Seminars in nuclear medicine最新文献_第6页

Artificial Intelligence for Tumor [18F]FDG PET Imaging: Advancements and Future Trends - Part II 人工智能在肿瘤中的应用[18F]FDG PET成像：进展和未来趋势-第二部分。

IF 5.9 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Seminars in nuclear medicine

Pub Date : 2025-07-18 DOI: 10.1053/j.semnuclmed.2025.06.012

Alireza Safarian , Seyed Ali Mirshahvalad , Abolfazl Farbod , Theresa Jung , Hadi Nasrollahi , Gregor Schweighofer-Zwink , Gundula Rendl , Christian Pirich , Reza Vali , Mohsen Beheshti

The integration of artificial intelligence (AI) into [¹⁸F]FDG PET/CT imaging continues to expand, offering new opportunities for more precise, consistent, and personalized oncologic evaluations. Building on the foundation established in Part I, this second part explores AI-driven innovations across a broader range of malignancies, including hematological, genitourinary, melanoma, and central nervous system tumors as well applications of AI in pediatric oncology.

Radiomics and machine learning algorithms are being explored for their ability to enhance diagnostic accuracy, reduce interobserver variability, and inform complex clinical decision-making, such as identifying patients with refractory lymphoma, assessing pseudoprogression in melanoma, or predicting brain metastases in extracranial malignancies. Additionally, AI-assisted lesion segmentation, quantitative feature extraction, and heterogeneity analysis are contributing to improved prediction of treatment response and long-term survival outcomes. Despite encouraging results, variability in imaging protocols, segmentation methods, and validation strategies across studies continues to challenge reproducibility and remains a barrier to clinical translation. This review evaluates recent advancements of AI, its current clinical applications, and emphasizes the need for robust standardization and prospective validation to ensure the reproducibility and generalizability of AI tools in PET imaging and clinical practice.

人工智能（AI）与[18F]FDG PET/CT成像的整合不断扩大，为更精确、一致和个性化的肿瘤评估提供了新的机会。在第一部分的基础上，第二部分探讨了人工智能驱动的创新在更广泛的恶性肿瘤中的应用，包括血液学、泌尿生殖系统、黑色素瘤和中枢神经系统肿瘤，以及人工智能在儿科肿瘤学中的应用。人们正在探索放射组学和机器学习算法，以提高诊断准确性，减少观察者之间的差异，并为复杂的临床决策提供信息，例如识别难治性淋巴瘤患者，评估黑色素瘤的假性进展，或预测颅外恶性肿瘤的脑转移。此外，人工智能辅助的病变分割、定量特征提取和异质性分析有助于改善治疗反应和长期生存结果的预测。尽管取得了令人鼓舞的结果，但不同研究的成像方案、分割方法和验证策略的可变性继续挑战着可重复性，并且仍然是临床转化的障碍。本文评估了人工智能的最新进展及其目前的临床应用，并强调需要强有力的标准化和前瞻性验证，以确保人工智能工具在PET成像和临床实践中的可重复性和普遍性。

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引用次数: 0

The Clinical Impact of FAPI PET Imaging: HCC, CCC, CUP & Peritoneal Carcinoma FAPI PET显像对HCC、CCC、CUP及腹膜癌的临床影响。

IF 5.9 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Seminars in nuclear medicine

Pub Date : 2025-07-18 DOI: 10.1053/j.semnuclmed.2025.07.001

Emil Novruzov, Eduards Mamlins, Yuriko Mori, Jens Cardinale, Frederik L. Giesel

In recent years, FAP-targeted imaging has emerged as a highly-promising modality as a pan-cancer agent. Until now, several studies and review articles have focused on efficacy of FAPI imaging in epithelial malignancies with a high global incidence and prevalence such as lung cancer or GI-tumors. This work sought to shed light on diagnostic performance and clinical impact of FAPI imaging in rather low-incidence tumor-entities, which are nevertheless characterized by a poor outcome.

近年来，fap靶向成像已成为一种非常有前途的泛癌症治疗方式。到目前为止，一些研究和综述文章都集中在FAPI成像在全球高发病率和患病率的上皮恶性肿瘤中的疗效，如肺癌或gi肿瘤。这项工作旨在阐明FAPI成像在相当低发病率肿瘤实体中的诊断性能和临床影响，然而这些肿瘤实体的特点是预后不佳。

引用次数: 0

Radiotracing the Future: Non-FDG Radiotracers Nuclear Medicine 放射性示踪的未来：非fdg放射性示踪剂核医学。

IF 5.9 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Seminars in nuclear medicine

Pub Date : 2025-07-16 DOI: 10.1053/j.semnuclmed.2025.06.005

Giuseppe Arturo Fuso , Gianfilippo Bianciardi , Riccardo Mei , Irene Brusa , Stefano Emiliani , Emilia Fortunati , Cristina Nanni

Positron Emission Tomography/Computed Tomography (PET/CT) is an advanced hybrid imaging modality that synergistically combines metabolic and anatomical data, revolutionizing diagnostic accuracy and therapeutic monitoring in various pathologies. While 18F-fluorodeoxyglucose (FDG) remains the cornerstone radiotracer for many oncologic and nononcologic applications, its limitations—such as nonspecific uptake in inflammation and limited sensitivity in certain tumor subtypes—have catalyzed the development and clinical adoption of non-FDG radiotracers. These novel agents exhibit diverse biological targets, enabling more precise characterization of tissue physiology and pathology. Among them, radiotracers such as 68Ga-DOTA Peptides, 18F-fluciclovine, 68Ga-PSMA, 11C-choline, and 18F-FDOPA have demonstrated utility in neuroendocrine tumors, prostate cancer, gliomas, and parkinsonian syndromes. Their application enhances disease detection, improves staging and restaging accuracy, and supports theranostic strategies. The integration of non-FDG PET tracers in clinical practice requires nuanced understanding of their pharmacokinetics, target specificity, and optimal imaging protocols. Furthermore, these tracers open avenues for personalized medicine, allowing for biomarker-guided management. As evidence continues to evolve, non-FDG PET/CT is poised to become indispensable in precision oncology and targeted molecular imaging across multiple disciplines.

正电子发射断层扫描/计算机断层扫描（PET/CT）是一种先进的混合成像模式，它协同结合了代谢和解剖数据，彻底改变了各种病理的诊断准确性和治疗监测。虽然18f -氟脱氧葡萄糖（FDG）仍然是许多肿瘤学和非肿瘤学应用的基础放射性示踪剂，但其局限性-例如炎症的非特异性摄取和某些肿瘤亚型的有限敏感性-催化了非FDG放射性示踪剂的发展和临床应用。这些新型药物表现出不同的生物靶点，能够更精确地表征组织生理学和病理学。其中，放射性示踪剂如68Ga-DOTA Peptides、18F-fluciclovine、68Ga-PSMA、11c -胆碱和18F-FDOPA已被证明在神经内分泌肿瘤、前列腺癌、胶质瘤和帕金森综合征中的应用。它们的应用增强了疾病检测，提高了分期和再分期的准确性，并支持了治疗策略。在临床实践中整合非fdg PET示踪剂需要对其药代动力学、靶特异性和最佳成像方案有细致的了解。此外，这些示踪剂为个性化医疗开辟了道路，允许生物标志物指导的管理。随着证据的不断发展，非fdg PET/CT在多个学科的精确肿瘤学和靶向分子成像中不可或缺。

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引用次数: 0

The Value of FAPI PET/CT in Cholangiocarcinoma and Pancreatic Cancer: An Update FAPI PET/CT在胆管癌和胰腺癌诊断中的价值

IF 5.9 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Seminars in nuclear medicine

Pub Date : 2025-07-16 DOI: 10.1053/j.semnuclmed.2025.06.011

Kim M. Pabst , Wolfgang P. Fendler , Leonie S. Jochheim , Ken Herrmann

To date, contrast-enhanced CT (ceCT), magnetic resonance imaging (MRI), and, in selected cases, ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) are the current standard imaging modalities for staging of pancreatic cancer and cholangiocarcinoma. Fibroblast activation protein alpha (FAP) has gained interest as a promising molecular imaging target, particularly in tumors with a pronounced desmoplastic reaction such as pancreatic cancer and cholangiocarcinoma. Radiolabeled FAP inhibitors (FAPIs) enable noninvasive visualization of cancer using PET/CT. Recent studies have demonstrated that FAPI PET/CT provides superior sensitivity compared to ceCT and ¹⁸F-FDG PET/CT in cholangiocarcinoma and pancreatic cancer for detecting primary tumors, lymph node involvement, and distant metastases, particularly in hepatic metastases due to low physiological background uptake. Furthermore, FAPI PET/CT has been shown to affect TNM staging and subsequently alter treatment-decision making. Beyond staging, early evidence suggests a prognostic potential of FAPI PET/CT in tumor grading, therapy response assessment, and survival outcomes, although data remain limited. On the other hand, FAPI PET/CT comes with limitations, particularly in the context of fibrotic and inflammatory processes such as liver cirrhosis, pancreatitis, or primary sclerosing cholangitis, which may result in false-positive findings. This review summarizes the current clinical evidence for FAPI PET/CT in pancreatic cancer and cholangiocarcinoma, with a focus on diagnostic performance, prognostic relevance, therapeutic implications, and potential pitfalls.

迄今为止，对比增强CT (ceCT)，磁共振成像（MRI），以及在某些情况下，18f -氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG PET/CT）是目前胰腺癌和胆管癌分期的标准成像方式。成纤维细胞活化蛋白（FAP）作为一种有前景的分子成像靶点，特别是在具有明显的结缔组织增生反应的肿瘤中，如胰腺癌和胆管癌，已引起人们的兴趣。放射标记FAP抑制剂（fapi）可以通过PET/CT实现肿瘤的无创可视化。最近的研究表明，与ceCT和18F-FDG PET/CT相比，FAPI PET/CT在胆管癌和胰腺癌中检测原发肿瘤、淋巴结累及和远处转移，特别是由于生理背景摄取低而导致的肝转移，具有更高的灵敏度。此外，FAPI PET/CT已显示影响TNM分期并随后改变治疗决策。除了分期，早期证据表明FAPI PET/CT在肿瘤分级、治疗反应评估和生存结果方面的预后潜力，尽管数据仍然有限。另一方面，FAPI PET/CT存在局限性，特别是在纤维化和炎症过程（如肝硬化、胰腺炎或原发性硬化性胆管炎）的情况下，这可能导致假阳性结果。本综述总结了FAPI PET/CT在胰腺癌和胆管癌中的临床证据，重点讨论了FAPI PET/CT在胰腺癌和胆管癌中的诊断表现、预后相关性、治疗意义和潜在缺陷。

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引用次数: 0

[177Lu]Lu-FAPI Radioligand Therapy: Emerging Horizons and Clinical Promise in Solid Tumors: A Comprehensive Review [177]卢- fapi放射治疗在实体瘤中的应用前景。

IF 5.9 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Seminars in nuclear medicine

Pub Date : 2025-07-04 DOI: 10.1053/j.semnuclmed.2025.06.010

Akram Al-Ibraheem , Ahmed Saad Abdlkadir , Saad Ruzzeh , Marwah Abdulrahman , Serin Moghrabi , Rawa Ahmed , Hongcheng Shi , Fadi Khreish , Michael C. Kreissl , Rula Amarin , Kamal Al-Rabi , Asem Mansour , Hikmat Abdel-Razeq

[¹⁷⁷Lu]Lu-FAPI, a novel and innovative radioligand targeting fibroblast activation protein (FAP), has rapidly emerged as a powerful therapeutic strategy for difficult-to-treat solid malignancies. FAP is highly expressed in cancer-associated fibroblasts (CAFs) across a broad spectrum of solid malignancies, thereby providing a valuable therapeutic target for novel radiopharmaceuticals. To date, a growing body of preliminary studies has explored the therapeutic potential of [¹⁷⁷Lu]Lu-FAPI in oncology, with numerous ongoing clinical trials currently recruiting patients to substantiate its evolving prospects. This comprehensive review critically synthesizes current clinical evidence on [¹⁷⁷Lu]Lu-FAPI radioligand therapy (RLT), outlining its available formulations, therapeutic efficacy, safety profile, recent advancements, challenges, and emerging applications across diverse tumor types. [¹⁷⁷Lu]Lu-FAPI has shown considerable promise as an effective and relatively safe theranostic agent, with particular advantages in combination therapy approaches. Nevertheless, larger, well-controlled clinical studies are essential to establish its long-term efficacy and safety profile. Despite current limitations, this review underscores the emerging role of [¹⁷⁷Lu]Lu-FAPI in oncological care, with growing relevance to personalized oncology strategies, and calls for further investigation to refine its clinical integration and maximize patient-specific outcomes.

[177Lu]Lu-FAPI是一种新颖的靶向成纤维细胞激活蛋白（FAP）的放射配体，已迅速成为治疗难以治疗的实体恶性肿瘤的有力策略。FAP在广泛的实体恶性肿瘤的癌症相关成纤维细胞（CAFs）中高度表达，从而为新型放射性药物提供了有价值的治疗靶点。迄今为止，越来越多的初步研究已经探索了[177Lu]Lu-FAPI在肿瘤中的治疗潜力，许多正在进行的临床试验正在招募患者来证实其不断发展的前景。本综述综合了[177Lu]Lu-FAPI放射配体治疗（RLT）的现有临床证据，概述了其可用配方、治疗效果、安全性、最新进展、挑战以及在不同肿瘤类型中的新应用。[177]Lu-FAPI作为一种有效且相对安全的治疗药物已显示出相当大的前景，在联合治疗方法中具有特别的优势。然而，更大规模、控制良好的临床研究是确定其长期疗效和安全性的必要条件。尽管目前存在局限性，但这篇综述强调了[177Lu]Lu-FAPI在肿瘤治疗中的新兴作用，与个性化肿瘤策略的相关性越来越大，并呼吁进一步研究以完善其临床整合并最大化患者特异性结果。

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引用次数: 0

Advances With 225Ac-DOTATATE Targeted Alpha Therapy in Somatostatin Receptor Positive Neuroendocrine Tumors 225Ac-DOTATATE靶向α治疗生长抑素受体阳性神经内分泌肿瘤的研究进展

IF 5.9 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Seminars in nuclear medicine

Pub Date : 2025-07-04 DOI: 10.1053/j.semnuclmed.2025.06.008

Kunal Ramesh Chandekar, Chandrasekhar Bal

²²⁵Ac-DOTATATE-based targeted alpha therapy (TAT) is emerging as a transformative option in the management of advanced, well-differentiated, somatostatin receptor (SSTR)-positive neuroendocrine tumors (NETs), particularly in patients refractory to conventional β-emitter peptide receptor radionuclide therapy (PRRT). This review synthesizes current evidence from preclinical models and early-phase clinical studies, highlighting its therapeutic promise in terms of potent antitumor efficacy and favorable toxicity profile. We discuss the radiobiological and mechanistic advantages of α-particle therapy while also addressing key limitations such as radionuclide supply constraints, recoil-induced daughter redistribution, challenges in dosimetry, and regulatory hurdles. Emerging strategies including improved chelators, SSTR antagonists, and tandem or combination therapies are described. Key ongoing trials have also been summarized. As ²²⁵Ac-DOTATATE-based TAT progresses toward mainstream clinical integration, multidisciplinary collaboration across academia, industry, and regulatory bodies will be essential to refine protocols, optimize safety, and expand access.

225Ac-DOTATATE-based靶向α治疗（TAT）正在成为治疗晚期、分化良好的生长抑制素受体（SSTR）阳性神经内分泌肿瘤（NETs）的一种变革性选择，特别是在传统β-发射器肽受体放射性核素治疗（PRRT）难治的患者中。本综述综合了临床前模型和早期临床研究的现有证据，强调了其在抗肿瘤功效和良好毒性方面的治疗前景。我们讨论了α-粒子治疗的放射生物学和机制优势，同时也解决了诸如放射性核素供应限制、反冲诱导子再分布、剂量学挑战和监管障碍等关键限制。新兴的策略包括改进的螯合剂，SSTR拮抗剂，串联或联合治疗的描述。还总结了正在进行的关键试验。随着基于225ac - dotate的TAT向主流临床整合发展，学术界、工业界和监管机构之间的多学科合作对于完善方案、优化安全性和扩大可及性至关重要。

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引用次数: 0

Mucin-Targeted Antibodies for Ovarian Cancer 用于卵巢癌的黏液蛋白靶向抗体

IF 5.9 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Seminars in nuclear medicine

Pub Date : 2025-07-03 DOI: 10.1053/j.semnuclmed.2025.06.007

Shaniqua A. Lawson, Jason S. Lewis

Ovarian cancer remains a leading cause of gynecologic cancer mortality, driven in part by late-stage diagnoses and high recurrence rates. Among emerging molecular targets, mucins—highly glycosylated transmembrane glycoproteins overexpressed and aberrantly glycosylated in epithelial ovarian cancers—have garnered increasing interest for both imaging and therapeutic strategies. This review highlights the expression profiles and clinical implications of key mucins (MUC1, MUC16) and evaluates antibody-based modalities that leverage these targets for enhanced tumor detection and treatment. We discuss the current landscape of therapeutic strategies, including monoclonal antibodies, antibody-drug conjugates, bispecific antibodies, and radioimmunotherapy, with emphasis on recent preclinical and clinical advances. We also examine the role of mucin-targeted antibodies in imaging and the integration of theranostic platforms. Key challenges such as antigen heterogeneity, immunogenicity, and tumor penetration are addressed, along with future directions for optimizing mucin-directed therapies. Together, these efforts underscore the ever-expanding potential of mucin-targeted immunotherapy to improve outcomes for patients with ovarian cancer.

卵巢癌仍然是妇科癌症死亡的主要原因，部分原因是晚期诊断和高复发率。在新兴的分子靶点中，黏液蛋白——在上皮性卵巢癌中过度表达和异常糖基化的高度糖基化的跨膜糖蛋白——在成像和治疗策略中引起了越来越多的兴趣。这篇综述强调了关键粘蛋白（MUC1, MUC16）的表达谱和临床意义，并评估了利用这些靶点增强肿瘤检测和治疗的基于抗体的模式。我们讨论了目前的治疗策略，包括单克隆抗体、抗体-药物偶联物、双特异性抗体和放射免疫治疗，重点是最近的临床前和临床进展。我们还研究了粘蛋白靶向抗体在成像和治疗平台整合中的作用。主要挑战如抗原异质性、免疫原性和肿瘤穿透性，以及优化黏液导向治疗的未来方向。总之，这些努力强调了黏液靶向免疫疗法在改善卵巢癌患者预后方面不断扩大的潜力。

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引用次数: 0

PET/CT in Movement Disorders: Update 运动障碍的PET/CT：更新。

IF 4.6 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Seminars in nuclear medicine

Pub Date : 2025-07-01 DOI: 10.1053/j.semnuclmed.2025.03.007

Matilde Nerattini , Elisabetta Maria Abenavoli , Valentina Berti

This review synthesizes recent literature, primarily from the last 5 years, to highlight the impact of innovative technologies and analytical approaches on the application of positron emission tomography (PET) in movement disorders. PET remains a cornerstone for investigating these conditions, with recent advancements enhancing our understanding of disease pathophysiology and progression. Established findings, such as the ability of [¹⁸F]-fluorodeoxyglucose PET (18F-FDG PET) to differentiate Parkinson's disease (PD) from atypical parkinsonian syndromes based on characteristic metabolic patterns, have been consistently validated. PD typically presents with relative hypermetabolism in the basal ganglia, thalamus and cerebellum, while atypical parkinsonisms exhibit more widespread subcortical hypometabolism. Technological innovations, particularly in quantification methods and metabolic connectivity analysis, have improved diagnostic precision and provided deeper insights into disease mechanisms. Dopaminergic PET imaging, crucial for assessing presynaptic and postsynaptic dysfunction, has also benefited from these advances. The field is further evolving with the development of novel tracers targeting pathological hallmarks, such as alpha-synuclein in PD and multiple system atrophy (MSA), tau in progressive supranuclear palsy (PSP) and cortico-basal degeneration (CBD), and tracers for neuroinflammation, microglial activation, and neurotransmitter systems like serotonin and acetylcholine. While PET is not yet routinely used for the clinical assessment of Huntington's disease or ataxia, research applications are expanding, driven by the potential of these new tracers and analytical techniques. These advancements not only reinforce existing knowledge but also open new avenues for enhancing the understanding and management of movement disorders.

本文综合了最近5年的文献，重点介绍了创新技术和分析方法对正电子发射断层扫描（PET）在运动障碍中的应用的影响。PET仍然是研究这些疾病的基石，最近的进展增强了我们对疾病病理生理学和进展的理解。已确立的研究结果，如[18F]-氟脱氧葡萄糖PET （18F- fdg PET）基于特征代谢模式区分帕金森病（PD）与非典型帕金森综合征的能力，已得到一致的验证。PD通常表现为基底神经节、丘脑和小脑的相对高代谢，而非典型帕金森则表现为更广泛的皮质下低代谢。技术创新，特别是在量化方法和代谢连通性分析方面的技术创新，提高了诊断精度，并为疾病机制提供了更深入的见解。多巴胺能PET成像对于评估突触前和突触后功能障碍至关重要，也受益于这些进展。随着针对病理标志的新型示踪剂的发展，该领域正在进一步发展，例如PD和多系统萎缩（MSA）中的α -突触核蛋白，进行性核上性麻痹（PSP）和皮质基底变性（CBD）中的tau，以及神经炎症，小胶质细胞激活和神经递质系统（如血清素和乙酰胆碱）的示踪剂。虽然PET尚未常规用于亨廷顿氏病或共济失调的临床评估，但由于这些新的示踪剂和分析技术的潜力，研究应用正在扩大。这些进步不仅加强了现有的知识，而且为加强对运动障碍的理解和管理开辟了新的途径。

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引用次数: 0

Positron Emission Tomography in Autism Spectrum Disorder: Current Status and Future Perspectives 自闭症谱系障碍的正电子发射断层扫描：现状和未来展望。

IF 4.6 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Seminars in nuclear medicine

Pub Date : 2025-07-01 DOI: 10.1053/j.semnuclmed.2025.06.003

Jeongryul Ryu, Minyoung Oh

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition marked by impairments in social communication and the presence of repetitive behaviors. While both genetic and environmental factors are known to contribute to ASD, its precise causes remain unclear. Advances in molecular imaging, particularly positron emission tomography (PET), have enhanced our ability to investigate the neurobiological mechanisms underlying ASD. PET offers valuable insights into brain metabolism, neurotransmitter systems, neuroinflammation, and synaptic density. This review highlights the contributions of PET imaging to understanding the pathophysiology of ASD, focusing on recent advancements in technology and novel radiotracers. These innovations may lead to more accurate biomarkers for diagnosis and targeted therapeutic strategies. As PET technology continues to improve, it holds significant potential for advancing ASD research and clinical applications.

自闭症谱系障碍（ASD）是一种复杂的神经发育疾病，其特征是社会沟通障碍和重复行为的存在。虽然已知遗传和环境因素都有助于ASD，但其确切原因尚不清楚。分子成像技术的进步，尤其是正电子发射断层扫描（PET），提高了我们研究ASD神经生物学机制的能力。PET为脑代谢、神经递质系统、神经炎症和突触密度提供了有价值的见解。本文综述了PET成像对理解ASD病理生理的贡献，重点介绍了PET成像技术和新型放射性示踪剂的最新进展。这些创新可能会导致更准确的诊断和靶向治疗策略的生物标志物。随着PET技术的不断完善，它在推进ASD研究和临床应用方面具有巨大的潜力。

引用次数: 0

CuII-bis(thioureido) Complex: A Potential Radiotracer for Detecting Oxidative Stress and Neuroinflammation in Neurodegenerative Diseases CuII-bis（硫脲）配合物：检测神经退行性疾病中氧化应激和神经炎症的潜在放射性示踪剂。

IF 4.6 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Seminars in nuclear medicine

Pub Date : 2025-07-01 DOI: 10.1053/j.semnuclmed.2025.03.008

Weiyuan Lin , Chongyi Huang , Zhiqiang Tan , Hao Xu , Weijun Wei , Lu Wang

Neurodegenerative diseases, characterized by progressive neuronal degeneration and associated with neuroinflammation and oxidative stress, present significant challenges in diagnosis and treatment. This review explores the potential of copper(II)-bis(thiosemicarbazone) complexes, particularly Cu-ATSM, as a dual-purpose radiopharmaceutical for imaging and therapeutic interventions. Cu-ATSM exhibits unique redox-dependent retention in pathological microenvironments, driven by mitochondrial dysfunction and hyper-reductive states, which enables the noninvasive detection of oxidative stress via positron emission tomography (PET). Preclinical studies demonstrate its efficacy in mitigating neuroinflammation by suppressing glial activation, reducing the secretion of pro-inflammatory cytokines (e.g., TNF-α, MCP-1), and increasing the expression of neuroprotective metallothionein-1 (MT1). Some Clinical research reveals elevated ⁶⁴Cu-ATSM uptake in Parkinson’s disease (PD), Alzheimer’s disease (AD), and amyotrophic lateral sclerosis (ALS) patients, correlating with disease severity and regional oxidative stress markers. Furthermore, Cu-ATSM derivatives show promise in modulating blood-brain barrier (BBB) permeability, enhancing amyloid-β clearance, and restoring copper homeostasis in ALS models. Despite these advances, limitations such as small cohort sizes and heterogeneity in clinical studies underscore the need for larger-scale validation. Multimodal imaging integrating PET and MRI, alongside novel structural analogs targeting Aβ plaques and redox imbalances, emerges as a strategic direction for future research. Collectively, Cu-ATSM represents a transformative tool for elucidating neuropathological mechanisms and advancing therapeutic strategies in neurodegenerative disorders.

神经退行性疾病以进行性神经元变性为特征，并伴有神经炎症和氧化应激，在诊断和治疗方面面临重大挑战。这篇综述探讨了铜(II)-双（硫代氨基脲）配合物的潜力，特别是铜- atsm，作为成像和治疗干预的双重用途放射性药物。在线粒体功能障碍和超还原状态的驱动下，Cu-ATSM在病理微环境中表现出独特的氧化还原依赖性保留，这使得通过正电子发射断层扫描（PET）无创性检测氧化应激成为可能。临床前研究表明，其通过抑制神经胶质活化、减少促炎细胞因子（如TNF-α、MCP-1）的分泌、增加神经保护性金属硫蛋白-1 （MT1）的表达来缓解神经炎症。一些临床研究显示，帕金森病（PD）、阿尔茨海默病（AD）和肌萎缩侧索硬化症（ALS）患者26⁴Cu-ATSM摄取升高，与疾病严重程度和区域氧化应激标志物相关。此外，Cu-ATSM衍生物在ALS模型中显示出调节血脑屏障（BBB）通透性、增强淀粉样蛋白-β清除和恢复铜稳态的前景。尽管取得了这些进展，但临床研究中的队列规模小和异质性等局限性强调了更大规模验证的必要性。结合PET和MRI的多模态成像，以及针对β斑块和氧化还原失衡的新型结构类似物，成为未来研究的战略方向。总之，Cu-ATSM代表了阐明神经病理机制和推进神经退行性疾病治疗策略的变革性工具。

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引用次数: 0