Pub Date : 2025-07-01DOI: 10.1053/j.semnuclmed.2025.04.002
Katarzyna Barańska , Katarzyna Niemas , Kacper Pełka , Jolanta Kunikowska
Central nervous system (CNS) tumors are quite rare but cause significant morbidity and mortality. Positron Emission Tomography (PET) is a widely utilized imaging modality within the field of nuclear medicine. CNS tumor diagnostics are an essential tool in the diagnosis and treatment of patients with glioma, offering valuable insights into tumor characteristics, treatment response and outcomes. A variety of different tracers are used in PET imaging of brain tumors including 18F-labeled fluorodeoxyglucose ([18F]FDG), markers showing amino acid metabolism, angiogenesis or inflammatory processes. In this article we describe possibility of use different tracers in different clinical scenario of CNS tumors.
{"title":"PET/CT in the Imaging of CNS Tumors","authors":"Katarzyna Barańska , Katarzyna Niemas , Kacper Pełka , Jolanta Kunikowska","doi":"10.1053/j.semnuclmed.2025.04.002","DOIUrl":"10.1053/j.semnuclmed.2025.04.002","url":null,"abstract":"<div><div>Central nervous system (CNS) tumors are quite rare but cause significant morbidity and mortality. Positron Emission Tomography (PET) is a widely utilized imaging modality within the field of nuclear medicine. CNS tumor diagnostics are an essential tool in the diagnosis and treatment of patients with glioma, offering valuable insights into tumor characteristics, treatment response and outcomes. A variety of different tracers are used in PET imaging of brain tumors including <sup>18</sup>F-labeled fluorodeoxyglucose ([<sup>18</sup>F]FDG), markers showing amino acid metabolism, angiogenesis or inflammatory processes. In this article we describe possibility of use different tracers in different clinical scenario of CNS tumors.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"55 4","pages":"Pages 475-486"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1053/j.semnuclmed.2025.06.001
Gilles N. Stormezand , Janine Doorduin , Andor W.J.M. Glaudemans , Anouk van der Hoorn , Bauke M. De Jong
2-Deoxy-2-[18F]fluoro-D-glucose positron emission tomography (FDG-PET) is widely used to study cerebral glucose metabolism and may be useful in several inflammatory disorders of the central nervous system. Emerging literature suggests that [18F]FDG may be more sensitive to detect abnormalities in auto-immune encephalitis (AIE) in comparison to MRI, especially in NDMA receptor encephalitis. Distinct patterns of regional abnormalities in AIE have been reported, depending on the auto-antibody involved. Predominant findings are hypermetabolism of the mediotemporal lobe and hypometabolism in parietal and occipital lobes. The possibility for whole body imaging in the setting of malignancy screening further strengthens the importance of [18F]FDG PET in AIE when associated with paraneoplastic syndromes. Other inflammatory conditions of the central nervous system where [18]FDG PET may facilitate diagnosis include neurosarcoidosis and potential neuropsychiatric manifestations of systemic lupus erythematodes. More recently, [18F]FDG PET has been used in patients to evaluate postacute sequelae of COVID-19, allowing assessment of specific neuronal impairments at the individual level and determination of time-dependent metabolic alterations.
2-脱氧-2-[18F]氟- d -葡萄糖正电子发射断层扫描（FDG-PET）被广泛用于研究脑葡萄糖代谢，并可能在中枢神经系统的几种炎症性疾病中有用。新出现的文献表明[18F]FDG可能比MRI更敏感地发现自身免疫性脑炎（AIE）的异常，特别是NDMA受体脑炎。据报道，AIE的不同区域异常模式取决于所涉及的自身抗体。主要表现为中颞叶代谢高，顶叶和枕叶代谢低。在恶性肿瘤筛查的背景下，全身显像的可能性进一步加强了[18F]FDG PET在与副肿瘤综合征相关的AIE中的重要性。[18]FDG PET可能有助于诊断中枢神经系统的其他炎症包括神经结节病和系统性红斑狼疮的潜在神经精神表现。最近，[18F]FDG PET已用于患者评估COVID-19急性后后遗症，可在个体水平上评估特异性神经元损伤并确定时间依赖性代谢改变。
{"title":"Current Developments on [18F]FDG PET/CT in Inflammatory Disorders of the Central Nervous System","authors":"Gilles N. Stormezand , Janine Doorduin , Andor W.J.M. Glaudemans , Anouk van der Hoorn , Bauke M. De Jong","doi":"10.1053/j.semnuclmed.2025.06.001","DOIUrl":"10.1053/j.semnuclmed.2025.06.001","url":null,"abstract":"<div><div>2-Deoxy-2-[<sup>18</sup>F]fluoro-D-glucose positron emission tomography (FDG-PET) is widely used to study cerebral glucose metabolism and may be useful in several inflammatory disorders of the central nervous system. Emerging literature suggests that [<sup>18</sup>F]FDG may be more sensitive to detect abnormalities in auto-immune encephalitis (AIE) in comparison to MRI, especially in NDMA receptor encephalitis. Distinct patterns of regional abnormalities in AIE have been reported, depending on the auto-antibody involved. Predominant findings are hypermetabolism of the mediotemporal lobe and hypometabolism in parietal and occipital lobes. The possibility for whole body imaging in the setting of malignancy screening further strengthens the importance of [<sup>18</sup>F]FDG PET in AIE when associated with paraneoplastic syndromes. Other inflammatory conditions of the central nervous system where [<sup>18</sup>]FDG PET may facilitate diagnosis include neurosarcoidosis and potential neuropsychiatric manifestations of systemic lupus erythematodes. More recently, [<sup>18</sup>F]FDG PET has been used in patients to evaluate postacute sequelae of COVID-19, allowing assessment of specific neuronal impairments at the individual level and determination of time-dependent metabolic alterations.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"55 4","pages":"Pages 503-511"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1053/j.semnuclmed.2025.05.005
Geoffrey M. Currie , K. Elizabeth Hawk
Artificial intelligence (AI), particularly machine learning (ML) and deep learning (DL), has significant potential to advance the capabilities of nuclear neuroimaging. The current and emerging applications of ML and DL in the processing, analysis, enhancement and interpretation of SPECT and PET imaging are explored for brain imaging. Key developments include automated image segmentation, disease classification, and radiomic feature extraction, including lower dimensionality first and second order radiomics, higher dimensionality third order radiomics and more abstract fourth order deep radiomics. DL-based reconstruction, attenuation correction using pseudo-CT generation, and denoising of low-count studies have a role in enhancing image quality. AI has a role in sustainability through applications in radioligand design and preclinical imaging while federated learning addresses data security challenges to improve research and development in nuclear cerebral imaging. There is also potential for generative AI to transform the nuclear cerebral imaging space through solutions to data limitations, image enhancement, patient-centered care, workflow efficiencies and trainee education. Innovations in ML and DL are re-engineering the nuclear neuroimaging ecosystem and reimagining tomorrow’s precision medicine landscape.
{"title":"Artificial Intelligence Augmented Cerebral Nuclear Imaging","authors":"Geoffrey M. Currie , K. Elizabeth Hawk","doi":"10.1053/j.semnuclmed.2025.05.005","DOIUrl":"10.1053/j.semnuclmed.2025.05.005","url":null,"abstract":"<div><div>Artificial intelligence (AI), particularly machine learning (ML) and deep learning (DL), has significant potential to advance the capabilities of nuclear neuroimaging. The current and emerging applications of ML and DL in the processing, analysis, enhancement and interpretation of SPECT and PET imaging are explored for brain imaging. Key developments include automated image segmentation, disease classification, and radiomic feature extraction, including lower dimensionality first and second order radiomics, higher dimensionality third order radiomics and more abstract fourth order deep radiomics. DL-based reconstruction, attenuation correction using pseudo-CT generation, and denoising of low-count studies have a role in enhancing image quality. AI has a role in sustainability through applications in radioligand design and preclinical imaging while federated learning addresses data security challenges to improve research and development in nuclear cerebral imaging. There is also potential for generative AI to transform the nuclear cerebral imaging space through solutions to data limitations, image enhancement, patient-centered care, workflow efficiencies and trainee education. Innovations in ML and DL are re-engineering the nuclear neuroimaging ecosystem and reimagining tomorrow’s precision medicine landscape.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"55 4","pages":"Pages 616-628"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1053/j.semnuclmed.2025.05.007
Kowshik Vengadesan , Ankita Phulia , Rakesh Kumar
Epilepsy is one of the commonest neurological disorders worldwide. It is characterized by recurrent unprovoked seizures and has significant effects on one’s daily life. Though almost two thirds of patients with epilepsy respond well with one or more antiepileptic drugs, about 30% patients suffer with drug resistant epilepsy (DRE). Patients with focal variant of DRE, often have a focal pathology in brain and benefit vastly by removing or disconnecting the foci of origin of epileptiform waves from other parts of the cerebral cortex. While clinical examination, MRI and EEG are the first line investigations done in such patients before surgery, many a times they yield normal or discordant or multiple lesions of which only 1 or 2 are epileptogenic. It is in such cases; molecular imaging such as SPECT and PET helps in accurately demarcating the EZ for planning epilepsy surgery. The functional integrity of the rest of the brain can also be assessed by PET and SPECT, which may also offer valuable insights into the potential pathophysiology of the neurocognitive and behavioral impairments commonly seen in these patients. Epilepsy continues to be a common indication for perfusion SPECT as it is the only imaging method that can visualize the ictal onset zone in vivo. Interictal FDG PET/CT is a single investigation that can provide most information about EZ whereas SPECT has to be done twice—ictal and interictal. The evolution of advanced image analysis techniques like SISCOM, SISCOS, PISCOM and newer receptor-based PET tracers has further refined the localization of the seizure onset zone.
{"title":"Update on Molecular Imaging in Epilepsy","authors":"Kowshik Vengadesan , Ankita Phulia , Rakesh Kumar","doi":"10.1053/j.semnuclmed.2025.05.007","DOIUrl":"10.1053/j.semnuclmed.2025.05.007","url":null,"abstract":"<div><div>Epilepsy is one of the commonest neurological disorders worldwide. It is characterized by recurrent unprovoked seizures and has significant effects on one’s daily life. Though almost two thirds of patients with epilepsy respond well with one or more antiepileptic drugs, about 30% patients suffer with drug resistant epilepsy (DRE). Patients with focal variant of DRE, often have a focal pathology in brain and benefit vastly by removing or disconnecting the foci of origin of epileptiform waves from other parts of the cerebral cortex. While clinical examination, MRI and EEG are the first line investigations done in such patients before surgery, many a times they yield normal or discordant or multiple lesions of which only 1 or 2 are epileptogenic. It is in such cases; molecular imaging such as SPECT and PET helps in accurately demarcating the EZ for planning epilepsy surgery. The functional integrity of the rest of the brain can also be assessed by PET and SPECT, which may also offer valuable insights into the potential pathophysiology of the neurocognitive and behavioral impairments commonly seen in these patients. Epilepsy continues to be a common indication for perfusion SPECT as it is the only imaging method that can visualize the ictal onset zone in vivo. Interictal FDG PET/CT is a single investigation that can provide most information about EZ whereas SPECT has to be done twice—ictal and interictal. The evolution of advanced image analysis techniques like SISCOM, SISCOS, PISCOM and newer receptor-based PET tracers has further refined the localization of the seizure onset zone.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"55 4","pages":"Pages 487-502"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dementia, which impairs a person's cognition and ability in daily tasks and is often caused by neurodegenerative disorders, remains one of the most challenging neuropsychiatric conditions. The prevalence of dementia has been steadily increasing in aging societies. Recently, antiamyloid treatment has been developed and approved for the treatment of Alzheimer’s disease (AD), which is known as the major cause of dementia. Such therapeutic developments have accelerated the use of in vivo biomarkers in research, clinical trials, and clinical practice. Past and recent developments of several biomarkers, including 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET), have played a pivotal role in understanding the underlying mechanisms of dementing disorders and accelerating progress in both research and clinical practice, leading to more accurate clinical diagnosis, recognition of co-pathologies, better understanding of new diseases, treatment planning, and response evaluation. This article reviews the roles of brain FDG PET, one of the well-established imaging biomarkers, as a valuable tool for studying brain metabolism and its applications in clinical and research settings, particularly for the treatment of dementia.
{"title":"18F-FDG PET for Dementia Evaluation: Co-pathologies, New Diseases, and Its Roles in the Era of Antiamyloid Treatment","authors":"Tanyaluck Thientunyakit , Weerasak Muangpaisan , Satoshi Minoshima","doi":"10.1053/j.semnuclmed.2025.04.007","DOIUrl":"10.1053/j.semnuclmed.2025.04.007","url":null,"abstract":"<div><div>Dementia, which impairs a person's cognition and ability in daily tasks and is often caused by neurodegenerative disorders, remains one of the most challenging neuropsychiatric conditions. The prevalence of dementia has been steadily increasing in aging societies. Recently, antiamyloid treatment has been developed and approved for the treatment of Alzheimer’s disease (AD), which is known as the major cause of dementia. Such therapeutic developments have accelerated the use of in vivo biomarkers in research, clinical trials, and clinical practice. Past and recent developments of several biomarkers, including <sup>18</sup>F-fluorodeoxyglucose (FDG) positron emission tomography (PET), have played a pivotal role in understanding the underlying mechanisms of dementing disorders and accelerating progress in both research and clinical practice, leading to more accurate clinical diagnosis, recognition of co-pathologies, better understanding of new diseases, treatment planning, and response evaluation. This article reviews the roles of brain FDG PET, one of the well-established imaging biomarkers, as a valuable tool for studying brain metabolism and its applications in clinical and research settings, particularly for the treatment of dementia.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"55 4","pages":"Pages 526-537"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neurodegenerative tauopathies are characterized by the pathological hyperphosphorylation of tau proteins that subsequently form aggregates. Tau PET tracers with affinity to bind these pathological tau aggregates have been developed to measure disease progression and to support therapeutic drug development. In this review, we summarize the pathophysiology of tau throughout the range of neurodegenerative tauopathies. We outline the available first- and second-generation tau PET tracers, with a focus on new tau PET tracer developments, and discuss the quantification of tau PET images. Next, we summarize how tau PET relates to cerebrospinal fluid and plasma tau biomarkers. Finally, we review the current recommendations on the clinical use of tau PET versus fluid tau biomarkers in diagnosis, prognosis and treatment development.
{"title":"The Current Role of Tau PET Imaging in Neurodegeneration","authors":"Greet Vanderlinden , Rik Vandenberghe , Mathieu Vandenbulcke , Koen Van Laere","doi":"10.1053/j.semnuclmed.2025.03.002","DOIUrl":"10.1053/j.semnuclmed.2025.03.002","url":null,"abstract":"<div><div>Neurodegenerative tauopathies are characterized by the pathological hyperphosphorylation of tau proteins that subsequently form aggregates. Tau PET tracers with affinity to bind these pathological tau aggregates have been developed to measure disease progression and to support therapeutic drug development. In this review, we summarize the pathophysiology of tau throughout the range of neurodegenerative tauopathies. We outline the available first- and second-generation tau PET tracers, with a focus on new tau PET tracer developments, and discuss the quantification of tau PET images. Next, we summarize how tau PET relates to cerebrospinal fluid and plasma tau biomarkers. Finally, we review the current recommendations on the clinical use of tau PET versus fluid tau biomarkers in diagnosis, prognosis and treatment development.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"55 4","pages":"Pages 548-564"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1053/j.semnuclmed.2025.06.002
Gabriela Capriotti , Alessia Guarnera , Andrea Romano , Giulia Moltoni , Giorgia Granese , Alessando Bozzao , Alberto Signore
Traumatic brain injury (TBI) is a global public health problem and is a leading cause of disability, morbidity and death in children and adults in USA It is characterised by alteration of neurological, behavioral and cognitive function as consequence of biomechanical insulte and possible progression to chronic encephalopathy. According to the CDC, approximately 75% of all reported TBIs are considered mild in form. Mild TBI is defined as individuals who had head trauma with subsequent mild deficit on the GCS and thu are frequently observed in military combat, athletes and motor vehicle accidents. Clinical assessment of mTBI is difficult and therefore different neuroimaging techniques have been used to characterized different stages of the disease. This article reviews the utility of imaging while focusing on the emerging applications of advanced MRI studies and PET in TBI.
{"title":"Neuroimaging of Mild Traumatic Injury","authors":"Gabriela Capriotti , Alessia Guarnera , Andrea Romano , Giulia Moltoni , Giorgia Granese , Alessando Bozzao , Alberto Signore","doi":"10.1053/j.semnuclmed.2025.06.002","DOIUrl":"10.1053/j.semnuclmed.2025.06.002","url":null,"abstract":"<div><div>Traumatic brain injury (TBI) is a global public health problem and is a leading cause of disability, morbidity and death in children and adults in USA It is characterised by alteration of neurological, behavioral and cognitive function as consequence of biomechanical insulte and possible progression to chronic encephalopathy. According to the CDC, approximately 75% of all reported TBIs are considered mild in form. Mild TBI is defined as individuals who had head trauma with subsequent mild deficit on the GCS and thu are frequently observed in military combat, athletes and motor vehicle accidents. Clinical assessment of mTBI is difficult and therefore different neuroimaging techniques have been used to characterized different stages of the disease. This article reviews the utility of imaging while focusing on the emerging applications of advanced MRI studies and PET in TBI.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"55 4","pages":"Pages 512-525"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1053/j.semnuclmed.2025.06.009
M Michael Sathekge, Kirsten Bouchelouche
{"title":"Letter from the Editors","authors":"M Michael Sathekge, Kirsten Bouchelouche","doi":"10.1053/j.semnuclmed.2025.06.009","DOIUrl":"10.1053/j.semnuclmed.2025.06.009","url":null,"abstract":"","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"55 4","pages":"Pages 471-474"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144534607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1053/j.semnuclmed.2024.07.002
Pierre Courault , Luc Zimmer , Sophie Lancelot
At present, spinal cord imaging primarily uses magnetic resonance imaging (MRI) or computed tomography (CT), but the greater sensitivity of positron emission tomography (PET) techniques and the development of new radiotracers are paving the way for a new approach. The substantial rise in publications on PET radiotracers for spinal cord exploration indicates a growing interest in the functional and molecular imaging of this organ. The present review aimed to provide an overview of the various radiotracers used in this indication, in preclinical and clinical settings. Firstly, we outline spinal cord anatomy and associated target pathologies. Secondly, we present the state-of-the-art of spinal cord imaging techniques used in clinical practice, with their respective strengths and limitations. Thirdly, we summarize the literature on radiotracers employed in functional PET imaging of the spinal cord. In conclusion, we propose criteria for an ideal radiotracer for molecular spinal cord imaging, emphasizing the relevance of multimodal hybrid cameras, and particularly the benefits of PET-MRI integration.
目前，脊髓成像主要使用磁共振成像（MRI）或计算机断层扫描（CT），但正电子发射断层扫描（PET）技术更高的灵敏度和新型放射性racer的开发正在为新方法铺平道路。有关正电子发射计算机断层成像（PET）放射性核素用于脊髓探查的论文大量增加，表明人们对这一器官的功能和分子成像越来越感兴趣。本综述旨在概述临床前和临床环境中用于该适应症的各种放射性核素。首先，我们概述了脊髓解剖结构和相关靶点病理。其次，我们介绍了临床实践中使用的最先进的脊髓成像技术，以及它们各自的优势和局限性。第三，我们总结了脊髓功能 PET 成像中使用的放射性racer 的文献。最后，我们提出了用于脊髓分子成像的理想放射性示踪剂的标准，强调了多模态混合相机的相关性，尤其是 PET-MRI 集成的优势。
{"title":"Toward Functional PET Imaging of the Spinal Cord","authors":"Pierre Courault , Luc Zimmer , Sophie Lancelot","doi":"10.1053/j.semnuclmed.2024.07.002","DOIUrl":"10.1053/j.semnuclmed.2024.07.002","url":null,"abstract":"<div><div>At present, spinal cord imaging primarily uses magnetic resonance imaging (MRI) or computed tomography (CT), but the greater sensitivity of positron emission tomography (PET) techniques and the development of new radiotracers are paving the way for a new approach. The substantial rise in publications on PET radiotracers for spinal cord exploration indicates a growing interest in the functional and molecular imaging of this organ. The present review aimed to provide an overview of the various radiotracers used in this indication, in preclinical and clinical settings. Firstly, we outline spinal cord anatomy and associated target pathologies. Secondly, we present the state-of-the-art of spinal cord imaging techniques used in clinical practice, with their respective strengths and limitations. Thirdly, we summarize the literature on radiotracers employed in functional PET imaging of the spinal cord. In conclusion, we propose criteria for an ideal radiotracer for molecular spinal cord imaging, emphasizing the relevance of multimodal hybrid cameras, and particularly the benefits of PET-MRI integration.</div></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"55 4","pages":"Pages 629-643"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1053/j.semnuclmed.2025.03.004
Luca Filippi, Orazio Schillaci
Brain amyloid imaging has become a crucial tool in diagnosing and understanding Alzheimer's disease (AD) and related neurodegenerative disorders. The introduction of amyloid positron emission tomography (PET) with [¹¹C]Pittsburgh Compound-B ([¹¹C]PiB) in the early 2000s marked a breakthrough in visualizing amyloid-β (Aβ) deposition in vivo. Subsequent development of ¹⁸F-labeled tracers, such as [¹⁸F]florbetapir, [¹⁸F]flutemetamol, and [¹⁸F]florbetaben, improved accessibility and extended imaging capabilities. However, global adoption remains uneven due to disparities in healthcare infrastructure, costs, and regulatory frameworks. In high-income countries, amyloid PET is increasingly used in clinical workflows, particularly for differentiating atypical dementia cases and selecting patients for anti-amyloid therapies like aducanumab and lecanemab. Despite its high sensitivity and specificity, challenges persist regarding its clinical utility, particularly in cognitively normal individuals with amyloid accumulation. Research is focusing on integrating amyloid PET with other biomarkers—tau PET, cerebrospinal fluid analysis, and plasma assays—to improve diagnostic accuracy. Geographical variations in amyloid PET research and implementation reveal North America and Europe as leaders, while access remains limited in low- and middle-income countries. Efforts such as the Worldwide Alzheimer's Disease Neuroimaging Initiative aim to enhance global standardization and accessibility. Emerging trends in artificial intelligence (AI)-assisted imaging analysis and next-generation tracers promise further improvements. Addressing ethical concerns related to preclinical screening and ensuring equitable access to amyloid PET are critical for optimizing its role in neurology and nuclear medicine worldwide.
脑淀粉样蛋白成像已成为诊断和了解阿尔茨海默病（AD）及相关神经退行性疾病的重要工具。21世纪初引入的带有[¹¹C]Pittsburgh Compound-B（[¹¹C]PiB）的淀粉样蛋白正电子发射断层扫描（PET）标志着在体内观察淀粉样蛋白-β (a β)沉积的突破。随后开发出的¹⁸F标记的示踪剂，如[¹⁸F]氟倍他吡、[¹⁸F]氟替他莫和[¹⁸F]氟倍他苯，改善了可及性并扩展了成像能力。然而，由于医疗基础设施、成本和监管框架的差异，全球的采用情况仍然不均衡。在高收入国家，淀粉样蛋白PET越来越多地用于临床工作流程，特别是用于区分非典型痴呆病例和选择患者进行抗淀粉样蛋白治疗，如aducanumab和lecanemab。尽管它具有很高的敏感性和特异性，但其临床应用仍然存在挑战，特别是在淀粉样蛋白积累的认知正常个体中。研究的重点是将淀粉样PET与其他生物标志物（tau PET、脑脊液分析和血浆分析）结合起来，以提高诊断的准确性。淀粉样蛋白PET研究和实施的地理差异表明，北美和欧洲处于领先地位，而低收入和中等收入国家的获取仍然有限。诸如全球阿尔茨海默病神经影像学倡议等努力旨在加强全球标准化和可及性。人工智能（AI）辅助成像分析和下一代示踪剂的新兴趋势有望进一步改善。解决与临床前筛查相关的伦理问题并确保公平获取淀粉样PET对于优化其在全球神经病学和核医学中的作用至关重要。
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