Tavares
Purpose The 18 kDa translocator protein (TSPO) has been a central molecular target for imaging inflammation in the preclinical and clinical research settings across a plethora of applications, including neuroinflammation, cardiovascular inflammation and cancer. Recently, we reported the development of [ 18 F]LW223 as a third-generation TSPO positron emission tomography (PET) radiotracer with binding to human TSPO independent of the rs6971 genetic polymorphism. This study reports the first whole-body human analysis, including biodistribution and dosimetry calculations, following intravenous administration of [ 18 F]LW223. Methods Whole-body PET images were acquired over 250 min after intravenous bolus injection of 184.3 ± 20.2 MBq of [ 18 F]LW223 in healthy adult human volunteers. Volumes of interest (VOIs) in different source organs were manually delineated by three independent observers, then time-activity curves were generated for residency times calculations for subsequent quantification of radiation equivalent and effective doses using OLINDA/EXM 2.2 software. Results The radiotracer biodistribution in humans recapitulated known TSPO expression in various tissues. The main elimination route was found to be hepatobiliary, and the critical organ was the intestine. The cumulated radioactivity excreted by the kidneys was < 10% over the measurement period and no bone uptake suggestive of in vivo defluorination was observed in any of the study subjects. The effective dose ranged between 11.8 ± 0.9 and 12.5 ± 0.9 µSv/MBq. Inter-observer VOI variability had no impact on estimated organ and whole-body effective doses. Conclusion [ 18 F]LW223 is predominantly excreted by the hepatobiliary route with no evidence of in vivo defluorination but demonstrates marked uptake into tissues with known TSPO expression. It complies with radiation limits and guidelines recommended by regulatory authorities and is in line with previously reported [ 18 F]-labelled radiotracers, such as [ 18 F]fluorodeoxyglucose. [ 18 F]LW223 is suitable for translation into human clinical studies.
{"title":"First human whole-body biodistribution and dosimetry analysis of [18F]LW223, a novel TSPO PET radiotracer","authors":"Phyo H. Khaing, Mark G. MacAskill, Jianfei Xiao, Shichao Liu, Zhuqin Gu, Xiaohiu Sun, Tao Xu, Norman Koglin, Andrew W. Stephens, David E. Newby, Yihui Guan, Holly McErlain, Andrew Sutherland, Gilles D. Tamagnan, Fang Xie, Adriana Alexandre S. Tavares","doi":"10.1007/s00259-025-07722-0","DOIUrl":"https://doi.org/10.1007/s00259-025-07722-0","url":null,"abstract":"Purpose The 18 kDa translocator protein (TSPO) has been a central molecular target for imaging inflammation in the preclinical and clinical research settings across a plethora of applications, including neuroinflammation, cardiovascular inflammation and cancer. Recently, we reported the development of [ <jats:sup>18</jats:sup> F]LW223 as a third-generation TSPO positron emission tomography (PET) radiotracer with binding to human TSPO independent of the rs6971 genetic polymorphism. This study reports the first whole-body human analysis, including biodistribution and dosimetry calculations, following intravenous administration of [ <jats:sup>18</jats:sup> F]LW223. Methods Whole-body PET images were acquired over 250 min after intravenous bolus injection of 184.3 ± 20.2 MBq of [ <jats:sup>18</jats:sup> F]LW223 in healthy adult human volunteers. Volumes of interest (VOIs) in different source organs were manually delineated by three independent observers, then time-activity curves were generated for residency times calculations for subsequent quantification of radiation equivalent and effective doses using OLINDA/EXM 2.2 software. Results The radiotracer biodistribution in humans recapitulated known TSPO expression in various tissues. The main elimination route was found to be hepatobiliary, and the critical organ was the intestine. The cumulated radioactivity excreted by the kidneys was < 10% over the measurement period and no bone uptake suggestive of in vivo defluorination was observed in any of the study subjects. The effective dose ranged between 11.8 ± 0.9 and 12.5 ± 0.9 µSv/MBq. Inter-observer VOI variability had no impact on estimated organ and whole-body effective doses. Conclusion [ <jats:sup>18</jats:sup> F]LW223 is predominantly excreted by the hepatobiliary route with no evidence of in vivo defluorination but demonstrates marked uptake into tissues with known TSPO expression. It complies with radiation limits and guidelines recommended by regulatory authorities and is in line with previously reported [ <jats:sup>18</jats:sup> F]-labelled radiotracers, such as [ <jats:sup>18</jats:sup> F]fluorodeoxyglucose. [ <jats:sup>18</jats:sup> F]LW223 is suitable for translation into human clinical studies.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"13 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The predictive value of 18F-FAPI PET/CT and voxel-based tumor absorbed dose for the response and clinical outcome of unresectable hepatocellular carcinoma patients treated with Yttrium-90 resin microsphere selective internal radiation therapy","authors":"Huanyu Gong, Yong Cheng, Qiang Li, Yulong Liu, Jingjie Shang, Yingxin Li, Lu Kuang, Xueying Ling, Changjing Zuo, Lu Wang, Jian Gong, Hao Xu","doi":"10.1007/s00259-025-07717-x","DOIUrl":"https://doi.org/10.1007/s00259-025-07717-x","url":null,"abstract":"","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"363 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-10DOI: 10.1007/s00259-025-07724-y
Mick M. Welling, Cathryn H. S. Driver, Palesa C. Koatale, Tricia Naicker, Thomas Ebenhan
Multimodal imaging using hybrid imaging agents is a promising strategy for diagnosing and evaluating pathologies after image-guided surgical interventions. Combining optical and radioactive imaging techniques provides a comprehensive approach to monitoring and diagnosing infections, which would be more effective than routine nuclear clinical tracers for SPECT or PET imaging, thereby enabling more effective treatment as in image-guided surgery. This review summarizes the latest developments in hybrid imaging agents and vectors for radioactive and optical imaging of bacterial, fungal, and viral infections. We pinpoint the pitfalls in the current preclinical landscape for developing infection imaging tracers. Besides diagnosing and tracking pathogens, the role of optical imaging in diagnosing and aiding antimicrobial interventions, including image-guided surgery, is discussed. Finally, practical considerations are addressed for multimodal workflow challenges in preclinical infection imaging with hybrid tracers.
{"title":"Recent advances in multimodal imaging of infections: research highlights using Nuclear-Optical imaging","authors":"Mick M. Welling, Cathryn H. S. Driver, Palesa C. Koatale, Tricia Naicker, Thomas Ebenhan","doi":"10.1007/s00259-025-07724-y","DOIUrl":"https://doi.org/10.1007/s00259-025-07724-y","url":null,"abstract":"Multimodal imaging using hybrid imaging agents is a promising strategy for diagnosing and evaluating pathologies after image-guided surgical interventions. Combining optical and radioactive imaging techniques provides a comprehensive approach to monitoring and diagnosing infections, which would be more effective than routine nuclear clinical tracers for SPECT or PET imaging, thereby enabling more effective treatment as in image-guided surgery. This review summarizes the latest developments in hybrid imaging agents and vectors for radioactive and optical imaging of bacterial, fungal, and viral infections. We pinpoint the pitfalls in the current preclinical landscape for developing infection imaging tracers. Besides diagnosing and tracking pathogens, the role of optical imaging in diagnosing and aiding antimicrobial interventions, including image-guided surgery, is discussed. Finally, practical considerations are addressed for multimodal workflow challenges in preclinical infection imaging with hybrid tracers.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"57 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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