Seminars in nuclear medicine最新文献_第8页

Global experience in brain amyloid imaging 脑淀粉样蛋白成像的全球经验。

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.2025.03.004

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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引用次数: 0

New Promising Targets for Imaging in Cardiovascular Diseases 心血管疾病成像的新靶点。

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

Seminars in nuclear medicine

Pub Date : 2025-06-23 DOI: 10.1053/j.semnuclmed.2025.05.006

Mia Ståhle , Cristina Popescu , Christoph Rischpler , Han Zhang , Samia Massalha , Leonor Lopes , Axel Rominger , Federico Caobelli

Cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality worldwide, driven by complex and dynamic molecular processes such as inflammation, fibrosis, metabolic dysregulation, thrombosis, and vascular remodeling. While conventional imaging techniques provide valuable anatomical and functional information, they fail to capture these underlying pathophysiological mechanisms at the molecular level. Molecular imaging, particularly with PET and SPECT, offers the potential to noninvasively visualize and quantify these processes, enabling earlier diagnosis, better risk stratification, and more precise treatment guidance. Despite substantial progress in clinical cardiology, there is a growing need for novel radiotracers that can target key disease-driving mechanisms beyond traditional perfusion or viability imaging. Emerging radiopharmaceuticals now enable the assessment of myocardial fibrosis (e.g., collagen-targeted and MMP-targeted tracers), cardiomyocyte stress responses (e.g., oxidative stress, unfolded protein response, endothelin signaling), and metabolic alterations (e.g., fatty acid, ketone, and glucose metabolism). Additionally, new tracers are being developed for thrombosis, vascular inflammation, plaque instability, and even for innovative targets such as cellular senescence and gut-derived inflammatory pathways. These developments reflect a paradigm shift towards imaging-driven phenotyping of cardiovascular disease. This review provides a comprehensive overview of the latest advances in molecular imaging tracers for cardiovascular applications, with a focus on their biological rationale, preclinical and clinical evidence, and translational challenges. We categorize tracers by their mechanistic targets and highlight their potential for integration into precision cardiology.

心血管疾病（cvd）仍然是世界范围内发病率和死亡率的主要原因，由复杂和动态的分子过程驱动，如炎症、纤维化、代谢失调、血栓形成和血管重塑。虽然传统的成像技术提供了有价值的解剖和功能信息，但它们无法在分子水平上捕获这些潜在的病理生理机制。分子成像，特别是PET和SPECT，提供了无创可视化和量化这些过程的潜力，使早期诊断，更好的风险分层和更精确的治疗指导成为可能。尽管临床心脏病学取得了实质性进展，但对新型放射性示踪剂的需求日益增长，这种示踪剂可以针对传统灌注或生存能力成像之外的关键疾病驱动机制。新兴的放射性药物现在能够评估心肌纤维化（例如，胶原靶向和mmp靶向示踪剂），心肌细胞应激反应（例如，氧化应激，未折叠蛋白反应，内皮素信号传导）和代谢改变（例如，脂肪酸，酮和葡萄糖代谢）。此外，新的示踪剂正在开发用于血栓形成、血管炎症、斑块不稳定，甚至用于创新靶点，如细胞衰老和肠道来源的炎症途径。这些发展反映了向成像驱动的心血管疾病表型的范式转变。本文综述了分子成像示踪剂在心血管应用方面的最新进展，重点介绍了分子成像示踪剂的生物学原理、临床前和临床证据以及转化挑战。我们将示踪剂按其机制靶点进行分类，并强调其整合到精确心脏病学中的潜力。

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引用次数: 0

New Targets for Positron Emission Tomography Imaging in Parkinson´s Disease 帕金森病正电子发射断层成像的新靶点。

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

Seminars in nuclear medicine

Pub Date : 2025-06-07 DOI: 10.1053/j.semnuclmed.2025.05.004

Yu-Jie Yang , Yi-Xin Zhao , Xin-Yi Li , Chuantao Zuo

In recent years, the neuroimaging biomarkers for Parkinson’s disease (PD) has advanced rapidly, targeting to the key pathological mechanisms such as α-synuclein (α-syn) aggregation, neuroinflammation, mitochondrial dysfunction and brain clearance. This review summarized the novel imaging targets and their clinical practice in human studies. The presynaptic dopamine transporters and ¹⁸F-Fluorodeoxyglucose positron emission tomography (PET) have been characterized as established biomarkers in PD. Furthermore, as the key pathogenic protein in PD, α-syn aggregation forming Lewy bodies could drive the neuronal degeneration, making the α-syn-targeted PET imaging a critical focus in PD research. Other co-pathologies, including amyloid-β and tau protein, were also concluded for their clinical implications in PD. Additionally, the PET imaging targets for neuroinflammatory mechanisms, including mitochondrial dysfunction, microglial and astrocyte activation, hold promise for further investigation. Finally, the radiotracers detecting disruptions of blood-brain barrier and glymphatic system would also represent as therapeutic opportunities. In conclusion, the vigorous development of novel imaging biomarkers in PD will refine the diagnostic frameworks, promoting for the future disease-modifying therapies.

近年来，帕金森病（PD）的神经影像学生物标志物研究进展迅速，主要针对α-突触核蛋白（α-syn）聚集、神经炎症、线粒体功能障碍和脑清除等关键病理机制。本文综述了新型成像靶点及其在人体研究中的临床应用。突触前多巴胺转运蛋白和18f -氟脱氧葡萄糖正电子发射断层扫描（PET）已被表征为帕金森病的既定生物标志物。此外，α-syn聚集形成的路易小体是PD的关键致病蛋白，可驱动神经元变性，因此α-syn靶向PET成像成为PD研究的关键焦点。其他共同病理，包括淀粉样蛋白-β和tau蛋白，也总结了它们在PD中的临床意义。此外，PET成像目标的神经炎症机制，包括线粒体功能障碍，小胶质细胞和星形胶质细胞活化，有希望进一步研究。最后，放射性示踪剂检测血脑屏障和淋巴系统的破坏也将代表治疗的机会。总之，PD中新型成像生物标志物的蓬勃发展将完善诊断框架，促进未来的疾病改善治疗。

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引用次数: 0

Fibroblast Activation Protein Inhibitor (FAPI) PET in Sarcoma: An Update and Future Perspective 成纤维细胞活化蛋白抑制剂（FAPI） PET在肉瘤中的应用：最新进展和未来展望。

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

Seminars in nuclear medicine

Pub Date : 2025-06-01 DOI: 10.1053/j.semnuclmed.2025.05.003

Roberto C. Delgado Bolton , Adriana K. Calapaquí Terán , Ludmila Santiago Almeida , Diana Paez , Enrique Estrada Lobato , Anita Brink , Peter Knoll , Giorgio Treglia , Francesco Giammarile

Nuclear medicine has seen significant advancements in recent years, especially in the area of Positron Emission Tomography (PET) imaging. One of these innovations is the use of Fibroblast Activation Protein Inhibitors (FAPI) as a novel radiotracer. FAPI PET imaging has shown promising results in various malignancies, including sarcomas, which are a diverse group of cancers originating from mesenchymal cells. This review aims to explore the potential of FAPI PET imaging in the diagnosis, staging, and treatment monitoring of sarcomas. Several studies have demonstrated the potential of FAPI PET in sarcomas. Furthermore, FAPI PET imaging has shown potential in assessing treatment response, with changes in FAPI uptake correlating with treatment outcomes. However, there are challenges to be addressed. The heterogeneity of sarcomas, both inter- and intra-tumoral, may affect the uniformity of Fibroblast Activation Protein (FAP) expression and thus the effectiveness of FAPI PET imaging. In conclusion, the introduction of FAPI PET imaging represents a significant advancement in the field of nuclear medicine and oncology. As we continue to deepen our understanding of this novel imaging technique, it is hoped that FAPI PET imaging will play an increasingly important role in the fight against cancer. However, as with any new technology, further research is needed to fully understand the potential and limitations of FAPI PET imaging in the clinical setting.

近年来，核医学取得了重大进展，特别是在正电子发射断层扫描（PET）成像领域。其中一个创新是使用成纤维细胞活化蛋白抑制剂（FAPI）作为一种新的放射性示踪剂。FAPI PET成像在各种恶性肿瘤中显示出令人鼓舞的结果，包括肉瘤，这是一种起源于间充质细胞的不同类型的癌症。本综述旨在探讨FAPI PET成像在肉瘤的诊断、分期和治疗监测中的潜力。一些研究已经证明了FAPI PET在肉瘤中的潜力。此外，FAPI PET成像显示出评估治疗反应的潜力，FAPI摄取的变化与治疗结果相关。然而，也有一些挑战需要解决。肉瘤的异质性（肿瘤间和肿瘤内）可能影响成纤维细胞活化蛋白（FAP）表达的均匀性，从而影响FAPI PET成像的有效性。总之，FAPI PET成像的引入代表了核医学和肿瘤学领域的重大进步。随着我们对这种新型成像技术的理解不断加深，希望FAPI PET成像在与癌症的斗争中发挥越来越重要的作用。然而，与任何新技术一样，需要进一步的研究来充分了解FAPI PET成像在临床环境中的潜力和局限性。

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引用次数: 0

Advances in Endocrine Tumor PET Imaging Targeting CXCR4 and GLP-1 靶向CXCR4和GLP-1的内分泌肿瘤PET成像研究进展

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

Seminars in nuclear medicine

Pub Date : 2025-05-29 DOI: 10.1053/j.semnuclmed.2025.05.001

Esther Mena , Liza Lindenberg , Peter Herscovitch , Samira M. Sadowski , Peter L. Choyke

Molecular imaging has experienced significant advances in the areas of imaging probes and technology, enabling the detection of tumors at earlier stages and more accurately identifying extent of disease. To better characterize lesions, nuclear medicine modalities utilize molecular imaging agents targeting specific pathways and cell surface molecules to improve both sensitivity and specificity. In the field of endocrinology, tumors encompass a wide spectrum of aggressiveness ranging from indolent, well differentiated tumors to highly aggressive cancers. Thus, in recent years, new molecular imaging biomarkers have been developed for noninvasively assessing different types of hormone-producing tumors. For instance, ⁶⁸Ga-PentixaFor is a novel PET imaging agent targeting the C-X-C chemokine receptor type 4 (CXCR4) with proven utility in various malignancies, and has also shown multifunctionality in detecting endocrine pathologies, such as primary aldosteronism, adrenocorticotropic hormone (ACTH)-producing pituitary adenomas and ACTH-independent cortisol-producing adrenal adenomas. Another novel receptor-targeted radiotracer using the glucagon-like peptide-1 receptor (GLP-1R) analog, Exendin-4 has recently developed to preoperatively localize insulinomas, arising from pancreatic beta cells. This review presents an overview of new developments and potential clinical implementation of CXCR4- and Exendin- based radiotracers for imaging applications in endocrinology.

分子成像在成像探针和技术领域取得了重大进展，能够在早期阶段检测肿瘤并更准确地确定疾病的程度。为了更好地表征病变，核医学模式利用靶向特定途径和细胞表面分子的分子显像剂来提高灵敏度和特异性。在内分泌学领域，肿瘤涵盖了广泛的侵袭性，从惰性的、分化良好的肿瘤到高度侵袭性的肿瘤。因此，近年来，新的分子成像生物标志物已经被开发出来，用于无创评估不同类型的激素产生肿瘤。例如，68Ga-PentixaFor是一种针对C-X-C趋化因子受体4型（CXCR4）的新型PET显像剂，已被证明在各种恶性肿瘤中具有实用价值，并且在检测内分泌病变（如原发性醛固酮增多症、促肾上腺皮质激素（ACTH）产生的垂体腺瘤和不依赖促肾上腺皮质激素产生的肾上腺腺瘤）方面也显示出多种功能。另一种新型受体靶向放射性示踪剂使用胰高血糖素样肽-1受体（GLP-1R）类似物Exendin-4，最近被开发用于术前定位胰岛细胞产生的胰岛素瘤。本文综述了基于CXCR4和Exendin的放射示踪剂在内分泌成像中的新进展和潜在的临床应用。

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引用次数: 0

Targets for Molecular Imaging of Neuroendocrine Tumors (NETs): An Overview and Update 神经内分泌肿瘤（NETs）分子成像靶点：综述与最新进展。

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

Seminars in nuclear medicine

Pub Date : 2025-05-28 DOI: 10.1053/j.semnuclmed.2025.04.003

Esmail Jafari , Majid Assadi , Meysam Nasiri , Hojjat Ahmadzadehfar

Neuroendocrine neoplasms (NENs) represent a diverse group of tumors originating from neuroendocrine cells, characterized by their unique biological behavior and clinical manifestations. The incidence of neuroendocrine tumors (NETs) has been rising, necessitating effective diagnostic and therapeutic strategies. Molecular imaging, particularly through techniques such as PET and SPECT, plays a pivotal role in the management of NETs. This review highlights the significance of somatostatin receptor imaging in the initial diagnostic work-up, staging, and treatment planning for NETs, emphasizing the utility of radiopharmaceuticals like [⁶⁸Ga]Ga-DOTATATE and [⁶⁸Ga]Ga-DOTA-LM3. These agents demonstrate high sensitivity and specificity, allowing for accurate delineation of disease extent and identification of occult primary tumors. Furthermore, the review discusses the emerging role of nonsomatostatin receptor targets, such as glucose metabolism and fibroblast activation protein, in enhancing the diagnostic capabilities of molecular imaging. The integration of advanced imaging modalities, including dual-tracer approaches, is explored for their potential to refine therapeutic strategies and improve patient outcomes. As the field of molecular imaging continues to evolve, ongoing research and clinical trials are essential to validate the efficacy and safety of novel imaging agents and techniques, ultimately enhancing the management of patients with neuroendocrine tumors.

神经内分泌肿瘤（NENs）是一类起源于神经内分泌细胞的肿瘤，具有独特的生物学行为和临床表现。神经内分泌肿瘤（NETs）的发病率一直在上升，需要有效的诊断和治疗策略。分子成像，特别是通过PET和SPECT等技术，在NETs的管理中起着关键作用。本综述强调了生长抑素受体成像在NETs的初始诊断、分期和治疗计划中的重要性，并强调了放射性药物如[68Ga]Ga-DOTATATE和[68Ga]Ga-DOTA-LM3的应用。这些药物具有很高的敏感性和特异性，可以准确地描述疾病的范围和识别隐匿的原发肿瘤。此外，本文还讨论了非生长抑素受体靶点（如葡萄糖代谢和成纤维细胞激活蛋白）在提高分子成像诊断能力方面的新作用。整合先进的成像方式，包括双示踪方法，探索其潜力，以完善治疗策略和改善患者的结果。随着分子成像领域的不断发展，正在进行的研究和临床试验对于验证新型成像剂和技术的有效性和安全性至关重要，最终增强神经内分泌肿瘤患者的管理。

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引用次数: 0

New Radiopharmaceutical Tools in Imaging 新放射药物成像工具。

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

Seminars in nuclear medicine

Pub Date : 2025-05-26 DOI: 10.1053/j.semnuclmed.2025.05.002

Dirk Bender

The strength of Nuclear Medicine imaging are the compounds to be used as radioactive probes. Unfortunately there are many constraints both in relation to physiological parameters such as metabolism as well to compound related properties like lipophilicity or chemical stability. Due these constraints, many, otherwise promising, compounds could not be used in Nuclear Medicine imaging. Within this review a brief summary is given regarding possible limitations for imaging probes and approaches or techniques to overcome the constraints. Even so the review focuses on imaging with central active compounds, many of these problems appear likewise when targeting peripheral organs. Besides the established approaches to overcome limitations some new, so far not explored, directions are discussed. Finally, a potential new tool in imaging will be presented, a trojan horse approach for transportation of radioligands. Here, like in conventional drug development, lipid nanoparticles may have potential to be used as carrier systems in Nuclear Medicine as well. This, so far not explored, concept is briefly presented.

核医学成像的强度是用来作为放射性探针的化合物。不幸的是，在生理参数（如代谢）以及化合物相关特性（如亲脂性或化学稳定性）方面存在许多限制。由于这些限制，许多原本很有前途的化合物不能用于核医学成像。在这篇综述中，简要总结了成像探针和方法或技术可能存在的局限性，以克服这些局限性。尽管这篇综述关注的是中枢活性化合物的成像，但在针对外周器官时，许多问题也同样出现。除了已建立的克服局限性的方法外，还讨论了一些迄今尚未探索的新方向。最后，将介绍一种潜在的成像新工具，一种用于放射性配体运输的特洛伊木马方法。在这里，就像在传统药物开发中一样，脂质纳米颗粒也有可能被用作核医学的载体系统。这个迄今尚未探讨的概念被简要地提出。

引用次数: 0

FAPI PET Versus FDG PET/CT in Gastrointestinal Cancers: An Overview FAPI PET与FDG PET/CT在胃肠道癌症中的对比：综述。

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

Seminars in nuclear medicine

Pub Date : 2025-05-21 DOI: 10.1053/j.semnuclmed.2025.04.006

Zhaoguo Lin , Pawel Rasinski , Ted Nilsson , Maria Holstensson , Yangmeihui Song , August Blomgren , Warissara Jutidamrongphan , Kalyani Pandya , Jimin Hong , Axel Rominger , Kuangyu Shi , Rimma Axelsson , Xiaoli Lan , Robert Seifert

Fibroblast activation protein (FAP) is a type II transmembrane serine protease that is highly expressed in cancer-associated fibroblasts (CAFs) but absent in quiescent fibroblasts. Its overexpression is associated with poor prognosis in various cancers and contributes to treatment resistance. In recent years, radiolabeled FAP inhibitors (FAPI) for PET imaging have shown promising clinical value across a range of cancers. Gastrointestinal (GI) malignancies, which often exhibit a desmoplastic reaction with a high density of FAP-expressing CAFs, are particularly well-suited for FAPI PET. Given the limitations of [¹⁸F]FDG PET in GI cancers, such as low sensitivity in certain histological subtypes and high physiological background uptake, FAPI PET is expected to serve as a complementary method, potentially enhancing both diagnostic accuracy and treatment guidance. This review provides a comprehensive comparison of the clinical applications of FAPI PET and [¹⁸F]FDG PET in various GI cancers, including their value in diagnosis, staging, and treatment guidance. Additionally, this review summarizes studies on the expanding role of FAPI PET, including its use in assessing treatment response and predicting prognosis, aiming to provide insights into its potential contribution to the improved management of GI malignancies.

成纤维细胞活化蛋白（FAP）是一种II型跨膜丝氨酸蛋白酶，在癌症相关成纤维细胞（CAFs）中高表达，但在静止成纤维细胞中不表达。它的过表达与各种癌症的不良预后有关，并有助于治疗耐药。近年来，放射性标记FAP抑制剂（FAPI）用于PET成像已显示出在一系列癌症中有希望的临床价值。胃肠道（GI）恶性肿瘤通常表现为高密度表达FAPI的caf的结缔组织增生反应，特别适合FAPI PET。考虑到[18F]FDG PET在胃肠道肿瘤中的局限性，如某些组织学亚型的低敏感性和高生理背景摄取，FAPI PET有望作为一种补充方法，潜在地提高诊断准确性和治疗指导。本文综述了FAPI PET和[18F]FDG PET在各种胃肠道肿瘤中的临床应用，包括其在诊断、分期和治疗指导方面的价值。此外，本综述总结了FAPI PET扩大作用的研究，包括其在评估治疗反应和预测预后方面的应用，旨在深入了解其对改善胃肠道恶性肿瘤管理的潜在贡献。

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引用次数: 0

Molecular Imaging for Response Assessment of Neuroendocrine Tumors (NET) 神经内分泌肿瘤反应评估的分子影像学研究。

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

Seminars in nuclear medicine

Pub Date : 2025-05-09 DOI: 10.1053/j.semnuclmed.2025.04.005

Martina Di Franco , Giuseppe Lamberti , Davide Campana , Valentina Ambrosini

Assessing treatment response in neuroendocrine tumors (NET) remains a significant challenge due to their typically indolent growth and heterogenity, the frequent occurrence of disease stabilization rather than tumor shrinkage after therapy, and the inherent limitations of conventional imaging criteria. While molecular imaging—primarily somatostatin receptor (SST) PET/CT—has improved lesion detection, the absence of standardized response criteria limits its clinical utility and prevents its use as full replacement of conventional imaging. Emerging strategies, including revised thresholds for dimensional changes, criteria evaluating different features, such as lesions’ density and functional tumor volumes, offer potential improvements in response evaluation but require further validation for routine clinical implementation. This review examines the current challenges in assessing NET treatment response, evaluates the strengths and limitations of available imaging modalities, and discusses emerging approaches and future directions for optimizing therapeutic monitoring in the heterogeneous panorama of NET.

评估神经内分泌肿瘤（NET）的治疗反应仍然是一个重大挑战，因为它们通常生长缓慢和异质性，治疗后经常出现疾病稳定而不是肿瘤缩小，以及传统影像学标准的固有局限性。虽然分子成像（主要是生长抑素受体（SST） PET/ ct）改善了病变检测，但缺乏标准化的反应标准限制了其临床应用，并阻碍了其作为传统成像的完全替代。新兴策略，包括修订尺寸变化的阈值，评估不同特征的标准，如病变密度和功能性肿瘤体积，为反应评估提供了潜在的改进，但需要进一步验证常规临床实施。本综述探讨了评估NET治疗反应的当前挑战，评估了可用成像方式的优势和局限性，并讨论了优化NET异质性全景治疗监测的新兴方法和未来方向。

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引用次数: 0

New Targets for Imaging in Nuclear Medicine 核医学成像新靶点。

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

Seminars in nuclear medicine

Pub Date : 2025-05-06 DOI: 10.1053/j.semnuclmed.2025.04.004

Anita Brink , Diana Paez , Enrique Estrada Lobato , Roberto C. Delgado Bolton , Peter Knoll , Aruna Korde , Adriana K. Calapaquí Terán , Mohamad Haidar , Francesco Giammarile

Nuclear medicine is rapidly evolving with new molecular imaging targets and advanced computational tools that promise to enhance diagnostic precision and personalized therapy. Recent years have seen a surge in novel PET and SPECT tracers, such as those targeting prostate-specific membrane antigen (PSMA) in prostate cancer, fibroblast activation protein (FAP) in tumor stroma, and tau protein in neurodegenerative disease. These tracers enable more specific visualization of disease processes compared to traditional agents, fitting into a broader shift toward precision imaging in oncology and neurology. In parallel, artificial intelligence (AI) and machine learning techniques are being integrated into tracer development and image analysis. AI-driven methods can accelerate radiopharmaceutical discovery, optimize pharmacokinetic properties, and assist in interpreting complex imaging datasets. This editorial provides an expanded overview of emerging imaging targets and techniques, including theranostic applications that pair diagnosis with radionuclide therapy, and examines how AI is augmenting nuclear medicine. We discuss the implications of these advancements within the field’s historical trajectory and address the regulatory, manufacturing, and clinical challenges that must be navigated. Innovations in molecular targeting and AI are poised to transform nuclear medicine practice, enabling more personalized diagnostics and radiotheranostic strategies in the era of precision healthcare.

核医学正在迅速发展，新的分子成像目标和先进的计算工具有望提高诊断精度和个性化治疗。近年来，新的PET和SPECT示踪剂出现了激增，例如针对前列腺癌中的前列腺特异性膜抗原（PSMA）、肿瘤基质中的成纤维细胞激活蛋白（FAP）和神经退行性疾病中的tau蛋白的示踪剂。与传统药物相比，这些示踪剂能够更具体地可视化疾病过程，适应肿瘤和神经病学向精确成像的更广泛转变。与此同时，人工智能（AI）和机器学习技术正在被整合到示踪剂开发和图像分析中。人工智能驱动的方法可以加速放射性药物的发现，优化药代动力学特性，并协助解释复杂的成像数据集。这篇社论提供了新兴成像靶点和技术的扩展概述，包括将诊断与放射性核素治疗相结合的治疗应用，并研究了人工智能如何增强核医学。我们将讨论这些进展对该领域历史轨迹的影响，并解决必须解决的监管、制造和临床挑战。分子靶向和人工智能的创新将改变核医学实践，在精准医疗时代实现更个性化的诊断和放射治疗策略。

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引用次数: 0