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Y90 radioembolization in advanced liver cancer of rarely treated tumor entities: prediction of treatment response and survival by clinical and imaging features. 晚期肝癌很少治疗的肿瘤实体的Y90放射栓塞:通过临床和影像学特征预测治疗反应和生存
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-01-01 Epub Date: 2025-10-30 DOI: 10.1097/MNM.0000000000002070
Carola Maria Bregenzer, Bianca Herm, Christine March, Maximilian Thormann, Romy Damm, Jazan Omari, Maciej Pech, Robert Damm

Background: Radioembolization is classically used in patients with hepatocellular carcinoma and secondary hepatic malignancies like colorectal cancer and neuroendocrine tumors. Up to now, data for other hepatic metastasized tumor entities are rare, and it is not clear which clinical and imaging features could predict the outcome.

Methods: Data of 60 patients exceptionally treated with radioembolization through the decision of an interdisciplinary board with tumor entities usually not treated by radioembolization were retrospectively analyzed. Hepatic features on cross-sectional preprocedural imaging, for example, like hypervascularization, hepatic tumor burden, maximum diameter, and clinical data, were also analyzed during follow-up. Predictive factors were calculated.

Results: Univariate Cox regression showed a significant impact of different features on overall survival, for example, primary malignancy histology in the case of sarcoma, with 25 months median vs. 6 months median overall survival ( P  = 0.015). Multivariate Cox regression revealed the two key factors for overall survival: arterial hypervascularization more than rim enhancement (15 vs. 6 months, P  = 0.011, hazard ratio: 0.339) and hepatic tumor burden below 10% (18 vs. 5 months, P  < 0.001, hazard ratio: 1.04).

Conclusion: Preprocedural hypervascularization of liver malignancies and hepatic tumor burden are overall survival predicting factors in tumor entities rarely treated by radioembolization. Consideration of these factors can help to carry out suitable patient selection in the interdisciplinary board for radioembolization.

背景:放射栓塞是肝细胞癌和继发性肝脏恶性肿瘤(如结直肠癌和神经内分泌肿瘤)的经典治疗方法。到目前为止,其他肝转移性肿瘤实体的资料很少,尚不清楚哪些临床和影像学特征可以预测预后。方法:回顾性分析60例通常不采用放射栓塞治疗的肿瘤实体通过跨学科委员会的决定而例外接受放射栓塞治疗的患者的资料。在随访期间,我们还分析了手术前横断面影像上的肝脏特征,如血管增生、肝脏肿瘤负荷、最大直径和临床资料。计算预测因子。结果:单因素Cox回归显示,不同特征对总生存期有显著影响,如肉瘤的原发恶性组织学,中位总生存期为25个月,中位总生存期为6个月(P = 0.015)。多因素Cox回归分析显示,影响患者总生存期的两个关键因素是动脉血管增生大于边缘增强(15个月vs. 6个月,P = 0.011,风险比:0.339)和肝脏肿瘤负荷低于10%(18个月vs. 5个月,P)。结论:术前肝恶性肿瘤血管增生和肝脏肿瘤负荷是很少接受放射栓塞治疗的肿瘤患者总生存期的预测因素。综合考虑这些因素有助于在放射栓塞的跨学科委员会中进行合适的患者选择。
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引用次数: 0
Impact of acquisition timing and background uptake on [ 131 I]meta-iodobenzylguanidine SPECT/CT interpretation in pheochromocytoma and adrenal adenoma. 获取时间和背景摄取对嗜铬细胞瘤和肾上腺腺瘤[131I]间碘苄基胍SPECT/CT解释的影响。
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-01-01 Epub Date: 2025-10-22 DOI: 10.1097/MNM.0000000000002062
Wei Liu, Yuyue Feng, Rui Zuo, Hua Pang

Objective: Pheochromocytoma is an intra-adrenal sympathetic paraganglioma that carries an inherent potential for metastasis, although such events are seldom encountered. Its clinical symptoms and signs are nonspecific. Early and precise identification is essential for effective clinical management and treatment; however, the diagnostic accuracy of pheochromocytoma is influenced by multiple factors, and studies addressing these influences remain limited. This study aimed to investigate the impact of different imaging backgrounds and acquisition times on the diagnostic performance of [ 131 I]meta-iodobenzylguanidine ([ 131 I]MIBG) single-photon emission computed tomography (SPECT)/computed tomography (CT) in differentiating pheochromocytoma from adrenocortical adenoma.

Methods: This retrospective study included 67 patients who had not undergone adrenal surgery before enrollment, underwent [ 131 I]MIBG SPECT/CT, and subsequently received surgical treatment within 2-5 months after imaging, with all lesions histopathologically confirmed. [ 131 I]MIBG SPECT/CT scans were acquired for each patient at different acquisition time points and under varying imaging conditions. Clinical characteristics and imaging data were collected and analyzed to evaluate the diagnostic performance of [ 131 I]MIBG SPECT/CT in differentiating pheochromocytoma.

Results: Significant differences in semiquantitative values of [ 131 I]MIBG SPECT/CT were observed for the same lesion across different imaging backgrounds and acquisition times ( P < 0.0001). The highest diagnostic performance for pheochromocytoma was achieved when the liver was used as the imaging background and images were acquired 48 h postinjection, yielding an area under the curve greater than 0.95. In addition, other imaging parameters also contributed to improving diagnostic accuracy.

Conclusion: Optimizing imaging background and acquisition time significantly enhances the diagnostic performance of [ 131 I]MIBG SPECT/CT for pheochromocytoma, facilitating timely and effective patient management.

目的:嗜铬细胞瘤是一种肾上腺内交感副神经节瘤,具有固有的转移潜力,尽管这种事件很少发生。其临床症状和体征是非特异性的。早期和准确的识别对于有效的临床管理和治疗至关重要;然而,嗜铬细胞瘤的诊断准确性受到多种因素的影响,针对这些影响的研究仍然有限。本研究旨在探讨不同成像背景和采集时间对[131I]间碘苄基胍([131I]MIBG)单光子发射计算机断层扫描(SPECT)/计算机断层扫描(CT)鉴别嗜铬细胞瘤和肾上腺皮质腺瘤诊断性能的影响。方法:本回顾性研究纳入67例入组前未接受肾上腺手术的患者,经[131I]MIBG SPECT/CT检查,并在成像后2-5个月内接受手术治疗,所有病变均经组织病理学证实。[131I]在不同的采集时间点和不同的成像条件下,对每位患者进行MIBG SPECT/CT扫描。收集临床特征及影像学资料进行分析,评价[131I]MIBG SPECT/CT对嗜铬细胞瘤的鉴别诊断价值。结果:在不同成像背景和采集时间下,同一病灶的[131I]MIBG SPECT/CT半定量值存在显著差异(P < 0.0001)。以肝脏为成像背景,注射后48小时获取图像,曲线下面积大于0.95时,嗜铬细胞瘤的诊断性能最高。此外,其他影像学参数也有助于提高诊断准确性。结论:优化成像背景和采集时间可显著提高[131I]MIBG SPECT/CT对嗜铬细胞瘤的诊断效能,促进患者及时有效的管理。
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引用次数: 0
99mTc-labeled antibiotics for infection imaging along with diagnostic potential: a comparative study of cephalosporin and fluoroquinolone. 99mtc标记抗生素用于感染成像及其诊断潜力:头孢菌素和氟喹诺酮的比较研究。
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-01-01 Epub Date: 2025-12-09 DOI: 10.1097/MNM.0000000000002063
Xiaodi Shen, Ying Jiang, Maryam Mehmood, Momna Warraich, Rida Sana, Bakhtawer Amin, Rubaida Mehmood

Background: Technetium-99m (Tc-99m)-labeled cefixime, ceftriaxone, and ciprofloxacin are explored for stable, effective radiopharmaceutical infection imaging agents.

Objective: This study optimizes Tc-99m labeling of antibiotics, evaluating stability, effectiveness, and infection imaging suitability.

Methods: TcO₄⁻ was reduced with stannous chloride to label antibiotics; scanning electron microscope, ITLC, Fourier transform infrared spectroscopy, HPLC, and biodistribution studies confirmed purity, labeling efficacy, and infection specificity.

Results: Tc-99m labeling of cefixime was performed at a concentration of 5 mg/ml, using 120 µl of SnCl₂ solution (96 µg) as the reducing agent, with the pH adjusted to 4.34 using 1N NaOH. For ciprofloxacin, the concentration was 7.5 mg/ml, with 120 µl of SnCl₂ solution (96 µg) and a pH of 4.5. Ceftriaxone was radiolabeled at 5 mg/ml, using 120 µl of SnCl₂·2H₂O (50 µg) and a pH of 6.8. Radiochemical binding was monitored for 3 h to assess stability. The labeled drugs were administered to mice for SPECT scintigraphy to assess biodistribution, confirm infection imaging, and evaluate their diagnostic potential.

Conclusion: This study examines 99mTc labeling of cefixime, ceftriaxone, and ciprofloxacin, achieving high binding efficiency. It compares their potential in infection imaging, distinguishing infections from inflammation, and exploring therapeutic applications.

背景:探讨了锝-99m (Tc-99m)标记的头孢克肟、头孢曲松和环丙沙星作为稳定、有效的放射性药物感染显像剂。目的:优化Tc-99m抗生素标记,评价其稳定性、有效性和感染成像的适宜性。方法:用氯化亚锡还原TcO₄来标记抗生素;扫描电镜、ITLC、傅里叶变换红外光谱、高效液相色谱和生物分布研究证实了其纯度、标记效果和感染特异性。结果:头孢克肟的Tc-99m标记浓度为5 mg/ml,使用120µl SnCl₂溶液(96µg)作为还原剂,使用1N NaOH调节pH为4.34。对于环丙沙星,浓度为7.5 mg/ml,加入120µl SnCl₂溶液(96µg), pH为4.5。头孢曲松以5 mg/ml放射性标记,使用120µl SnCl₂·2H₂O(50µg), pH为6.8。监测放射化学结合3小时以评估稳定性。将标记的药物给予小鼠进行SPECT显像,以评估生物分布,确认感染成像,并评估其诊断潜力。结论:本研究检测了头孢克肟、头孢曲松和环丙沙星的99mTc标记,具有较高的结合效率。它比较了它们在感染成像、区分感染和炎症以及探索治疗应用方面的潜力。
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引用次数: 0
Retrospective analysis of [ 99m Tc]Tc-HYNIC-PSMA single photon emission computed tomography CT in patients with prostate cancer. [99mTc]Tc-HYNIC-PSMA单光子发射CT在前列腺癌患者中的回顾性分析。
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-01-01 Epub Date: 2025-10-07 DOI: 10.1097/MNM.0000000000002060
Olof Jonmarker, Michael Sunderland, Lotte Steffens, Carl Samuelsson, Darin O'Keeffe, Janvi Puri, Stefan Erik Olof Gabrielson

Objective: Prostate cancer is one of the most common malignancies in men. While multiparametric MRI is the gold standard for local staging of prostate cancer, accessibility may be limited. The same is true for Prostate Specific Membrane Antigen (PSMA) PET/computed tomography (CT). This study evaluates the diagnostic performance of [ 99m Tc]Tc-PSMA single photon emission computed tomography (SPECT) as an alternative molecular imaging modality.

Methods: This retrospective study of 82 patients with newly diagnosed prostate cancer compares the performance of [ 99m Tc]Tc-PSMA SPECT/CT with multiple readers, with MRI, and with respect to histopathological correlation from biopsies. SPECT/CT findings were evaluated both locally, using a standardised 12-segment prostate model, and with respect to metastases. Agreement between modalities and readers was measured using intraclass correlation and Cohen's kappa.

Results: PSMA SPECT/CT identified clinically relevant prostate lesions with the best interreader agreement for bone metastases and laterality, and poorest agreement for extraprostatic extension and seminal vesicle invasion. Sector-based comparison showed PSMA SPECT/CT to have comparable detection rates to MRI. Higher SPECT standardised uptake values (SUV) were associated with stronger concordance with biopsy results, higher than both the low SPECT SUV group and clinical MRI readings.

Conclusion: [ 99m Tc]Tc-PSMA SPECT/CT demonstrates promise as an alternative to MRI in the primary staging of prostate cancer, particularly in high SPECT SUV settings. While MRI remains more sensitive for local extension, PSMA SPECT may offer complementary value in comprehensive staging, especially in a resource-limited setting.

目的:前列腺癌是男性最常见的恶性肿瘤之一。虽然多参数MRI是前列腺癌局部分期的金标准,但可及性可能有限。前列腺特异性膜抗原(PSMA) PET/计算机断层扫描(CT)也是如此。本研究评估了[99mTc]Tc-PSMA单光子发射计算机断层扫描(SPECT)作为一种替代的分子成像方式的诊断性能。方法:对82例新诊断的前列腺癌患者进行回顾性研究,比较[99mTc]Tc-PSMA SPECT/CT与多读卡器、MRI和活检组织病理学相关性的表现。使用标准化的12节段前列腺模型对局部SPECT/CT结果和转移灶进行评估。模式和读者之间的一致性使用班级内相关和Cohen’s kappa进行测量。结果:PSMA SPECT/CT识别出临床相关的前列腺病变,其中骨转移和侧侧性的解释器一致性最好,前列腺外展和精囊侵犯的解释器一致性最差。基于扇区的比较显示PSMA SPECT/CT的检出率与MRI相当。较高的SPECT标准化摄取值(SUV)与活检结果的一致性较强,高于低SPECT SUV组和临床MRI读数。结论:[99mTc]Tc-PSMA SPECT/CT在前列腺癌的初级分期中,特别是在高SPECT SUV环境中,有望替代MRI。虽然MRI对局部扩展更敏感,但PSMA SPECT在全面分期方面可能提供补充价值,特别是在资源有限的情况下。
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引用次数: 0
The clinical value of interim PET/computed tomography scanning in patients with classical Hodgkin's lymphoma and its influence on prognosis in Duhok Province, Kurdistan Region - Northern Iraq. 杜胡克省库尔德斯坦地区-伊拉克北部地区经典霍奇金淋巴瘤患者中期PET/ ct扫描的临床价值及其对预后的影响
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-01-01 Epub Date: 2025-10-30 DOI: 10.1097/MNM.0000000000002065
Tamara Qais Faraja, Zeki A Mohamedb

Background: Classical Hodgkin's lymphoma (cHL) is a largely curable cancer, although a percentage of patients experience recurrence or treatment failure. Interim PET(iPET)/computed tomography (CT) scanning after 2-4 rounds of adriamycin, bleomycin, vinblastine, and dacarbazine chemotherapy has emerged as a useful predictor of treatment response and survival. The current study aimed to assess the prognostic significance of iPET/CT in patients with cHL treated at Azadi Hematology Oncology Center in Duhok Province, Kurdistan Region, and compare the results to worldwide data.

Methods: This retrospective analysis comprised 53 patients who had histologically proven cHL treatment between January 2020 and March 2024. PET/CT scans were performed on all patients at the intermediate and end of therapy stages. Deauville scoring was used to categorize the replies. Kaplan-Meier analysis was used to determine survival results.

Results: Interim complete metabolic response (iCR, Deauville 1-3) was observed in 83% of patients, with a corresponding end-of-treatment complete response rate of 93.2%. Patients with iCR had significantly improved overall survival (OS) and progression-free survival (PFS) compared to those with partial response or no response/progression (OS: P  = 0.001; PFS: P  < 0.001). The concordance rate between iPET/CT and final response was 90.6%.

Conclusion: iPET/CT is a reliable prognostic indicator in cHL and significantly correlates with OS and PFS. The findings support its use in response-adapted therapy in resource-limited settings like Duhok. These results align with international studies, reinforcing the utility of iPET/CT in guiding treatment modifications.

背景:经典霍奇金淋巴瘤(cHL)是一种很大程度上可治愈的癌症,尽管有一定比例的患者复发或治疗失败。2-4轮阿霉素、博来霉素、长春碱和达卡巴嗪化疗后的中期PET(iPET)/计算机断层扫描(CT)扫描已成为治疗反应和生存的有用预测指标。目前的研究旨在评估iPET/CT对库尔德地区杜胡克省Azadi血液肿瘤中心治疗的cHL患者的预后意义,并将结果与全球数据进行比较。方法:回顾性分析了2020年1月至2024年3月期间经组织学证实的53例cHL治疗患者。在治疗中期和结束时对所有患者进行PET/CT扫描。多维尔评分用于对回答进行分类。Kaplan-Meier分析用于确定生存结果。结果:83%的患者观察到中期完全代谢缓解(iCR, Deauville 1-3),相应的治疗结束完全缓解率为93.2%。与部分缓解或无缓解/进展患者相比,iCR患者的总生存期(OS)和无进展生存期(PFS)显著改善(OS: P = 0.001; PFS: P)结论:iPET/CT是cHL可靠的预后指标,与OS和PFS显著相关。研究结果支持将其用于像杜霍克这样资源有限的环境中的反应适应治疗。这些结果与国际研究一致,加强了iPET/CT在指导治疗修改方面的效用。
{"title":"The clinical value of interim PET/computed tomography scanning in patients with classical Hodgkin's lymphoma and its influence on prognosis in Duhok Province, Kurdistan Region - Northern Iraq.","authors":"Tamara Qais Faraja, Zeki A Mohamedb","doi":"10.1097/MNM.0000000000002065","DOIUrl":"10.1097/MNM.0000000000002065","url":null,"abstract":"<p><strong>Background: </strong>Classical Hodgkin's lymphoma (cHL) is a largely curable cancer, although a percentage of patients experience recurrence or treatment failure. Interim PET(iPET)/computed tomography (CT) scanning after 2-4 rounds of adriamycin, bleomycin, vinblastine, and dacarbazine chemotherapy has emerged as a useful predictor of treatment response and survival. The current study aimed to assess the prognostic significance of iPET/CT in patients with cHL treated at Azadi Hematology Oncology Center in Duhok Province, Kurdistan Region, and compare the results to worldwide data.</p><p><strong>Methods: </strong>This retrospective analysis comprised 53 patients who had histologically proven cHL treatment between January 2020 and March 2024. PET/CT scans were performed on all patients at the intermediate and end of therapy stages. Deauville scoring was used to categorize the replies. Kaplan-Meier analysis was used to determine survival results.</p><p><strong>Results: </strong>Interim complete metabolic response (iCR, Deauville 1-3) was observed in 83% of patients, with a corresponding end-of-treatment complete response rate of 93.2%. Patients with iCR had significantly improved overall survival (OS) and progression-free survival (PFS) compared to those with partial response or no response/progression (OS: P  = 0.001; PFS: P  < 0.001). The concordance rate between iPET/CT and final response was 90.6%.</p><p><strong>Conclusion: </strong>iPET/CT is a reliable prognostic indicator in cHL and significantly correlates with OS and PFS. The findings support its use in response-adapted therapy in resource-limited settings like Duhok. These results align with international studies, reinforcing the utility of iPET/CT in guiding treatment modifications.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"115-120"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12695281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145346494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A novel ventricular systolic workload index enhances prognostic evaluation using gated single photon emission computed tomography in patients with suspected coronary artery disease. 一种新的心室收缩负荷指数增强了门控单光子发射计算机断层扫描对疑似冠状动脉疾病患者的预后评估。
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-01-01 Epub Date: 2025-10-15 DOI: 10.1097/MNM.0000000000002064
Guillermo Romero-Farina, Santiago Aguadé-Bruix, Azahara Palomar-Muñoz, María Jesús Diez-Castro, Cristina Gámez-Cenzano, Jaume Candell-Riera, Ignacio Ferreira-González, Charles David Cooke, Ernest V Garcia

Objective: We aimed to create a new combined left ventricular (LV) systolic function index (left ventricular systolic workload index: LEVESWI-1 and LEVESWI-2) in a gated single-photon emission computed tomography (gSPECT) study to estimate major adverse cardiovascular events (MACE: nonfatal myocardial infarction or cardiac death).

Methods: We analyzed 2727 consecutive patients with suspected coronary artery disease who underwent gSPECT (age 63.82 ± 11, male 60.73%). LEVESWI was obtained through the relationship between LV end-systolic volume (ESV), noninvasive SBP measurement, body surface area, approximate noninvasive LV systolic pressure, and stress heart rate (stress-HR). (LEVESWI-1 = ESV-index × 8.5/stress-HR; LEVESWI-2 = SBP × 0.9/stress-HR). During a follow-up of 3.85 ± 2.7 years, MACE were evaluated. Multivariate Cox regression analysis (MCRA) and receiver operating characteristic curve analysis were used.

Results: In MCRA age greater than 66 years (hazard ratio: 3.29, P  < 0.001); diabetes (hazard ratio: 1.86, P  = 0.008), ST-segment depression greater than or equal to 1 mm (hazard ratio : 1.95, P  = 0.005), METs less than 6.08 (hazard ratio: 1.85, P  = 0.029), LV ejection fraction less than or equal to 57% (hazard ratio: 2.4, P  = 0.005), summed stress score greater than 6 (hazard ratio: 2.32, P  = 0.002), LEVESWI-1 greater than 1.46 mmHg/ml/m²/bpm (hazard ratio: 2.18, P  = 0.017) and LEVESWI-2 greater than 1.34 mmHg/m²/bpm (hazard ratio: 1.98, P  = 0.01) were the independent predictors of MACE (Harell's C -statistic: 0.85; Akaike information criterion: 1003.64). The index LEVESWI was the principal predictor of MACE and improved the stratification of Vall-d'Hebron-Risk-Score-II for detecting MACE (net reclassification improvement: 85.5%; P  < 0.001).

Conclusions: LEVESWI is a new tool that incorporates key hemodynamic variables and offers a better perspective of ventricular systolic function as an independent predictor of MACE.

目的:我们的目的是在门控单光子发射计算机断层扫描(gSPECT)研究中创建一个新的联合左心室(LV)收缩功能指数(左心室收缩负荷指数:LEVESWI-1和LEVESWI-2)来估计主要不良心血管事件(MACE:非致死性心肌梗死或心源性死亡)。方法:我们分析了2727例连续行gSPECT的疑似冠状动脉疾病患者(年龄63.82±11岁,男性60.73%)。LEVESWI通过左室收缩末容积(ESV)、无创收缩压测量、体表面积、无创左室近似收缩压和应激心率(stress- hr)之间的关系获得。(LEVESWI-1 = ESV-index × 8.5/stress-HR; LEVESWI-2 = SBP × 0.9/stress-HR)。随访3.85±2.7年,评估MACE。采用多变量Cox回归分析(MCRA)和受试者工作特征曲线分析。结果:在MCRA年龄大于66岁的患者中(风险比:3.29,P)结论:LEVESWI是一种新的工具,结合了关键的血流动力学变量,可以更好地预测心室收缩功能,作为MACE的独立预测因子。
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引用次数: 0
Awareness of the high rate of false positive [ 68 Ga]Ga-prostate specific membrane antigen-11 uptake in the prostate gland: can PET/MRI solve this problem? 对前列腺假阳性[68Ga] ga -前列腺特异性膜抗原-11摄取率高的认识:PET/MRI能解决这一问题吗?
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-01-01 Epub Date: 2025-10-23 DOI: 10.1097/MNM.0000000000002071
Lebriz Uslu-Beşli, Bariş Bakir, Nil Urganci, İclal Gürses, Emre Karayel, Hüseyin Pehlivanoğlu, Sevda Özel-Yildiz, Çetin Demirdağ, Haluk Burçak Sayman

Objective: To assess the false positive gallium-68-labeled urea-based prostate-specific membrane antigen ( 68 Ga-PSMA) uptake rate in the prostate gland in patients with primary prostate cancer (PCa), and determine whether multiparametric prostate MRI (mpMRI) within hybrid PET/MRI can reduce false positives.

Methods: Fifty-one treatment-naive patients with PCa undergoing radical prostatectomy were prospectively recruited. All underwent 68 Ga-PSMA-11 PET/MRI with mpMRI. Images were assessed independently by the nuclear medicine physicians and radiologist using PRIMARY score and PIRADS v2.1, then jointly as fused PET/MRI. Radical prostatectomy followed imaging after a mean interval of 46 ± 32 days. Imaging findings were compared with postoperative histological mapping. Prostate was divided into sextants for lesion localization, and false positive uptake was recorded. Diagnostic performance metrics were calculated.

Results: Seven of 51 patients (13.7%) exhibited false positive PSMA uptake because of benign findings - asymmetrical central zone thickening, benign prostatic hyperplasia, or prostatitis. mpMRI was true negative in all. PET/MRI showed higher sensitivity and accuracy (74.9 and 83.0%) than PET (65.0 and 74.5%) and mpMRI (66.5 and 77.5%). For index lesion detection, PET/MRI had 92.2% sensitivity, outperforming PET (80.4%) and mpMRI (86.3%). PET/MRI was significantly more accurate than mpMRI ( P  < 0.001) and PET ( P  = 0.014), while PET and mpMRI were similar ( P  = 0.770).

Conclusion: False positive 68 Ga-PSMA uptake is common and can affect clinical decisions, including focal therapy or recurrence assessment after radiotherapy. mpMRI helps clarify benign mimics, improving diagnostic accuracy. PET/MRI may offer more reliable assessment of PCa, potentially aiding focal therapy planning and posttreatment evaluation.

目的:评估原发性前列腺癌(PCa)患者前列腺中镓-68标记的前列腺特异性膜抗原(68Ga-PSMA)摄取率的假阳性情况,并确定PET/MRI混合中多参数前列腺MRI (mpMRI)是否能减少假阳性。方法:前瞻性招募51例接受根治性前列腺切除术的前列腺癌患者。所有患者均行68Ga-PSMA-11 PET/MRI和mpMRI检查。图像由核医学医师和放射科医师使用PRIMARY评分和PIRADS v2.1独立评估,然后联合进行PET/MRI融合。平均间隔时间46±32天,行根治性前列腺切除术。将影像学结果与术后组织学作图进行比较。前列腺分六分仪定位病变,记录假阳性摄取。计算诊断性能指标。结果:51例患者中有7例(13.7%)表现出PSMA摄取假阳性,因为良性发现-不对称中心区增厚,良性前列腺增生或前列腺炎。mpMRI均为真阴性。PET/MRI的灵敏度和准确度分别为74.9%和83.0%,高于PET(65.0和74.5%)和mpMRI(66.5和77.5%)。对于指数病变的检测,PET/MRI的灵敏度为92.2%,优于PET(80.4%)和mpMRI(86.3%)。结论:68Ga-PSMA假阳性摄取是常见的,并可影响临床决策,包括局灶性治疗或放疗后复发评估。mpMRI有助于澄清良性模拟,提高诊断准确性。PET/MRI可能提供更可靠的PCa评估,可能有助于局灶性治疗计划和治疗后评估。
{"title":"Awareness of the high rate of false positive [ 68 Ga]Ga-prostate specific membrane antigen-11 uptake in the prostate gland: can PET/MRI solve this problem?","authors":"Lebriz Uslu-Beşli, Bariş Bakir, Nil Urganci, İclal Gürses, Emre Karayel, Hüseyin Pehlivanoğlu, Sevda Özel-Yildiz, Çetin Demirdağ, Haluk Burçak Sayman","doi":"10.1097/MNM.0000000000002071","DOIUrl":"10.1097/MNM.0000000000002071","url":null,"abstract":"<p><strong>Objective: </strong>To assess the false positive gallium-68-labeled urea-based prostate-specific membrane antigen ( 68 Ga-PSMA) uptake rate in the prostate gland in patients with primary prostate cancer (PCa), and determine whether multiparametric prostate MRI (mpMRI) within hybrid PET/MRI can reduce false positives.</p><p><strong>Methods: </strong>Fifty-one treatment-naive patients with PCa undergoing radical prostatectomy were prospectively recruited. All underwent 68 Ga-PSMA-11 PET/MRI with mpMRI. Images were assessed independently by the nuclear medicine physicians and radiologist using PRIMARY score and PIRADS v2.1, then jointly as fused PET/MRI. Radical prostatectomy followed imaging after a mean interval of 46 ± 32 days. Imaging findings were compared with postoperative histological mapping. Prostate was divided into sextants for lesion localization, and false positive uptake was recorded. Diagnostic performance metrics were calculated.</p><p><strong>Results: </strong>Seven of 51 patients (13.7%) exhibited false positive PSMA uptake because of benign findings - asymmetrical central zone thickening, benign prostatic hyperplasia, or prostatitis. mpMRI was true negative in all. PET/MRI showed higher sensitivity and accuracy (74.9 and 83.0%) than PET (65.0 and 74.5%) and mpMRI (66.5 and 77.5%). For index lesion detection, PET/MRI had 92.2% sensitivity, outperforming PET (80.4%) and mpMRI (86.3%). PET/MRI was significantly more accurate than mpMRI ( P  < 0.001) and PET ( P  = 0.014), while PET and mpMRI were similar ( P  = 0.770).</p><p><strong>Conclusion: </strong>False positive 68 Ga-PSMA uptake is common and can affect clinical decisions, including focal therapy or recurrence assessment after radiotherapy. mpMRI helps clarify benign mimics, improving diagnostic accuracy. PET/MRI may offer more reliable assessment of PCa, potentially aiding focal therapy planning and posttreatment evaluation.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"88-98"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145346453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Combining the prognostic values of entropy-based heterogeneity features from 18F-fluorodeoxyglucose PET and transmission computed tomography using machine learning in patients with lung adenocarcinoma undergoing curative surgery. 结合18f -氟脱氧葡萄糖PET和使用机器学习的透射计算机断层扫描在接受治疗性手术的肺腺癌患者中的基于熵的异质性特征的预后价值。
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-12-25 DOI: 10.1097/MNM.0000000000002098
Kun-Han Lue, Yu-Hung Chen, Sung-Chao Chu, Chih-Bin Lin, Bee-Song Chang, Pau-Yuan Chang, Shu-Hsin Liu

Objective: The objective of this study is to evaluate the combined prognostic values of 18F-fluorodeoxyglucose (18F-FDG) PET and computed tomography (CT)-derived entropy-based heterogeneity features from hybrid PET/CT scanner using machine learning in patients with lung adenocarcinoma undergoing curative surgery.

Methods: Presurgical 18F-FDG PET/CT from 131 patients with lung adenocarcinoma were divided into training (n = 92) and temporal validation (n = 39) cohorts. In the training cohort, we integrated entropy-based heterogeneity features from 18F-FDG PET/CT for disease-free survival (DFS) prediction using machine learning approach. The predictive value of clinical variables and 18F-FDG PET/CT-based machine learning for DFS was examined using Cox regression analyses, and independent prognosticators were used to develop the survival prediction model. The model was then tested in the temporal validation cohort.

Results: In the training cohort, 18F-FDG PET/CT-based machine learning, female sex, and pN status independently predicted DFS. The model, incorporating these predictors significantly predicted DFS in the training (hazard ratio = 1.483, P < 0.001) and validation cohorts (hazard ratio = 1.753, P < 0.001). This model outperformed traditional staging system in both cohorts (c-indices = 0.717 vs. 0.621 in training; and 0.728 vs. 0.644 in validation). The model also predicted overall survival in both cohorts (hazard ratio = 1.370, P < 0.001 in training; hazard ratio = 1.574, P = 0.017 in validation).

Conclusion: Our preliminary results suggest that integrating prognostic values from 18F-FDG PET and CT-based heterogeneity features with clinical prognosticators is feasible and may support personalized treatment strategies for patients with resectable lung adenocarcinoma.

目的:本研究的目的是评估18f -氟脱氧葡萄糖(18F-FDG) PET和计算机断层扫描(CT)基于熵的异质性特征的混合PET/CT扫描仪使用机器学习在接受根治性手术的肺腺癌患者中的预后价值。方法:131例肺腺癌患者的术前18F-FDG PET/CT分为训练组(n = 92)和时间验证组(n = 39)。在训练队列中,我们使用机器学习方法整合了18F-FDG PET/CT的基于熵的异质性特征,用于无病生存(DFS)预测。采用Cox回归分析检验临床变量和基于18F-FDG PET/ ct的机器学习对DFS的预测价值,并采用独立预测因子建立生存预测模型。然后在时间验证队列中对该模型进行测试。结果:在训练队列中,基于PET/ ct的18F-FDG机器学习、女性性别和pN状态独立预测DFS。结论:我们的初步结果表明,将18F-FDG PET和基于ct的异质性特征的预后值与临床预后指标相结合是可行的,并可能为可切除肺腺癌患者的个性化治疗策略提供支持。
{"title":"Combining the prognostic values of entropy-based heterogeneity features from 18F-fluorodeoxyglucose PET and transmission computed tomography using machine learning in patients with lung adenocarcinoma undergoing curative surgery.","authors":"Kun-Han Lue, Yu-Hung Chen, Sung-Chao Chu, Chih-Bin Lin, Bee-Song Chang, Pau-Yuan Chang, Shu-Hsin Liu","doi":"10.1097/MNM.0000000000002098","DOIUrl":"https://doi.org/10.1097/MNM.0000000000002098","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to evaluate the combined prognostic values of 18F-fluorodeoxyglucose (18F-FDG) PET and computed tomography (CT)-derived entropy-based heterogeneity features from hybrid PET/CT scanner using machine learning in patients with lung adenocarcinoma undergoing curative surgery.</p><p><strong>Methods: </strong>Presurgical 18F-FDG PET/CT from 131 patients with lung adenocarcinoma were divided into training (n = 92) and temporal validation (n = 39) cohorts. In the training cohort, we integrated entropy-based heterogeneity features from 18F-FDG PET/CT for disease-free survival (DFS) prediction using machine learning approach. The predictive value of clinical variables and 18F-FDG PET/CT-based machine learning for DFS was examined using Cox regression analyses, and independent prognosticators were used to develop the survival prediction model. The model was then tested in the temporal validation cohort.</p><p><strong>Results: </strong>In the training cohort, 18F-FDG PET/CT-based machine learning, female sex, and pN status independently predicted DFS. The model, incorporating these predictors significantly predicted DFS in the training (hazard ratio = 1.483, P < 0.001) and validation cohorts (hazard ratio = 1.753, P < 0.001). This model outperformed traditional staging system in both cohorts (c-indices = 0.717 vs. 0.621 in training; and 0.728 vs. 0.644 in validation). The model also predicted overall survival in both cohorts (hazard ratio = 1.370, P < 0.001 in training; hazard ratio = 1.574, P = 0.017 in validation).</p><p><strong>Conclusion: </strong>Our preliminary results suggest that integrating prognostic values from 18F-FDG PET and CT-based heterogeneity features with clinical prognosticators is feasible and may support personalized treatment strategies for patients with resectable lung adenocarcinoma.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145889382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Preoperative loco-regional assessment of prostate carcinoma using multi-parametric MRI and prostate-specific membrane antigen PET-computed tomography: correlation with histopathology. 术前使用多参数MRI和前列腺特异性膜抗原pet计算机断层扫描评估前列腺癌的局部区域:与组织病理学的相关性。
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-12-25 DOI: 10.1097/MNM.0000000000002101
Hira Lal, Devesh Malik, Anuradha Singh, Raghunandan Prasad, Sanjoy Sureka, Aftab Hasan Nazar, Vinita Agarwal, Jai Kishun, Priyank Yadav, Pinky Jowel

Objectives: The objective of this study is to evaluate the efficacy of multi-parametric MRI (mpMRI) and prostate-specific membrane antigen (PSMA) PET-computed tomography (CT) in preoperative loco-regional assessment of prostate carcinoma, correlating findings with histopathology.

Materials and methods: This prospective observational study enrolled 44 men (mean age 67.5 years) with suspected localized prostate cancer. All participants underwent mpMRI and PSMA PET-CT scans prior to histopathological confirmation via transrectal ultrasound-guided biopsies or radical prostatectomy. Imaging results were analyzed for sensitivity, specificity, and agreement with histopathology using Cohen's Kappa statistic. Key parameters, such as Prostate Imaging Reporting and Data System (PI-RADS) scores (mpMRI) and maximum standardized uptake (SUVmax) values (PSMA PET-CT), were correlated with Gleason scores.

Results: MpMRI exhibited a sensitivity of 95% and specificity of 50%, while PSMA PET-CT achieved 96.3% sensitivity and 57.1% specificity. MpMRI showed strong agreement with histopathology for tumor site localization (Kappa = 0.760), surpassing PSMA PET-CT (Kappa = 0.651). PSMA PET-CT identified metastases in 27.2% of cases, while mpMRI detected extra-prostatic extension in 50%. Higher PI-RADS scores and SUVmax values were associated with increased Gleason scores, indicating aggressive disease.

Conclusion: Both mpMRI and PSMA PET-CT offer high sensitivity for prostate cancer detection. MpMRI is superior for local staging, while PSMA PET-CT excels in identifying distant metastases. Their combined application enhances diagnostic accuracy and supports improved preoperative risk stratification in prostate carcinoma management.

目的:本研究的目的是评估多参数磁共振成像(mpMRI)和前列腺特异性膜抗原(PSMA) pet计算机断层扫描(CT)在前列腺癌术前局部区域评估中的有效性,并将结果与组织病理学相关联。材料和方法:这项前瞻性观察性研究招募了44名疑似局限性前列腺癌的男性(平均年龄67.5岁)。所有参与者在经直肠超声引导活检或根治性前列腺切除术前进行mpMRI和PSMA PET-CT扫描。使用Cohen’s Kappa统计分析成像结果的敏感性、特异性和与组织病理学的一致性。关键参数,如前列腺成像报告和数据系统(PI-RADS)评分(mpMRI)和最大标准化摄取(SUVmax)值(PSMA PET-CT),与Gleason评分相关。结果:MpMRI的敏感性为95%,特异性为50%;PSMA PET-CT的敏感性为96.3%,特异性为57.1%。MpMRI结果与组织病理学结果吻合较好(Kappa = 0.760),优于PSMA PET-CT (Kappa = 0.651)。PSMA PET-CT在27.2%的病例中发现转移,而mpMRI在50%的病例中发现前列腺外延伸。较高的PI-RADS评分和SUVmax值与Gleason评分升高相关,表明疾病侵袭性。结论:mpMRI和PSMA PET-CT对前列腺癌的检测均具有较高的灵敏度。MpMRI在局部分期方面优于PSMA PET-CT,而PSMA PET-CT在确定远处转移方面优于PSMA PET-CT。它们的联合应用提高了诊断的准确性,并支持前列腺癌管理的术前风险分层。
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引用次数: 0
Added value of delayed imaging after diuretic injection in evaluation of cases of bladder cancer with PET. 利尿剂注射后延迟显像在PET评价膀胱癌病例中的价值。
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-12-01 Epub Date: 2025-10-15 DOI: 10.1097/MNM.0000000000002056
Doaa Ibrahim, Alshaymaa Abdelghaffar, Emad Eldin Nabil Hassan

Background: The clinical utility of 18 F-fluorodeoxyglucose (FDG) PET/computed tomography (PET/CT) imaging in bladder cancer is often compromised by high urinary FDG accumulation, which can interfere with the accurate detection of primary tumors and metastatic sites. This study aimed to evaluate the added benefit of delayed PET/CT imaging after diuretic administration in patients with bladder cancer, focusing on its ability to overcome the limitations posed by high FDG excretion into the bladder.

Methods: This prospective study was conducted at the Sohag Oncology Center, Egypt, and included patients with pathologically confirmed bladder cancer between March 2022 and March 2024. All patients underwent dual-phase PET/CT imaging, with early-phase imaging performed 45-90 min after the 18 F-FDG injection, followed by delayed imaging 1 h later after administering intravenous furosemide (20 mg) and enhanced hydration. The PET/CT images were analyzed qualitatively and quantitatively, with a maximum standardized uptake value (SUV max ) used to assess tumor activity in both early and delayed phases. Results were validated through biopsy, a combination of MRI and clinical follow-up for at least 6 months, or both.

Results: A total of 39 patients were included in the study (33 males, 6 females, aged 42-80 years). Residual bladder lesions were observed in 12.8% of the early images and 58.9% of the delayed images, with a significant increase in SUV max ( P  = 0.018). Lymph node involvement was detected in 12 patients, showing a similar rise in SUVmax ( P  = 0.012). Also, delayed PET/CT imaging improved sensitivity for both bladder lesions and metastatic lymph nodes (92.6 and 93%, respectively), while maintaining specificity (100% for bladder lesions, 74% for lymph nodes).

Conclusion: Delayed PET/CT postdiuretic administration improves image quality in bladder cancer via reducing urinary radiotracer activity, thus minimizing bladder interference and improving lesion detectability and characterization.

背景:18f -氟脱氧葡萄糖(FDG) PET/计算机断层扫描(PET/CT)在膀胱癌中的临床应用常常受到尿中FDG高积累的影响,这可能干扰原发肿瘤和转移部位的准确检测。本研究旨在评估膀胱癌患者使用利尿剂后延迟PET/CT成像的附加益处,重点关注其克服膀胱中大量FDG排泄所带来的限制的能力。方法:这项前瞻性研究在埃及Sohag肿瘤中心进行,纳入了2022年3月至2024年3月期间病理证实的膀胱癌患者。所有患者都进行了双期PET/CT成像,在18F-FDG注射后45-90分钟进行早期成像,在静脉注射呋塞米(20mg)并加强水合作用后1小时延迟成像。定性和定量分析PET/CT图像,使用最大标准化摄取值(SUVmax)评估早期和延迟期肿瘤活性。结果通过活检、MRI联合临床随访至少6个月或两者同时进行验证。结果:共纳入39例患者,其中男性33例,女性6例,年龄42 ~ 80岁。12.8%的早期图像和58.9%的延迟图像观察到残留的膀胱病变,SUVmax显著增加(P = 0.018)。在12例患者中检测到淋巴结受累,显示SUVmax相似的升高(P = 0.012)。此外,延迟PET/CT成像提高了膀胱病变和转移性淋巴结的敏感性(分别为92.6%和93%),同时保持特异性(膀胱病变100%,淋巴结74%)。结论:利尿后延迟PET/CT给药可通过降低尿放射性示踪剂活性改善膀胱癌图像质量,从而减少膀胱干扰,提高病变的可检出性和表征。
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引用次数: 0
期刊
Nuclear Medicine Communications
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