Pub Date : 2025-12-11DOI: 10.2967/jnumed.125.271101
Jiaming Song,Jiani Ye
{"title":"Critical Evaluation of HER2 PET Imaging in Metastatic Breast Cancer: Addressing Key Challenges and Future Directions.","authors":"Jiaming Song,Jiani Ye","doi":"10.2967/jnumed.125.271101","DOIUrl":"https://doi.org/10.2967/jnumed.125.271101","url":null,"abstract":"","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145728565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-11DOI: 10.2967/jnumed.125.271194
Sara Lopes van den Broek, Klas Bratteby, Ximena Aguilar, Thuy A. Tran, Stina Syvänen, Dag Sehlin
Visual Abstract
视觉文摘
{"title":"Radionuclide Selection Influences Imaging Outcomes in Immuno-PET with a Brain-Penetrating Anti–Amyloid-β Antibody","authors":"Sara Lopes van den Broek, Klas Bratteby, Ximena Aguilar, Thuy A. Tran, Stina Syvänen, Dag Sehlin","doi":"10.2967/jnumed.125.271194","DOIUrl":"https://doi.org/10.2967/jnumed.125.271194","url":null,"abstract":"<sec><st>Visual Abstract</st><p><fig loc=\"float\"><link locator=\"jnumed.125.271194absf1\"></fig></p></sec>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"366 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145728871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Incidental Findings in Nuclear Imaging: Should Patient Consent Be Obtained Before Disclosure?","authors":"Jasper Debrabander,Stefano Fanti,Luigia Vetrone,Elisabetta Lalumera","doi":"10.2967/jnumed.125.271479","DOIUrl":"https://doi.org/10.2967/jnumed.125.271479","url":null,"abstract":"","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145728479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-11DOI: 10.2967/jnumed.125.270654
Julia G Fricke,Frida Westerbergh,Lisa McDougall,Chiara Favaretto,Emanuel Christ,Guillaume P Nicolas,Susanne Geistlich,David E Schmid,Francesca Borgna,Melpomeni Fani,Peter Bernhardt,Nicholas P van der Meulen,Cristina Müller,Roger Schibli,Damian Wild
The goal of this phase 0 study was to determine the absorbed doses in tumors and relevant organs after a test injection of [161Tb]Tb-DOTA-LM3 and [177Lu]Lu-DOTATOC in the same cohort of patients with grade 1 and 2 somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors. Methods: In this randomized, crossover, prospective, single-center, open-label phase 0 study, 8 patients received 1 GBq of [161Tb]Tb-DOTA-LM3 and 1 GBq of [177Lu]Lu-DOTATOC, with a 4-wk interval between injections. Quantitative SPECT/CT imaging was performed 3, 24, 72, and 168 h after administration of each radiopharmaceutical to calculate tumor and organ absorbed doses (3-dimensional dosimetry using a Monte Carlo-based ordered-subset expectation maximization algorithm). Results: After injection of 1 GBq of [161Tb]Tb-DOTA-LM3, SPECT/CT revealed excellent image quality with intense tumor uptake in all patients and a median of the mean effective tumor half-life of 103 h (range, 56-152 h) for [161Tb]Tb-DOTA-LM3 and 83 h (range, 30-122 h) for [177Lu]Lu-DOTATOC (P = 0.012). The medians of the mean tumor absorbed doses of [161Tb]Tb-DOTA-LM3 and [177Lu]Lu-DOTATOC were 36.6 Gy/GBq (range, 15-196 Gy/GBq) and 7.0 Gy/GBq (range, 2.4-14.2 Gy/GBq), respectively (P = 0.008). The median kidney and bone marrow absorbed doses were 2.4 Gy/GBq (range, 1.8-3.1 Gy/GBq) and 0.31 Gy/GBq (range, 0.24-0.48 Gy/GBq) for [161Tb]Tb-DOTA-LM3 and 0.6 Gy/GBq (range, 0.4-0.8 Gy/GBq) and 0.04 Gy/GBq (range, 0.03-0.06 Gy/GBq) for [177Lu]Lu-DOTATOC, respectively (both P = 0.008). According to Common Terminology Criteria for Adverse Events version 5.0, grade 1-3 treatment-emergent adverse events occurred in 6 of 8 patients after administration of 1 GBq of [161Tb]Tb-DOTA-LM3. Conclusion: [161Tb]Tb-DOTA-LM3 showed a 7.6-fold-higher median tumor absorbed dose than that of [177Lu]Lu-DOTATOC. The tumor-to-bone marrow absorbed dose ratio was in the same range for [161Tb]Tb-DOTA-LM3 as for [177Lu]Lu-DOTATOC. The administration of 1 GBq of [161Tb]Tb-DOTA-LM3 was safe for all patients, without relevant adverse events.
{"title":"Targeted β--Particle Plus Conversion and Auger-Electron Therapy with 161Tb-Labeled Somatostatin Receptor Antagonist DOTA-LM3: A Phase 0 Study.","authors":"Julia G Fricke,Frida Westerbergh,Lisa McDougall,Chiara Favaretto,Emanuel Christ,Guillaume P Nicolas,Susanne Geistlich,David E Schmid,Francesca Borgna,Melpomeni Fani,Peter Bernhardt,Nicholas P van der Meulen,Cristina Müller,Roger Schibli,Damian Wild","doi":"10.2967/jnumed.125.270654","DOIUrl":"https://doi.org/10.2967/jnumed.125.270654","url":null,"abstract":"The goal of this phase 0 study was to determine the absorbed doses in tumors and relevant organs after a test injection of [161Tb]Tb-DOTA-LM3 and [177Lu]Lu-DOTATOC in the same cohort of patients with grade 1 and 2 somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors. Methods: In this randomized, crossover, prospective, single-center, open-label phase 0 study, 8 patients received 1 GBq of [161Tb]Tb-DOTA-LM3 and 1 GBq of [177Lu]Lu-DOTATOC, with a 4-wk interval between injections. Quantitative SPECT/CT imaging was performed 3, 24, 72, and 168 h after administration of each radiopharmaceutical to calculate tumor and organ absorbed doses (3-dimensional dosimetry using a Monte Carlo-based ordered-subset expectation maximization algorithm). Results: After injection of 1 GBq of [161Tb]Tb-DOTA-LM3, SPECT/CT revealed excellent image quality with intense tumor uptake in all patients and a median of the mean effective tumor half-life of 103 h (range, 56-152 h) for [161Tb]Tb-DOTA-LM3 and 83 h (range, 30-122 h) for [177Lu]Lu-DOTATOC (P = 0.012). The medians of the mean tumor absorbed doses of [161Tb]Tb-DOTA-LM3 and [177Lu]Lu-DOTATOC were 36.6 Gy/GBq (range, 15-196 Gy/GBq) and 7.0 Gy/GBq (range, 2.4-14.2 Gy/GBq), respectively (P = 0.008). The median kidney and bone marrow absorbed doses were 2.4 Gy/GBq (range, 1.8-3.1 Gy/GBq) and 0.31 Gy/GBq (range, 0.24-0.48 Gy/GBq) for [161Tb]Tb-DOTA-LM3 and 0.6 Gy/GBq (range, 0.4-0.8 Gy/GBq) and 0.04 Gy/GBq (range, 0.03-0.06 Gy/GBq) for [177Lu]Lu-DOTATOC, respectively (both P = 0.008). According to Common Terminology Criteria for Adverse Events version 5.0, grade 1-3 treatment-emergent adverse events occurred in 6 of 8 patients after administration of 1 GBq of [161Tb]Tb-DOTA-LM3. Conclusion: [161Tb]Tb-DOTA-LM3 showed a 7.6-fold-higher median tumor absorbed dose than that of [177Lu]Lu-DOTATOC. The tumor-to-bone marrow absorbed dose ratio was in the same range for [161Tb]Tb-DOTA-LM3 as for [177Lu]Lu-DOTATOC. The administration of 1 GBq of [161Tb]Tb-DOTA-LM3 was safe for all patients, without relevant adverse events.","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145728475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clear cell renal cell carcinoma (ccRCC) frequently metastasizes after surgical resection, and accurate diagnosis of ccRCC metastases remains a significant clinical challenge. This study aims to evaluate the expression of CD70 and carbonic anhydrase IX (CAIX) in pulmonary metastases of ccRCC and assess the value of CD70-targeted [18F]RCCB6 immuno-PET/CT in diagnosing ccRCC metastases. Methods: We retrospectively reviewed the cases of patients who underwent lung surgery at our hospital between January 2016 and December 2024. Available specimens of pathology-confirmed ccRCC lung metastases were collected and stained for CD70 and CAIX expression. Four of these patients were enrolled to receive CD70-targeted [18F]RCCB6 immuno-PET/CT to detect potential metastases. The diagnostic performance of [18F]RCCB6 immuno-PET/CT was validated in an independent cohort of 51 patients with suspected ccRCC lung metastases. Results: Of the 13,037 patients who underwent lung surgery, 305 had lung metastases, including 40 patients with ccRCC lung metastases. Immunohistochemical analysis of 28 lung metastasis specimens revealed higher expression of CD70 than CAIX (P < 0.05). Four of the 28 patients received CD70-targeted [18F]RCCB6 immuno-PET/CT imaging, of whom 1 exhibited recurrent multiple pulmonary metastases and 3 showed no evidence of disease. In an independent validation cohort of 51 patients with suspected ccRCC lung metastases, 26 underwent dual-tracer [18F]RCCB6 and [18F]FDG PET/CT. In addition to detecting a greater number of metastases, [18F]RCCB6 demonstrated significantly higher tumor uptake (SUVmax) than did [18F]FDG PET/CT in the lung (7.61 vs. 4.28; P < 0.001), lymph nodes (10.49 vs. 6.30; P < 0.001), and other distant metastases (13.84 vs. 4.92; P < 0.001). Conclusion: CD70 is a viable biomarker for ccRCC lung metastases. CD70-targeted [18F]RCCB6 immuno-PET/CT accurately detects ccRCC lung metastases and other distant metastases.
透明细胞肾细胞癌（ccRCC）经常在手术切除后转移，准确诊断ccRCC转移仍然是一个重大的临床挑战。本研究旨在评估CD70和碳酸酐酶IX （CAIX）在ccRCC肺转移中的表达，并评估CD70靶向[18F]RCCB6免疫pet /CT对ccRCC转移的诊断价值。方法：回顾性分析2016年1月至2024年12月在我院行肺外科手术的患者。收集经病理证实的ccRCC肺转移瘤标本，染色检测CD70和CAIX的表达。其中4例患者接受cd70靶向[18F]RCCB6免疫pet /CT检测潜在转移。[18F]RCCB6免疫pet /CT的诊断效能在51例疑似ccRCC肺转移患者的独立队列中得到验证。结果：在13037例接受肺手术的患者中，305例发生肺转移，其中40例为ccRCC肺转移。28例肺转移标本的免疫组化分析显示CD70表达高于CAIX （P < 0.05）。28例患者中有4例接受了cd70靶向[18F]RCCB6免疫pet /CT成像，其中1例出现复发性多发肺转移，3例无疾病迹象。在51例疑似ccRCC肺转移患者的独立验证队列中，26例接受了双示踪剂[18F]RCCB6和[18F]FDG PET/CT。除了检测到更多的转移瘤外，[18F]RCCB6在肺（7.61 vs. 4.28, P < 0.001）、淋巴结（10.49 vs. 6.30, P < 0.001）和其他远处转移瘤（13.84 vs. 4.92, P < 0.001）中的肿瘤摄取（SUVmax）也明显高于[18F]FDG PET/CT。结论：CD70是一种可行的ccRCC肺转移标志物。cd70靶向[18F]RCCB6免疫pet /CT可准确检测ccRCC肺转移及其他远处转移。
{"title":"CD70-Targeted [18F]RCCB6 Immuno-PET/CT for Diagnosing Clear Cell Renal Cell Carcinoma Metastases: A Prospective Study.","authors":"Cheng Ma,Min Cao,Lianghua Li,Qianyun Wu,You Zhang,Dongsheng Xu,Shuxian An,Yanfei Wu,Cheng Wang,Yihui Guan,Wen Kong,Jin Zhang,Fang Xie,Wei Zhai,Gang Huang,Jianjun Liu,Xiaojing Zhao,Weijun Wei","doi":"10.2967/jnumed.125.270958","DOIUrl":"https://doi.org/10.2967/jnumed.125.270958","url":null,"abstract":"Clear cell renal cell carcinoma (ccRCC) frequently metastasizes after surgical resection, and accurate diagnosis of ccRCC metastases remains a significant clinical challenge. This study aims to evaluate the expression of CD70 and carbonic anhydrase IX (CAIX) in pulmonary metastases of ccRCC and assess the value of CD70-targeted [18F]RCCB6 immuno-PET/CT in diagnosing ccRCC metastases. Methods: We retrospectively reviewed the cases of patients who underwent lung surgery at our hospital between January 2016 and December 2024. Available specimens of pathology-confirmed ccRCC lung metastases were collected and stained for CD70 and CAIX expression. Four of these patients were enrolled to receive CD70-targeted [18F]RCCB6 immuno-PET/CT to detect potential metastases. The diagnostic performance of [18F]RCCB6 immuno-PET/CT was validated in an independent cohort of 51 patients with suspected ccRCC lung metastases. Results: Of the 13,037 patients who underwent lung surgery, 305 had lung metastases, including 40 patients with ccRCC lung metastases. Immunohistochemical analysis of 28 lung metastasis specimens revealed higher expression of CD70 than CAIX (P < 0.05). Four of the 28 patients received CD70-targeted [18F]RCCB6 immuno-PET/CT imaging, of whom 1 exhibited recurrent multiple pulmonary metastases and 3 showed no evidence of disease. In an independent validation cohort of 51 patients with suspected ccRCC lung metastases, 26 underwent dual-tracer [18F]RCCB6 and [18F]FDG PET/CT. In addition to detecting a greater number of metastases, [18F]RCCB6 demonstrated significantly higher tumor uptake (SUVmax) than did [18F]FDG PET/CT in the lung (7.61 vs. 4.28; P < 0.001), lymph nodes (10.49 vs. 6.30; P < 0.001), and other distant metastases (13.84 vs. 4.92; P < 0.001). Conclusion: CD70 is a viable biomarker for ccRCC lung metastases. CD70-targeted [18F]RCCB6 immuno-PET/CT accurately detects ccRCC lung metastases and other distant metastases.","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145728477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-11DOI: 10.2967/jnumed.125.270555
Gyu Seong Heo,Ying-Hwey Nai,Jaume R Otaegui,Steven Yang,Hannah P Luehmann,Gengyang Yuan,David Onthank,Matt Ennis,Jeff Brown,Kory J Lavine,Robert J Gropler,Yongjian Liu
Fibroblast activation protein-expressing (FAP+) fibroblasts are central mediators of cardiac remodeling after injury or disease. The aim of this study was to evaluate a new PET tracer, 64Cu-LNTH-1363S, to detect FAP+ fibroblasts in myocardial infarction (MI) mouse models. Methods: The permanent left anterior descending coronary artery ligation and the echocardiography-guided ischemia reperfusion models were used to assess the targeting efficiency of 64Cu-LNTH-1363S. Competitive receptor blocking and autoradiography studies were performed to confirm the in vivo targeting specificity. Results: 64Cu-LNTH-1363S demonstrated sensitive and specific detection of FAP+ cells in the 2 MI models. Kinetic modeling data showed that the distribution volume was higher in the infarct zone than in the remote myocardium. Conclusion: This study establishes the feasibility of 64Cu-LNTH-1363S for noninvasive detection of FAP+ fibroblasts in MI mouse models and provides preclinical data to support further investigation of this process in humans after various forms of cardiac injury.
{"title":"Preclinical Evaluation of 64Cu-LNTH-1363S to Detect Cardiac FAP-Positive Fibroblasts Using PET Imaging.","authors":"Gyu Seong Heo,Ying-Hwey Nai,Jaume R Otaegui,Steven Yang,Hannah P Luehmann,Gengyang Yuan,David Onthank,Matt Ennis,Jeff Brown,Kory J Lavine,Robert J Gropler,Yongjian Liu","doi":"10.2967/jnumed.125.270555","DOIUrl":"https://doi.org/10.2967/jnumed.125.270555","url":null,"abstract":"Fibroblast activation protein-expressing (FAP+) fibroblasts are central mediators of cardiac remodeling after injury or disease. The aim of this study was to evaluate a new PET tracer, 64Cu-LNTH-1363S, to detect FAP+ fibroblasts in myocardial infarction (MI) mouse models. Methods: The permanent left anterior descending coronary artery ligation and the echocardiography-guided ischemia reperfusion models were used to assess the targeting efficiency of 64Cu-LNTH-1363S. Competitive receptor blocking and autoradiography studies were performed to confirm the in vivo targeting specificity. Results: 64Cu-LNTH-1363S demonstrated sensitive and specific detection of FAP+ cells in the 2 MI models. Kinetic modeling data showed that the distribution volume was higher in the infarct zone than in the remote myocardium. Conclusion: This study establishes the feasibility of 64Cu-LNTH-1363S for noninvasive detection of FAP+ fibroblasts in MI mouse models and provides preclinical data to support further investigation of this process in humans after various forms of cardiac injury.","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145728478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-04DOI: 10.2967/jnumed.125.270478
S Ted Treves,Frederic H Fahey,Valentina Ferrer Valencia,Nanci Burchell,Christiane Burton,Michael Czachowski,Frederick D Grant,Hollie Lai,Ruth Lim,Helen Nadel,Miguel Hernandez Pampaloni,Neeta Pandit-Taskar,Marguerite Parisi,Victor Seghers,Summit Shah,Barry Shulkin,Lisa States,Reza Vali,Don Yoo,Katherine Zukotynski
{"title":"Summary of the 2024 Update of the North American Guidelines for Pediatric Administered Radiopharmaceutical Activities.","authors":"S Ted Treves,Frederic H Fahey,Valentina Ferrer Valencia,Nanci Burchell,Christiane Burton,Michael Czachowski,Frederick D Grant,Hollie Lai,Ruth Lim,Helen Nadel,Miguel Hernandez Pampaloni,Neeta Pandit-Taskar,Marguerite Parisi,Victor Seghers,Summit Shah,Barry Shulkin,Lisa States,Reza Vali,Don Yoo,Katherine Zukotynski","doi":"10.2967/jnumed.125.270478","DOIUrl":"https://doi.org/10.2967/jnumed.125.270478","url":null,"abstract":"","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145674391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-04DOI: 10.2967/jnumed.125.270763
Jennifer M Specht,Jasper J L van Geel,Shaoli Song,Cheng Liu,Daniel S Hippe,Nicholas A DiGregorio,Christine J Brand,Hannah M Linden
[18F]16α-fluoro-17β-fluoroestradiol ([18F]FES) PET/CT imaging enables whole-body assessment of functional estrogen receptor (ER) expression in metastatic breast cancer (mBC). Identifying imaging biomarkers that predict endocrine therapy (ET) response remains a critical need in optimizing treatment selection. Our objective was to assess the predictive utility of [18F]FES PET/CT imaging in determining response to ET, with a focus on interlesional heterogeneity and individual patient outcomes. Methods: A systematic literature review and metaanalysis were conducted using 6 major databases through April 2024. Ten studies met inclusion criteria based on quantitative SUV reporting, use of FES PET/CT in mBC, and correlation with clinical outcomes. All patients had ER-positive mBC and received ET. Primary endpoints included progression-free survival (PFS) and response to ET. Patients were stratified by baseline [18F]FES PET/CT SUVmean or SUVmax thresholds (including 1.8) and by interlesional [18F]FES heterogeneity (presence of both [18F]FES-positive and [18F]FES-negative lesions). Results: Responders had a significantly higher baseline SUVmean than nonresponders (standardized mean difference, 0.91; 95% CI, 0.49-1.34; P < 0.001). Patients with a baseline SUVmax below 1.5 were significantly less likely to respond (odds ratio, 0.11; 95% CI, 0.02-0.72; P = 0.02). Across 5 studies, patients with heterogeneous [18F]FES uptake had a shorter median PFS (2.4-12.4 mo) than did those with all [18F]FES-positive lesions (14.6-23.6 mo), a statistically significant difference (ratio of median PFS, 0.25; 95% CI, 0.17-0.36; P < 0.001). In an individual-level analysis (n = 101), lesion-level [18F]FES-heterogeneous uptake was associated with a PFS of 5.5 versus 21.6 mo and a hazard ratio of 5.4 (95% CI, 3.2-9.4; P < 0.001). An [18F]FES SUVmax threshold of at least 1.8 was more prognostic of PFS than were higher SUVmax thresholds. Conclusion: [18F]FES PET/CT imaging provides prognostic insight beyond static ER testing by identifying functional heterogeneity in mBC. Lesion-level FES heterogeneity based on an SUVmax threshold of 1.8 may help stratify patients unlikely to benefit from ET, guiding more personalized treatment strategies.
{"title":"The Role of Estrogen Receptor-Targeted PET with 16α-18F-Fluoro-17β-Estradiol in Predicting Response to Endocrine Therapies in Metastatic Breast Cancer: A Metaanalysis.","authors":"Jennifer M Specht,Jasper J L van Geel,Shaoli Song,Cheng Liu,Daniel S Hippe,Nicholas A DiGregorio,Christine J Brand,Hannah M Linden","doi":"10.2967/jnumed.125.270763","DOIUrl":"https://doi.org/10.2967/jnumed.125.270763","url":null,"abstract":"[18F]16α-fluoro-17β-fluoroestradiol ([18F]FES) PET/CT imaging enables whole-body assessment of functional estrogen receptor (ER) expression in metastatic breast cancer (mBC). Identifying imaging biomarkers that predict endocrine therapy (ET) response remains a critical need in optimizing treatment selection. Our objective was to assess the predictive utility of [18F]FES PET/CT imaging in determining response to ET, with a focus on interlesional heterogeneity and individual patient outcomes. Methods: A systematic literature review and metaanalysis were conducted using 6 major databases through April 2024. Ten studies met inclusion criteria based on quantitative SUV reporting, use of FES PET/CT in mBC, and correlation with clinical outcomes. All patients had ER-positive mBC and received ET. Primary endpoints included progression-free survival (PFS) and response to ET. Patients were stratified by baseline [18F]FES PET/CT SUVmean or SUVmax thresholds (including 1.8) and by interlesional [18F]FES heterogeneity (presence of both [18F]FES-positive and [18F]FES-negative lesions). Results: Responders had a significantly higher baseline SUVmean than nonresponders (standardized mean difference, 0.91; 95% CI, 0.49-1.34; P < 0.001). Patients with a baseline SUVmax below 1.5 were significantly less likely to respond (odds ratio, 0.11; 95% CI, 0.02-0.72; P = 0.02). Across 5 studies, patients with heterogeneous [18F]FES uptake had a shorter median PFS (2.4-12.4 mo) than did those with all [18F]FES-positive lesions (14.6-23.6 mo), a statistically significant difference (ratio of median PFS, 0.25; 95% CI, 0.17-0.36; P < 0.001). In an individual-level analysis (n = 101), lesion-level [18F]FES-heterogeneous uptake was associated with a PFS of 5.5 versus 21.6 mo and a hazard ratio of 5.4 (95% CI, 3.2-9.4; P < 0.001). An [18F]FES SUVmax threshold of at least 1.8 was more prognostic of PFS than were higher SUVmax thresholds. Conclusion: [18F]FES PET/CT imaging provides prognostic insight beyond static ER testing by identifying functional heterogeneity in mBC. Lesion-level FES heterogeneity based on an SUVmax threshold of 1.8 may help stratify patients unlikely to benefit from ET, guiding more personalized treatment strategies.","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145674406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-04DOI: 10.2967/jnumed.125.270405
Benjamin Auer,Alyssa De Moraes,Ardel J Romero Pabon,Olivier F Clerc,Sudhir Bhimaniya,Marie Foley Kijewski,Annu Kurian,Shilpa Vijayakumar,Sarah A M Cuddy,Marcelo F Di Carli,Sharmila Dorbala
The objectives of this study were to determine the timing of peak [99mTc]Tc-pyrophosphate uptake in the myocardium, blood pool, and bone and to explore the feasibility and advantage of early imaging compared with the standard late imaging in participants with and without transthyretin amyloid cardiomyopathy (ATTR-CM). Methods: Dynamic [99mTc]Tc-pyrophosphate SPECT/CT data were acquired at 0-5 min and 10-65 min, with additional 15-min static scans at 90 and 150 min using a full-ring cadmium zinc telluride scanner. Image analysis included visual assessment and established quantitative metrics that require calibrated SPECT images, such as SUVmean and SUVmax and percentage injected dose per milliliter, along with relative uptake ratios (myocardium to bone and myocardium to blood pool) that do not require calibration. ATTR-CM and non-ATTR-CM cohorts were compared. Results: Our study included 19 participants: 8 with ATTR-CM (median age of 80 y with an interquartile range of 9.3 y) and 11 (57.9%) without ATTR-CM. In ATTR-CM, SUVmean was significantly higher in the myocardium than in the blood pool at 10 min (3.86 ± 0.77 vs. 3.08 ± 0.58, P = 0.0055). Myocardial SUVmean remained elevated over time, with a statistically significant decline from 3.86 ± 0.77 at 10 min to 2.88 ± 0.57 at 150 min (P = 0.0025). In patients without ATTR-CM, myocardial SUVmean remain relatively stable across all time points (1.24 ± 0.41 at 10 min to 0.94 ± 0.21 at 150 min, P = not statistically significant). In both groups, bone SUVmean peaked at 90 min, and the blood pool showed the highest SUV at 10 min, followed by a decrease through 150 min. Percentage injected dose per milliliter clearly separated the ATTR-CM from the non-ATTR-CM groups at all time points. Conclusion: In participants with ATTR-CM, myocardial uptake peaked by 10 min after injection and remained stable, with minimal washout, through 150 min; non-ATTR-CM participants showed consistently lower myocardial uptake than blood pool uptake at all time points. These findings suggest that early imaging can perform as well as late imaging for diagnosis of ATTR-CM, supporting the potential of early imaging to streamline patient care.
{"title":"Dynamic Acquisition of [99mTc]Tc-Pyrophosphate SPECT/CT Images in Transthyretin Cardiac Amyloidosis: A Pilot Study.","authors":"Benjamin Auer,Alyssa De Moraes,Ardel J Romero Pabon,Olivier F Clerc,Sudhir Bhimaniya,Marie Foley Kijewski,Annu Kurian,Shilpa Vijayakumar,Sarah A M Cuddy,Marcelo F Di Carli,Sharmila Dorbala","doi":"10.2967/jnumed.125.270405","DOIUrl":"https://doi.org/10.2967/jnumed.125.270405","url":null,"abstract":"The objectives of this study were to determine the timing of peak [99mTc]Tc-pyrophosphate uptake in the myocardium, blood pool, and bone and to explore the feasibility and advantage of early imaging compared with the standard late imaging in participants with and without transthyretin amyloid cardiomyopathy (ATTR-CM). Methods: Dynamic [99mTc]Tc-pyrophosphate SPECT/CT data were acquired at 0-5 min and 10-65 min, with additional 15-min static scans at 90 and 150 min using a full-ring cadmium zinc telluride scanner. Image analysis included visual assessment and established quantitative metrics that require calibrated SPECT images, such as SUVmean and SUVmax and percentage injected dose per milliliter, along with relative uptake ratios (myocardium to bone and myocardium to blood pool) that do not require calibration. ATTR-CM and non-ATTR-CM cohorts were compared. Results: Our study included 19 participants: 8 with ATTR-CM (median age of 80 y with an interquartile range of 9.3 y) and 11 (57.9%) without ATTR-CM. In ATTR-CM, SUVmean was significantly higher in the myocardium than in the blood pool at 10 min (3.86 ± 0.77 vs. 3.08 ± 0.58, P = 0.0055). Myocardial SUVmean remained elevated over time, with a statistically significant decline from 3.86 ± 0.77 at 10 min to 2.88 ± 0.57 at 150 min (P = 0.0025). In patients without ATTR-CM, myocardial SUVmean remain relatively stable across all time points (1.24 ± 0.41 at 10 min to 0.94 ± 0.21 at 150 min, P = not statistically significant). In both groups, bone SUVmean peaked at 90 min, and the blood pool showed the highest SUV at 10 min, followed by a decrease through 150 min. Percentage injected dose per milliliter clearly separated the ATTR-CM from the non-ATTR-CM groups at all time points. Conclusion: In participants with ATTR-CM, myocardial uptake peaked by 10 min after injection and remained stable, with minimal washout, through 150 min; non-ATTR-CM participants showed consistently lower myocardial uptake than blood pool uptake at all time points. These findings suggest that early imaging can perform as well as late imaging for diagnosis of ATTR-CM, supporting the potential of early imaging to streamline patient care.","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145674349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Occult peritoneal metastasis (OPM) is common in locally advanced gastric cancer, and accurate detection is critical. This prospective cohort study evaluated the diagnostic accuracy and cost of 68Ga-FAPI-04 PET/CT for detecting OPM. Methods: This single-center, prospective cohort study included patients with locally advanced gastric adenocarcinoma. All patients underwent 68Ga-FAPI-04 PET/CT before laparoscopic staging, and the diagnosis of OPM was established using laparoscopic staging combined with peritoneal washing cytology as the gold standard. The primary endpoint was the proportion of patients whose treatment intent changed based on 68Ga-FAPI-04 PET/CT results. Secondary endpoints included diagnostic accuracy and cost analysis of 68Ga-FAPI-04 PET/CT in detecting OPM. Results: In total, 109 patients were recruited between November 2022 and August 2024. 68Ga-FAPI-04 PET/CT identified OPM in 17 patients (15.6%), resulting in upstaging to stage IV, with sensitivity, specificity, and diagnostic accuracy of 75.0%, 94.6%, and 91.7%, respectively (area under the curve, 0.83; 95% CI, 0.72-0.94). Economic analysis demonstrated a net cost savings of $979.30 per patient when compared with laparoscopic staging. The combination of 68Ga-FAPI-04 PET/CT and laparoscopic staging reduced the need for laparoscopic procedures by 84% and prevented 11% of futile gastrectomies, yielding a minimal cost savings of $232.30 per patient. Conclusion: 68Ga-FAPI-04 PET/CT demonstrates high diagnostic accuracy, low cost, and the potential to reduce invasive procedures, making it a promising alternative to laparoscopic staging in patients with locally advanced gastric cancer.
{"title":"68Ga-FAPI-04 PET for Detecting Occult Peritoneal Metastasis in Locally Advanced Gastric Cancer: Diagnostic Performance and Cost Analyses in a Single-Center, Prospective Cohort Study.","authors":"Qiancheng Hu,Shunyu Zhang,Kun Yang,Yuan Yin,Xiaolong Chen,Mojin Wang,Bo Zhang,Wen Zhuang,Ming Liu,Chaoyong Shen,Pengfei Zhang,Hongyuan Dai,Junjun Cheng,Shuming Ji,Minggang Su,Hongfeng Gou,Jiankun Hu","doi":"10.2967/jnumed.125.270633","DOIUrl":"https://doi.org/10.2967/jnumed.125.270633","url":null,"abstract":"Occult peritoneal metastasis (OPM) is common in locally advanced gastric cancer, and accurate detection is critical. This prospective cohort study evaluated the diagnostic accuracy and cost of 68Ga-FAPI-04 PET/CT for detecting OPM. Methods: This single-center, prospective cohort study included patients with locally advanced gastric adenocarcinoma. All patients underwent 68Ga-FAPI-04 PET/CT before laparoscopic staging, and the diagnosis of OPM was established using laparoscopic staging combined with peritoneal washing cytology as the gold standard. The primary endpoint was the proportion of patients whose treatment intent changed based on 68Ga-FAPI-04 PET/CT results. Secondary endpoints included diagnostic accuracy and cost analysis of 68Ga-FAPI-04 PET/CT in detecting OPM. Results: In total, 109 patients were recruited between November 2022 and August 2024. 68Ga-FAPI-04 PET/CT identified OPM in 17 patients (15.6%), resulting in upstaging to stage IV, with sensitivity, specificity, and diagnostic accuracy of 75.0%, 94.6%, and 91.7%, respectively (area under the curve, 0.83; 95% CI, 0.72-0.94). Economic analysis demonstrated a net cost savings of $979.30 per patient when compared with laparoscopic staging. The combination of 68Ga-FAPI-04 PET/CT and laparoscopic staging reduced the need for laparoscopic procedures by 84% and prevented 11% of futile gastrectomies, yielding a minimal cost savings of $232.30 per patient. Conclusion: 68Ga-FAPI-04 PET/CT demonstrates high diagnostic accuracy, low cost, and the potential to reduce invasive procedures, making it a promising alternative to laparoscopic staging in patients with locally advanced gastric cancer.","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"364 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145674376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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