Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique最新文献_第2页

Rôle de la TEP en neuro-oncologie : apport des traceurs FDG, aux acides aminés et des récepteurs de la somatostatine dans la prise en charge des tumeurs cérébrales PET在神经肿瘤学中的作用：FDG示踪剂、氨基酸和生长抑素受体在脑肿瘤管理中的作用

IF 0.2 4区医学 Q4 PATHOLOGY

Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique

Pub Date : 2025-10-08 DOI: 10.1016/j.mednuc.2025.09.004

A. Verger , O. Couturier

Positron emission tomography (PET) is playing an increasingly central role in neuro-oncology, complementing MRI to refine diagnosis, guide treatment, and assess therapeutic response in primary brain tumors. This article provides a focused overview of current PET indications for gliomas, brain metastases, meningiomas, and primary central nervous system lymphomas. In glioma patients, amino acid tracers (F-DOPA, FET) are recommended during all the course of the disease. They contribute to the initial characterization of lesions, support therapeutic planning (biopsy, radiotherapy), differentiate post-treatment changes from true progression, and enable early treatment response assessment. For brain metastases, the key indication is distinguishing progression from treatment related changes. Here, like for gliomas, amino acid PET outperforms FDG-PET. In meningiomas, somatostatin receptor imaging (e.g., DOTATOC) facilitates diagnostic confirmation, radiotherapy planning, recurrence detection, and patient selection for radionuclide therapy. Lastly, FDG-PET is particularly valuable for primary CNS lymphomas, both for initial differential diagnosis and response monitoring, as in systemic lymphomas. Through the targeted use of specific radiotracers, PET imaging is emerging as a cornerstone of precision medicine in the management of brain tumors, while requiring thoughtful integration into existing diagnostic and therapeutic pathways.

正电子发射断层扫描（PET）在神经肿瘤学中发挥着越来越重要的作用，它补充了MRI来完善原发性脑肿瘤的诊断、指导治疗和评估治疗反应。这篇文章提供了一个集中的概述目前PET指征胶质瘤，脑转移瘤，脑膜瘤，原发性中枢神经系统淋巴瘤。在胶质瘤患者中，推荐在整个病程中使用氨基酸示踪剂（F-DOPA， FET）。它们有助于病灶的初步表征，支持治疗计划（活检，放疗），区分治疗后的变化和真正的进展，并能够早期评估治疗反应。对于脑转移，关键的适应症是区分进展和治疗相关的改变。在这里，就像神经胶质瘤一样，氨基酸PET优于FDG-PET。在脑膜瘤中，生长抑素受体成像（如DOTATOC）有助于诊断确认、放疗计划、复发检测和患者选择放射性核素治疗。最后，FDG-PET对原发性中枢神经系统淋巴瘤特别有价值，无论是对初始鉴别诊断还是对系统性淋巴瘤的反应监测。通过有针对性地使用特定的放射性示踪剂，PET成像正在成为脑肿瘤治疗中精准医学的基石，同时需要与现有的诊断和治疗途径进行深思熟虑的整合。

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引用次数: 0

Lettre à l’éditeur au sujet de l’article « Innovation thérapeutique et enjeux capacitaires en médecine nucléaire : la situation de la RIV en Occitanie » par Guignard et al. (1) 致编辑关于文章“创新therapeutique et enjeux capacitaires en medecine nucleaire: la situation de la RIV en Occitanie”(1)作者：Guignard等人

IF 0.2 4区医学 Q4 PATHOLOGY

Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique

Pub Date : 2025-09-16 DOI: 10.1016/j.mednuc.2025.06.008

F. Courbon , P.O. Kotzki , V. Boudousq , C. Fersing , P.-Y. Salaun , E. Deshayes

引用次数: 0

Lettre à l’éditeur au sujet de l’article « Innovation thérapeutique et enjeux capacitaires en médecine nucléaire : la situation de la RIV en Occitanie » par Guignard et al. (1) 致编辑关于文章“创新therapeutique et enjeux capacitaires en medecine nucleaire: la situation de la RIV en Occitanie”(1)作者：Guignard等人

IF 0.2 4区医学 Q4 PATHOLOGY

Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique

Pub Date : 2025-09-16 DOI: 10.1016/j.mednuc.2025.06.008

F. Courbon , P.O. Kotzki , V. Boudousq , C. Fersing , P.-Y. Salaun , E. Deshayes

引用次数: 0

Predictive role of 18F-FDG PET/CT in neoadjuvant therapy response in breast cancer with axillary metastasis 18F-FDG PET/CT在乳腺癌腋窝转移新辅助治疗反应中的预测作用

IF 0.2 4区医学 Q4 PATHOLOGY

Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique

Pub Date : 2025-09-12 DOI: 10.1016/j.mednuc.2025.07.002

S. Saraçoğlu , F. Özülker , O. Güven , T. Özülker

Objective

The aim of this study is to investigate whether it is possible to predict the response to neoadjuvant therapy (NAT) in axillary lymph node metastasis of breast cancer patients using parameters from ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) scans, and to evaluate the correlation of post-NAT PET/CT findings with axillary histopathology results.

Materials and methods

Breast cancer patients with axillary lymph node involvement, who underwent staging and post-NAT PET/CT, followed by surgery or histopathological evaluation, were included. Metabolic and volumetric ¹⁸F-FDG PET/CT parameters were analyzed to determine their predictive value for NAT response. Receiver operating characteristic (ROC) curves and Chi-square tests were used for statistical evaluation.

Results

Forty-three breast cancer patients were included in the study. Statistically significant differences were observed between the axillary pathology-negative and positive patient groups for the following variables: post-NAT SUVmax (primary and axilla), ΔSUVmax% (primary and axilla), the largest lymph node diameter on staging PET/CT, and the change in diameter of the same lymph node post-NAT. In the post-NAT axillary lymph node visual evaluation, the sensitivity, specificity, the positive predictive value (PPV), and the negative predictive value (NPV) for detecting metastatic axillary lymph nodes on PET/CT, based on pathology results, were calculated as 81.8%, 66.7%, 72%, and 77.7%, respectively. When a 92.38% threshold value was determined for ΔSUVmax% (axilla), they were 90.9%, 42.9%, 62.5%, and 81.8%, respectively.

Conclusion

Metabolic parameters obtained from ¹⁸F-FDG PET/CT can contribute to predicting the treatment response for axillary metastases. ¹⁸F-FDG PET/CT provides insights into the necessity of sentinel lymph node biopsy (SLNB) and axillary dissection. However, due to ¹⁸F-FDG PET/CT's inability to achieve sufficient sensitivity and specificity, it is unlikely to replace SLNB.

目的探讨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）参数能否预测乳腺癌腋窝淋巴结转移患者对新辅助治疗（NAT）的反应，并评价NAT后PET/CT表现与腋窝组织病理学结果的相关性。材料和方法纳入经分期和nat后PET/CT、手术或组织病理学评估的乳腺癌腋窝淋巴结受累者。分析代谢和体积18F-FDG PET/CT参数，以确定其对NAT响应的预测值。采用受试者工作特征（ROC）曲线和卡方检验进行统计学评价。结果共纳入43例乳腺癌患者。腋窝病理阴性组与腋窝病理阳性组在nat后SUVmax（原发和腋窝）、ΔSUVmax%（原发和腋窝）、PET/CT分期最大淋巴结直径、nat后同一淋巴结直径变化等指标上差异均有统计学意义。在nat后腋窝淋巴结视觉评价中，基于病理结果计算PET/CT检测腋窝淋巴结转移的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为81.8%、66.7%、72%和77.7%。当确定ΔSUVmax%（腋窝）的92.38%阈值时，它们分别为90.9%,42.9%，62.5%和81.8%。结论18F-FDG PET/CT代谢参数可预测腋窝转移瘤的治疗效果。18F-FDG PET/CT为前哨淋巴结活检（SLNB）和腋窝清扫的必要性提供了见解。然而，由于18F-FDG PET/CT无法达到足够的灵敏度和特异性，因此不太可能取代SLNB。

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引用次数: 0

Predictive role of 18F-FDG PET/CT in neoadjuvant therapy response in breast cancer with axillary metastasis 18F-FDG PET/CT在乳腺癌腋窝转移新辅助治疗反应中的预测作用

IF 0.2 4区医学 Q4 PATHOLOGY

Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique

Pub Date : 2025-09-12 DOI: 10.1016/j.mednuc.2025.07.002

S. Saraçoğlu , F. Özülker , O. Güven , T. Özülker

Objective

The aim of this study is to investigate whether it is possible to predict the response to neoadjuvant therapy (NAT) in axillary lymph node metastasis of breast cancer patients using parameters from ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) scans, and to evaluate the correlation of post-NAT PET/CT findings with axillary histopathology results.

Materials and methods

Breast cancer patients with axillary lymph node involvement, who underwent staging and post-NAT PET/CT, followed by surgery or histopathological evaluation, were included. Metabolic and volumetric ¹⁸F-FDG PET/CT parameters were analyzed to determine their predictive value for NAT response. Receiver operating characteristic (ROC) curves and Chi-square tests were used for statistical evaluation.

Results

Forty-three breast cancer patients were included in the study. Statistically significant differences were observed between the axillary pathology-negative and positive patient groups for the following variables: post-NAT SUVmax (primary and axilla), ΔSUVmax% (primary and axilla), the largest lymph node diameter on staging PET/CT, and the change in diameter of the same lymph node post-NAT. In the post-NAT axillary lymph node visual evaluation, the sensitivity, specificity, the positive predictive value (PPV), and the negative predictive value (NPV) for detecting metastatic axillary lymph nodes on PET/CT, based on pathology results, were calculated as 81.8%, 66.7%, 72%, and 77.7%, respectively. When a 92.38% threshold value was determined for ΔSUVmax% (axilla), they were 90.9%, 42.9%, 62.5%, and 81.8%, respectively.

Conclusion

Metabolic parameters obtained from ¹⁸F-FDG PET/CT can contribute to predicting the treatment response for axillary metastases. ¹⁸F-FDG PET/CT provides insights into the necessity of sentinel lymph node biopsy (SLNB) and axillary dissection. However, due to ¹⁸F-FDG PET/CT's inability to achieve sufficient sensitivity and specificity, it is unlikely to replace SLNB.

目的探讨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）参数能否预测乳腺癌腋窝淋巴结转移患者对新辅助治疗（NAT）的反应，并评价NAT后PET/CT表现与腋窝组织病理学结果的相关性。材料和方法纳入经分期和nat后PET/CT、手术或组织病理学评估的乳腺癌腋窝淋巴结受累者。分析代谢和体积18F-FDG PET/CT参数，以确定其对NAT响应的预测值。采用受试者工作特征（ROC）曲线和卡方检验进行统计学评价。结果共纳入43例乳腺癌患者。腋窝病理阴性组与腋窝病理阳性组在nat后SUVmax（原发和腋窝）、ΔSUVmax%（原发和腋窝）、PET/CT分期最大淋巴结直径、nat后同一淋巴结直径变化等指标上差异均有统计学意义。在nat后腋窝淋巴结视觉评价中，基于病理结果计算PET/CT检测腋窝淋巴结转移的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为81.8%、66.7%、72%和77.7%。当确定ΔSUVmax%（腋窝）的92.38%阈值时，它们分别为90.9%,42.9%，62.5%和81.8%。结论18F-FDG PET/CT代谢参数可预测腋窝转移瘤的治疗效果。18F-FDG PET/CT为前哨淋巴结活检（SLNB）和腋窝清扫的必要性提供了见解。然而，由于18F-FDG PET/CT无法达到足够的灵敏度和特异性，因此不太可能取代SLNB。

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引用次数: 0

Imaging brain metastases of prostate cancer with 68Ga-PSMA PET/MRI: Two case reports 68Ga-PSMA PET/MRI诊断前列腺癌脑转移2例

IF 0.2 4区医学 Q4 PATHOLOGY

Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique

Pub Date : 2025-09-03 DOI: 10.1016/j.mednuc.2025.06.009

S. Gülbahar Ateş, U. Aydos, Ü.Ö. Akdemir, L.Ö. Atay

Brain metastasis in prostate cancer is a rare entity with a poor prognosis. Early detection of brain metastasis might improve patient management and prognosis. 68-Gallium prostate-specific membrane antigen (68Ga-PSMA) positron emission tomography/magnetic resonance imaging (PET/MRI) is a unique imaging modality for prostate cancer patients with higher accuracy and soft tissue resolution, which provides excellent identification of soft tissue metastases. We have presented two prostate adenocarcinoma patients with unexpected brain metastases demonstrated by 68Ga-PSMA PET/MRI.

摘要前列腺癌脑转移是一种罕见且预后差的肿瘤。早期发现脑转移可能会改善患者的治疗和预后。68-镓前列腺特异性膜抗原（68Ga-PSMA）正电子发射断层扫描/磁共振成像（PET/MRI）是前列腺癌患者独特的成像方式，具有较高的准确性和软组织分辨率，为软组织转移提供了良好的鉴别。我们报告了两例前列腺癌患者，通过68Ga-PSMA PET/MRI显示其出现了意想不到的脑转移。

引用次数: 0

Imaging brain metastases of prostate cancer with 68Ga-PSMA PET/MRI: Two case reports 68Ga-PSMA PET/MRI诊断前列腺癌脑转移2例

IF 0.2 4区医学 Q4 PATHOLOGY

Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique

Pub Date : 2025-09-03 DOI: 10.1016/j.mednuc.2025.06.009

S. Gülbahar Ateş, U. Aydos, Ü.Ö. Akdemir, L.Ö. Atay

Brain metastasis in prostate cancer is a rare entity with a poor prognosis. Early detection of brain metastasis might improve patient management and prognosis. 68-Gallium prostate-specific membrane antigen (68Ga-PSMA) positron emission tomography/magnetic resonance imaging (PET/MRI) is a unique imaging modality for prostate cancer patients with higher accuracy and soft tissue resolution, which provides excellent identification of soft tissue metastases. We have presented two prostate adenocarcinoma patients with unexpected brain metastases demonstrated by 68Ga-PSMA PET/MRI.

摘要前列腺癌脑转移是一种罕见且预后差的肿瘤。早期发现脑转移可能会改善患者的治疗和预后。68-镓前列腺特异性膜抗原（68Ga-PSMA）正电子发射断层扫描/磁共振成像（PET/MRI）是前列腺癌患者独特的成像方式，具有较高的准确性和软组织分辨率，为软组织转移提供了良好的鉴别。我们报告了两例前列腺癌患者，通过68Ga-PSMA PET/MRI显示其出现了意想不到的脑转移。

引用次数: 0

Diagnostic de l’amylose cardiaque à TTR par une approche quantitative 心脏淀粉样蛋白TTR定量诊断

IF 0.2 4区医学 Q4 PATHOLOGY

Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique

Pub Date : 2025-09-03 DOI: 10.1016/j.mednuc.2025.04.003

A. Iep , R. Chequer , V. Algalarrondo , B. Mahida , T. Cabilic , K. Doyeux , F. Rouzet

Background

International recommendations for the non-invasive diagnosis of transthyretin cardiac amyloidosis (TTR-CA) rely on visual analysis according to the Perugini 4-point-grading described with planar scintigraphy.

Objective

To evaluate the diagnostic performance of quantitative metrics with ^99mTc-DPD whole-body SPECT/CT for TTR-CA.

Methods

Consecutive patients imaged on the Veriton-CT with whole-body ^99mTc-DPD SPECT/CT were retrospectively analyzed and compared with the TTR-CA diagnosis established by the reference center.

Results

One hundred and ninety-four patients were included (47 with TTR-CA) and diagnostic performance of quantitative measure of cardiac amyloid burden normalized to the whole body, was high with an area under the curve (AUC) of 0.956 (95% CI = [0.916; 0.995]), a sensitivity of 87.2%, and a specificity of 93.2%; comparable to Perugini grading with an AUC of 0.936 (95% CI = [0.088; 0.984]), a sensitivity of 87.2%, and a specificity of 100%.

Conclusion

Semi-automated quantitative analysis with whole-body ^99mTc-DPD SPECT/CT is not inferior to Perugini visual analysis for the diagnosis of ATTR-CA.

国际推荐的经甲状腺素型心脏淀粉样变性（TTR-CA）的无创诊断依赖于平面闪烁显像描述的Perugini 4点分级的视觉分析。目的评价99mTc-DPD全身SPECT/CT定量指标对TTR-CA的诊断价值。方法回顾性分析连续患者在verton -CT和全身99mTc-DPD SPECT/CT上的影像，并与参考中心建立的TTR-CA诊断进行比较。结果纳入194例患者（47例为TTR-CA），曲线下面积（AUC）为0.956 (95% CI =[0.916; 0.995])，灵敏度为87.2%，特异性为93.2%；与Perugini分级相当，AUC为0.936 (95% CI =[0.088; 0.984])，敏感性为87.2%，特异性为100%。结论全身99mTc-DPD SPECT/CT半自动化定量分析对atr - ca的诊断不低于Perugini目视分析。

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引用次数: 0

Diagnostic de l’amylose cardiaque à TTR par une approche quantitative 心脏淀粉样蛋白TTR定量诊断

IF 0.2 4区医学 Q4 PATHOLOGY

Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique

Pub Date : 2025-09-03 DOI: 10.1016/j.mednuc.2025.04.003

A. Iep , R. Chequer , V. Algalarrondo , B. Mahida , T. Cabilic , K. Doyeux , F. Rouzet

Background

International recommendations for the non-invasive diagnosis of transthyretin cardiac amyloidosis (TTR-CA) rely on visual analysis according to the Perugini 4-point-grading described with planar scintigraphy.

Objective

To evaluate the diagnostic performance of quantitative metrics with ^99mTc-DPD whole-body SPECT/CT for TTR-CA.

Methods

Consecutive patients imaged on the Veriton-CT with whole-body ^99mTc-DPD SPECT/CT were retrospectively analyzed and compared with the TTR-CA diagnosis established by the reference center.

Results

One hundred and ninety-four patients were included (47 with TTR-CA) and diagnostic performance of quantitative measure of cardiac amyloid burden normalized to the whole body, was high with an area under the curve (AUC) of 0.956 (95% CI = [0.916; 0.995]), a sensitivity of 87.2%, and a specificity of 93.2%; comparable to Perugini grading with an AUC of 0.936 (95% CI = [0.088; 0.984]), a sensitivity of 87.2%, and a specificity of 100%.

Conclusion

Semi-automated quantitative analysis with whole-body ^99mTc-DPD SPECT/CT is not inferior to Perugini visual analysis for the diagnosis of ATTR-CA.

国际推荐的经甲状腺素型心脏淀粉样变性（TTR-CA）的无创诊断依赖于平面闪烁显像描述的Perugini 4点分级的视觉分析。目的评价99mTc-DPD全身SPECT/CT定量指标对TTR-CA的诊断价值。方法回顾性分析连续患者在verton -CT和全身99mTc-DPD SPECT/CT上的影像，并与参考中心建立的TTR-CA诊断进行比较。结果纳入194例患者（47例为TTR-CA），曲线下面积（AUC）为0.956 (95% CI =[0.916; 0.995])，灵敏度为87.2%，特异性为93.2%；与Perugini分级相当，AUC为0.936 (95% CI =[0.088; 0.984])，敏感性为87.2%，特异性为100%。结论全身99mTc-DPD SPECT/CT半自动化定量分析对atr - ca的诊断不低于Perugini目视分析。

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引用次数: 0

Boiteries : diagnostic différentiel en scintigraphie osseuse 箱形：骨扫描鉴别诊断

IF 0.2 4区医学 Q4 PATHOLOGY

Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique

Pub Date : 2025-08-01 DOI: 10.1016/j.mednuc.2025.07.001

T. Paunet, A. Bourdon

Limping in children is a common and polymorphic symptom that can reveal a wide spectrum of underlying conditions, from benign mechanical disorders to severe infectious, inflammatory, or tumoral diseases. Bone scintigraphy plays a key role in the diagnostic workup, especially when a systemic or infectious cause is suspected. Through a series of illustrative clinical cases, this article highlights unusual causes of limping identified by bone scintigraphy, including oncological (metastatic neuroblastoma, acute leukemia), infectious (appendicitis, spondylodiscitis, sacroiliitis), inflammatory (osteochondrosis, SAPHO syndrome), and traumatic (tendinopathies) conditions. We emphasize the importance of systematically evaluating both soft tissue and delayed phases of scintigraphy, as certain extra-skeletal abnormalities may be the first signs of serious underlying diseases.

儿童跛行是一种常见的多形性症状，可以揭示广泛的潜在疾病，从良性机械疾病到严重的感染性、炎性或肿瘤疾病。骨显像在诊断工作中起着关键作用，特别是当怀疑是系统性或感染性原因时。通过一系列说明性的临床病例，本文重点介绍了由骨显像识别的不寻常的跛行原因，包括肿瘤（转移性神经母细胞瘤，急性白血病），感染性（阑尾炎，脊椎椎间盘炎，骶髂炎），炎症性（骨软骨病，SAPHO综合征）和创伤性（肌腱病变）病症。我们强调系统评估软组织和延迟期闪烁成像的重要性，因为某些骨骼外异常可能是严重潜在疾病的第一个迹象。

引用次数: 0