Nuclear Medicine and Molecular Imaging最新文献

[This corrects the article DOI: 10.1007/s13139-023-00831-4.].

Thyroid cancer, one of the most common endocrine tumors, generally has a favorable prognosis but remains a significant medical and societal concern due to its high incidence. Early diagnosis and treatment of differentiated thyroid cancer (DTC) significantly affect long-term outcomes, requiring the selection and application of appropriate initial treatments to improve prognosis and quality of life. Recent advances in technology and health information systems have enhanced our understanding of the molecular genetics of thyroid cancer, facilitating the identification of aggressive subgroups and enabling the accumulation of research on risk factors through big data. The Korean Thyroid Association (KTA) has revised the "KTA Guidelines on the Management of Differentiated Thyroid Cancers 2024" to incorporate these advances, which were developed by a multidisciplinary team and underwent extensive review and approval processes by various academic societies. This article summarizes the 2024 KTA guidelines for nuclear medicine imaging in patients with DTC, written by the Nuclear Medicine members of the KTA Guideline Committee, and covers ¹⁸F-FDG PET/CT and radioiodine imaging with SPECT/CT in the management of DTC.

Purpose: Prostate-specific membrane antigen (PSMA) Positron emission tomography/magnetic resonance imaging (PET/MRI) surpasses conventional MRI (cMRI) in prostate cancer (PCa) evaluation. Our objective is to evaluate correlation of quantitative parameters in PCa using Fluorine-18 (F-18) PSMA-1007 PET/MRI and their potential for predicting metastases.

Methods: This retrospective study included 51 PCa patients. Apparent diffusion coefficient (ADC), maximum standardized uptake value (SUVmax), PSMA total lesion uptake (PSMA-TLU), and PSMA total volume (PSMA-TV) were calculated in primary tumor. Correlation of ADC with other parameters was analyzed. Receiver Operating Characteristic curve analysis was conducted to determine optimal cut-off values for predicting metastases.

Results: ADC inversely correlated with SUVmax, PSMA-TLU, and PSMA-TV (p < 0.0001, < 0.0001, 0.0050, respectively). Lower ADC was associated with metastatic disease (p < 0.001). SUVmax, PSMA-TLU, PSMA-TV, SUVmax/ADC, PSMA-TLU/ADC, and PSMA-TV/ADC were higher in patients with metastases (p = 0.033 to < 0.001). PSMA-TLU/ADC and PSMA-TV/ADC best predicted metastases (sensitivity: 73.91% and 82.61%; specificity: 89.29% and 71.43%). PSMA-TLU, PSMA-TV, PSMA-TLU/ADC, and PSMA-TV/ADC were higher in patients with lymph node metastasis (p = 0.001 to 0.005). PSMA-TLU/ADC and PSMA-TV/ADC best predicted lymph node metastasis (sensitivity: 77.78% and 100%; specificity: 89.29% and 71.43%). SUVmax and SUVmax/ADC were higher in bone metastasis cases (p = 0.045), but their predictive value for bone metastasis was limited (Area under the curve (AUC): 0.634 and 0.652).

Conclusion: F-18 PSMA-1007 PET/MRI may improve diagnostic accuracy for primary PCa lesions by utilizing the inverse relationship between ADC and other parameters. Moreover, a strong correlation between such parameters and presence of metastasis holds prognostic value of this modality.

This guideline outlines the use of 3,4-dihydroxy-6-¹⁸F-fluoro-L-phenylalanine positron emission tomography / computed tomography for the diagnosis and management of neuroendocrine tumors, brain tumors, and other tumorous conditions. It provides detailed recommendations on patient preparation, imaging procedures, and result interpretation. Based on international standards and adapted to local clinical practices, the guideline emphasizes safety, quality control, and the effective application of 3,4-dihydroxy-6-¹⁸F-fluoro-L-phenylalanine positron emission tomography / computed tomography for various tumors such as insulinomas, pheochromocytomas, and medullary thyroid carcinoma. It also addresses the use of premedication with carbidopa, fasting protocols, and optimal imaging techniques. The aim is to assist nuclear medicine professionals in delivering precise diagnoses, improving patient outcomes, and accommodating evolving medical knowledge and technology. This comprehensive document serves as a practical resource to enhance the accuracy, quality, and safety of 3,4-dihydroxy-6-¹⁸F-fluoro-L-phenylalanine positron emission tomography / computed tomography in oncology.

[This corrects the article DOI: 10.1007/s13139-024-00871-4.].

Background this systematic review was conducted to assess the practical application of terbium radioisotopes, utilizing systematic search methodologies to identify relevant studies. Methods the databases of PubMed, Web of Science, and Scopus were systematically scoured, targeting the research on four terbium isotopes: ¹⁴⁹ Tb, ¹⁵² Tb, ¹⁵⁵ Tb, and ¹⁶¹ Tb. Various combinations of keywords related to terbium and its four radioisotopes were used in the search process. The search encompassed studies conducted up to July 27, 2024. Results following the removal of 335 duplicate research articles, a cohort of 429 papers was curated for potential inclusion in the study. Out of 429 articles reviewed, a mere nine addressed the potential uses of ¹⁶¹ Tb and ¹⁵² Tb. Notably, ¹⁵⁵ Tb and ¹⁴⁹ Tb have yet to be examined in human subjects. Conclusions the research trajectory is now veering towards clinical studies that provide in-human data, with the goal of advancing radiotheranostics and nuclear oncology. The preliminary outcomes are stimulating and have led to the initiation of several clinical trials. The success of these trials and the establishment of production facilities will be critical for the clinical adoption of these agents.

[This corrects the article DOI: 10.1007/s13139-024-00847-4.].

[This corrects the article DOI: 10.1007/s13139-024-00840-x.].

Abstract: This guideline outlines the use of ¹⁸F-fluoro-2-deoxyglucose positron emission tomography / computed tomography for the diagnosis and management of infectious and inflammatory diseases. It provides detailed recommendations for healthcare providers on patient preparation, imaging procedures, and the interpretation of results. Adapted from international standards and tailored to local clinical practices, the guideline emphasizes safety, quality control, and effective use of the technology in various conditions, including spinal infections, diabetic foot, osteomyelitis, vasculitis, and cardiac inflammation. The aim is to assist nuclear medicine professionals in delivering accurate diagnoses and improving patient outcomes while allowing flexibility to adapt to individual patient needs, technological advancements, and evolving medical knowledge. This document is a comprehensive resource for enhancing the quality and safety of ¹⁸F-fluoro-2-deoxyglucose positron emission tomography / computed tomography for the evaluation of infectious and inflammatory diseases.

Preamble: The Korean Society of Nuclear Medicine (KSNM) was established in 1961 to promote the clinical and technological advancement of nuclear medicine in South Korea, with members that include nuclear medicine physicians and associated scientists. The KSNM regularly formulates and revises procedural guidelines for nuclear medicine examinations to enhance the field and improve the quality of patient care. These guidelines are designed to support healthcare professionals in providing appropriate medical care to patients. However, they are not immutable rules or mandatory requirements for conducting examinations.Therefore, KSNM states that these guidelines should not be used in legal actions challenging a healthcare professional's medical decisions. The ultimate judgment regarding specific procedures or appropriate measures should be made by nuclear medicine physicians, considering the unique circumstances of each case. Deviation from these guidelines does not imply substandard medical practice. Rather, reasonable judgments differing from the guidelines can be made based on the patient's condition, available resources, and advancements in knowledge or technology. Due to the diversity and complexity of patients, it is often challenging to predict the most appropriate diagnostic and accurate therapeutic responses. Thus, adherence to these guidelines does not always guarantee an exact diagnosis or successful outcomes.The purpose of this guideline is to assist healthcare providers in making reasonable decisions and conducting effective and safe examinations based on current medical knowledge, available resources, and patient needs when performing 18F-fluoro-2-deoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) examinations for infectious/inflammatory diseases.

Purpose: ¹¹C-Methionine PET/CT is a promising method for detecting parathyroid lesions in patients with primary hyperparathyroidism (PHPT). We aimed to determine the diagnostic ability and correlation of digital ¹¹C-Methionine PET/CT for parathyroid lesions in patients with PHPT, particularly in cases where standard imaging methods yielded inconclusive results.

Methods: This retrospective analysis was conducted on patients diagnosed with PHPT who underwent digital ¹¹C-Methionine PET/CT imaging because of ambiguous results on standard imaging work-up (^99mTc-MIBI parathyroid scan and/or neck ultrasonography). Quantitative ¹¹C-Methionine PET/CT parameters, including maximum standardized uptake value (SUVmax), mean SUV (SUVmean), peak SUV (SUVpeak), parathyroid methionine volume (PMV), and whole methionine uptake (WMU: PMV multiplied by SUVmean) were calculated with various thresholds, and their correlations with biochemical and pathologic parameters were investigated.

Results: This study included 22 consecutive patients (10 men and 12 women) with a median age of 64.0 years. The lesion detection rate and sensitivity of digital ¹¹C-Methionine PET/CT were 81.8% (18/22) and 100.0% (18/18), respectively. Quantitative analysis revealed that serum PTH (r = 0.490, P = 0.039) and serum calcium (r = 0.583, P = 0.011) were significantly correlated with PMV50%.

Conclusion: Digital ¹¹C-Methionine PET/CT offers good performance in the detection of parathyroid lesions in PHPT patients with inconclusive standard imaging work-up. The volume parameter of PMV50% significantly correlated biochemical parameters and can serve as a complementary diagnostic tool.

Supplementary information: The online version contains supplementary material available at 10.1007/s13139-024-00878-x.