Nuclear Medicine Communications最新文献

Objectives: Cardiac resynchronization therapy (CRT) is an intervention for heart failure patients with reduced ejection fraction who exhibit specific electrocardiographic indicators of electrical dyssynchrony. However, electrical dyssynchrony does not universally correspond to left ventricular mechanical dyssynchrony (LVMD). Gated single-photon emission computed tomography (SPECT) myocardial perfusion allows for the assessment of LVMD, yet its role in the CRT selection process remains debated.

Methods: We conducted a systematic literature review to critically evaluate the evidence for the prediction and prognostic utility of SPECT for LVMD in assessing LVMD among CRT candidates. The review adhered to PRISMA 2020 Statement criteria and included articles from PubMed, Embase, and Cochrane databases. The quality of evidence was appraised using the Grading of Recommendations, Assessment, Development, and Evaluation framework.

Results: From an initial pool of 1055 records, 33 met the inclusion criteria and provided original data on the predictive value of myocardial perfusion SPECT for LVMD. Most of them measured LVMD according to established recommendations, focusing on phase histogram bandwidth (HBW) and phase histogram standard deviation (PSD). Out of 2066 patients from 27 studies, 62% ( n  = 1214) were qualified as CRT responders. Five studies reported SPECT-based cutoffs for predicting CRT response (HBW ranging 55°-152° and for PSD 20°-54°). Only five studies assessed the prognostic implications of baseline SPECT-measured LVMD, indicating that elevated baseline HBW and PSD values are associated with poorer outcomes.

Conclusion: The objective and reproducible measurement of LVMD provided by SPECT underscores its potential as a valuable tool. Such assessment seems to be emerging as a promising adjunctive technique with potential to enhance CRT outcomes.

A woman in her 70s presented with features of hyperandrogenism including clitoral enlargement and deepening of her voice. Biochemical investigations revealed raised plasma androgens and urinary androgen metabolites and imaging findings showed a highly F-18 fluorodeoxyglucose (FDG)-PET avid left adrenal tumour initially suspected to be a malignant adrenocortical carcinoma (ACC). She subsequently underwent an uncomplicated laparoscopic adrenalectomy where complete resection of her tumour was achieved. Histopathological analysis demonstrated a benign adrenal oncocytoma with no evidence of malignancy. This case illustrates a rare presentation of a functioning virilising adrenal oncocytoma as a benign mimic of ACC.

Objectives: To investigate the effects of selenium on functional and histopathological changes and mRNA expression levels of insulin-like growth factors 1 and 2 (IGF-1 and -2) and aquaporins 4 and 5 (AQP-4 and -5) in 131 I-induced damaged rat parotid glands.

Methods: Rats were divided into three groups: iodotherapy-with-selenium, iodotherapy-only, and control. Rats in the iodotherapy-with-selenium group were intragastrically administered 131 I on the first day and selenomethionine through drinking water. Rats in the iodotherapy-only group were only administered 131 I. Changes in parotid gland function were evaluated using the functional parameters of salivary gland dynamics imaging pre-experiment and on days 7, 30, and 90 post-treatment. Immunofluorescence and quantitative real-time PCR analyses detected IGF-1, IGF-2, AQP-4, and AQP-5 expression levels in tissues.

Results: The gland-to background ratio at a maximum count (G/BG max ), T max /T min , and S max values were significantly impacted over time in the iodotherapy-with-selenium group; on day 30, the G/BG max value was significantly higher than that in the iodotherapy-only group. Histopathological analysis revealed that on days 30 and 90, the iodotherapy-with-selenium group displayed greater parotid gland repair than the iodotherapy-only group. In the iodotherapy-with-selenium group, fluorescence intensity and mRNA levels of AQP-5 increased with the selenium supplementation period, reaching significantly higher levels on days 30 and 90 than in the iodotherapy-only group. Whereas the fluorescence intensity and mRNA levels of IGF-1 in the iodotherapy-with-selenium group were significantly higher on day 7 than on day 30 in the iodotherapy-only group.

Conclusion: Selenium may repair 131 I-induced tissue and functional damage in rat salivary glands by upregulating AQP-5 and IGF-1 expression.

Objective: The objective of this study is to evaluate and compare the clinical utility of 18 F-fluoro-2-deoxy-d-glucose PET and computed tomography ( 18 F-FDG PET/CT) in detecting recurrence and metastasis in patients with nasopharyngeal carcinoma (NPC) who exhibit elevated levels of Epstein-Barr virus (EBV) DNA following treatment.

Methods: A total of 103 patients with NPC were studied retrospectively. All patients were in remission following initial treatment. Elevated EBV DNA was found for the first time at review and 18 F-FDG PET/CT imaging was completed. The number of tracer lesions and the maximum standardized uptake value in the body region were recorded to evaluate the diagnostic ability of 18 F-FDG PET/CT. The final diagnosis was confirmed either through pathology or clinical follow-up lasting 6 months or longer.

Results: Out of the 103 patients, 97 patients had a total of 434 lesions that were ultimately diagnosed as recurrent or metastatic. In patient-based analyses, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 18 F-FDG PET/CT imaging were 100%, 50%, 97%, and 100%, respectively. In lesion-based analyses, the sensitivity, specificity, PPV, and NPV of 18 F-FDG PET/CT imaging were 99.3%, 30.3%, 94.9%, and 83.3%, respectively.

Conclusion: 18 F-FDG PET/CT demonstrates potential value in detecting recurrence and metastasis of NPC.

Purpose: Coronary artery disease (CAD) underestimation represents a major pitfall of single-photon emission computed tomography-myocardial perfusion imaging (SPECT-MPI). Coronary artery calcium score (CACS) has emerged as a sensitive tool for the assessment of suspect CAD; however, the integration of SPECT-MPI with CACS has been seldom evaluated, so far, and was therefore the aim of the present study.

Methods: Patients undergoing SPECT-MPI with CACS and subsequent coronary angiography were included. ROC curves were used to identify the CACS values best predictive for CAD. In SPECT-MPI negative patients, the formula: defined the optimal CACS cut-points. The Systematic Coronary Risk Evaluation 2 was applied for 10-year cardiovascular risk estimation. Significant CAD was defined for an epicardial coronary stenosis >70 or 50% for the left main.

Results: Among 124 patients, 61 (49.19%) displayed positive SPECT-MPI, whereas 69 (56%) had significant CAD at angiography. Sensitivity, specificity, and positive predictive value (PPV) for SPECT-MPI were, respectively, 74, 82, and 84%. Considering 63 SPECT-MPI negative cases, the index values for CACS at the optimal cutoff value of 1949 were: sensitivity 28%, specificity 89%, and PPV 50%, allowing to further detect five (8%) of the patients with significant CAD. The increased discriminative power of the combined SPECT-MPI with CACS was not conditioned by the pretest cardiovascular risk.

Conclusion: Among patients with suspect CAD undergoing SPECT-MPI, the addition of CACS in negative cases allows to detect a consistent further 8% of patients with significant CAD, thus limiting the risk of disease underestimation and offering potential prognostic benefits.

Treatment with radioactive drugs (molecular radiotherapy, MRT) is an option for selected children with neuroblastoma and neuroendocrine cancers. As few hospitals are appropriately equipped and staffed to provide paediatric MRT, many families have to travel long distances from home for prolonged periods. To improve professional understanding of the challenges faced by children receiving these treatments and their parents, and to help them appreciate the difficulties faced by professionals in delivering complex treatments, a meeting bringing together parents, patients and professionals was held. Ten people (five parents of children with neuroblastoma, two parents of children with neuroendocrine cancers, two adults who had received treatment for neuroendocrine cancers in childhood and one adult treated for neuroblastoma) gave personal perspectives of treatment with MRT. Three professionals from different disciplines involved with this treatment and research to improve its results gave their views on the administration of MRT, and how treatment outcomes might be improved. Fifteen people, including parents and professionals, contributed to the general discussion. Following the meeting, a questionnaire was circulated to those attending to capture their overall views, and any reflections they may have had after the meeting. Whilst many positive comments and compliments were received, this report focuses on the reported challenges and difficulties. The event is an example of meaningful Patient and Public Involvement and Engagement and has resulted in development of better information resources, strategies to mitigate inconveniences experienced and a standing group of advocates to advise on research design and acceptability.

Purpose: The primary objective of this study was to explore the prognostic significance of serum cholinesterase (CHE) and metabolic parameters obtained from 18 F-fluorodeoxyglucose (FDG) PET/computed tomography (CT) scans in patients with non-small cell lung cancer (NSCLC).

Methods: A retrospective observational cohort study was conducted with 202 NSCLC patients. Serum CHE was evaluated alongside metabolic tumor volume (MTV) and total lesion glycolysis (TLG) derived from PET/CT scans. The correlation between these parameters and overall survival (OS) was analyzed using log-rank tests, as well as univariate and multivariate Cox regression analyses. A nomogram prediction model was developed and assessed using time-dependent receiver operating characteristic curves, calibration curves, and decision curve analysis (DCA).

Results: High MTV (≥16) and TLG (≥108) were found to be significantly correlated with worse OS outcomes (both P < 0.001), whereas lower CHE levels (<6818) were associated with worse OS ( P = 0.002). A multivariate analysis revealed that MTV, TLG, serum CHE, and the presence of distant metastasis were independent prognostic factors for OS. The nomogram prediction model, incorporating these variables, exhibited strong predictive performance, as indicated by area under the curve values of 0.826, 0.796, and 0.845 for 1-, 3-, and 5-year OS predictions, respectively. Calibration curves demonstrated good concordance between predicted and observed survival rates, and DCA confirmed clinical relevance.

Conclusions: Serum CHE and 18 F-FDG PET/CT metabolic parameters may serve as important prognostic indicators for patients with NSCLC. The integration of these factors into a nomogram prediction model can assist in clinical decision-making and patient risk stratification.

The study aim was to evaluate whether reducing bed position acquisition time would result in significant detriment to image quality. Secondary aims were to compare effect of time of flight (TOF) and Q.Clear reconstructions and patient BMI on image quality. Fluorodeoxyglucose PET-CT performed in 30 patients on a new scanner at our institution between March and May 2024 was retrospectively evaluated. Four PET reconstructions were performed: (a) 1 min 45 s TOF, (b) 2 min TOF, (c) 1 min 45 s Q.Clear, and (d) 2 min Q.Clear. For qualitative analysis, four maximum intensity projection images were evaluated side-by-side using a five-point visual score (1 = non-diagnostic, 5 = excellent). For quantitative analysis, liver signal-to-noise ratio (SNR) was calculated. A statistically significant reduction in visual score occurred when reducing bed position time from 2 min to 1 min 45 s (mean TOF scores 0.24 reduction, P = 0.0002; mean Q.Clear scores 0.04 reduction, P  = 0.02. There was also a statistically significant difference in liver SNR when reducing bed position time. Deterioration in image quality was minimised when bed position acquisition time was reduced if Q.Clear construction was utilized. This could facilitate increased scanning capacity without clinical detriment.

Purpose: Prediction of epidermal growth factor receptor (EGFR) mutation status and subtypes in patients with non-small cell lung cancer (NSCLC) based on 18 F-fluorodeoxyglucose ( 18 F-FDG) PET/computed tomography (CT) radiomics features.

Patients and methods: Retrospective analysis of 201 NSCLC patients with 18 F-FDG PET/CT and EGFR genetic testing was carried out. Radiomics features and clinical factors were used to construct a combined model for identifying EGFR mutation status. Mutation/wild-type models were trained in a training cohort ( n  = 129) and validated in an internal validation cohort ( n  = 41) vs an external validation cohort ( n  = 50). A second model predicting the 19/21 mutation locus was also built and evaluated in a subset of EGFR mutations (training cohort, n  = 55; validation cohort, n  = 14). The predictive performance and net clinical benefit of the models were assessed by analysis of the area under curve (AUC) of the subjects, nomogram, calibration curve and decision curve.

Results: The AUC of the combined model distinguishing EGFR mutation status was 0.864 in the training cohort and 0.806 and 0.791 in the internal vs external test sets respectively, and the AUC of the 19/21 mutation site model was 0.971 and 0.867 in the training cohort and internal validation cohort respectively. The calibration curves of the individual models showed better model predictions (Brier score <0.25). Decision curve analysis showed that the models had clinical application.

Conclusion: The combined model based on 18 F-FDG PET/CT radiomics features combined and clinical features can predict EGFR mutation status and subtypes in NSCLC patients, and guiding targeted therapy, and facilitate precision medicine development.

Objectives: Parkinson's disease (PD) is a neurodegenerative disorder with distinct metabolic alterations in the brain, which are detectable via 18 F-FDG PET. This study aims to delineate glucose metabolism patterns and network topology changes across early- and mid-stage PD patients.

Methods: A total of 80 PD patients (Hoehn-Yahr stages 1-3) were retrospectively analyzed, including 40 early-stage and 40 mid-stage cases, along with 40 age-matched healthy controls. All participants underwent 18 F-FDG PET imaging. The brain metabolic activity was quantified, and network topology was assessed using graph theory metrics. Statistical comparisons between PD stages and control groups were performed to identify significant differences in metabolic patterns and network alterations.

Results: Early-stage PD patients exhibited hypermetabolism in regions such as the pons and thalamus, with significant differences in metabolic activity compared with controls. Mid-stage PD patients showed more extensive hypermetabolism in the pons, right cerebellum, and putamen, alongside hypometabolism in the cuneus and calcarine regions. Hub node connectivity analysis revealed decreased connectivity in temporal and occipital lobes for both stages, while the limbic and frontal lobes showed enhanced connectivity. Compared with early-stage PD, mid-stage PD had reduced connectivity in the limbic system but increased in the frontal and occipital lobes.

Conclusions: 18 F-FDG PET imaging reveals progressive metabolic disruptions and network changes in PD, offering potential biomarkers for disease staging and therapeutic targeting, while also aiding in the understanding of disease progression and guiding therapeutic interventions.