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Accurate brain pharmacokinetic parametric imaging using the blood input function extracted from the cavernous sinus. 利用从海绵窦提取的血液输入函数进行精确的大脑药物动力学参数成像。
IF 2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-25 eCollection Date: 2024-01-01 DOI: 10.62347/LSYG1380
Yafen Kang, Zixiang Chen, Zhuoyue Song, Yaping Wu, Zhenxing Huang, Yuxi Jin, Ting Zhang, Meiyun Wang, Zhanli Hu, Yang Yu

Brain pharmacokinetic parametric imaging based on dynamic positron emission tomography (PET) scan is valuable in the diagnosis of brain tumor and neurodegenerative diseases. For short-axis PET system, standard blood input function (BIF) of the descending aorta is not acquirable during the dynamic brain scan. BIF extracted from the intracerebral vascular is inaccurate, making the brain parametric imaging task challenging. This study introduces a novel technique tailored for brain pharmacokinetic parameter imaging in short-axis PET in which the head BIF (hBIF) is acquired from the cavernous sinus. The proposed method optimizes the hBIF within the Patlak model via data fitting, curve correction and Patlak graphical model rewriting. The proposed method was built and evaluated using dynamic PET datasets of 67 patients acquired by uEXPLORER PET/CT, among which 64 datasets were used for data fitting and model construction, and 3 were used for method testing; using cross-validation, a total of 15 patient datasets were finally used to test the model. The performance of the new method was evaluated via visual inspection, root-mean-square error (RMSE) measurements and VOI-based accuracy analysis using linear regression and Person's correlation coefficients (PCC). Compared to directly using the cavernous sinus BIF directly for parameter imaging, the new method achieves higher accuracy in parametric analysis, including the generation of Patlak plots closer to the standard plots, better visual effects and lower RMSE values in the Ki (P = 0.0012) and V (P = 0.0042) images. VOI-based analysis shows regression lines with slopes closer to 1 (P = 0.0019 for Ki ) and smaller intercepts (P = 0.0085 for V). The proposed method is capable of achieving accurate brain pharmacokinetic parametric imaging using cavernous sinus BIF with short-axis PET scan. This may facilitate the application of this imaging technology in the clinical diagnosis of brain diseases.

基于动态正电子发射断层扫描(PET)的脑药动学参数成像在诊断脑肿瘤和神经退行性疾病方面具有重要价值。对于短轴 PET 系统,在动态脑扫描过程中无法获得降主动脉的标准血液输入函数(BIF)。从脑内血管提取的 BIF 也不准确,因此脑参数成像任务具有挑战性。本研究介绍了一种为短轴 PET 脑药代动力学参数成像量身定制的新技术,即从海绵窦获取头部 BIF(hBIF)。该方法通过数据拟合、曲线校正和 Patlak 图形模型重写,在 Patlak 模型内优化 hBIF。利用uEXPLORER PET/CT获取的67名患者的动态PET数据集建立并评估了所提出的方法,其中64个数据集用于数据拟合和模型构建,3个数据集用于方法测试;通过交叉验证,最终共有15个患者数据集用于测试模型。通过目视检查、均方根误差(RMSE)测量以及使用线性回归和Person相关系数(PCC)进行基于VOI的准确性分析,对新方法的性能进行了评估。与直接使用海绵窦 BIF 进行参数成像相比,新方法的参数分析准确度更高,包括生成的 Patlak 图更接近标准图,视觉效果更好,Ki(P = 0.0012)和 V(P = 0.0042)图像的 RMSE 值更低。基于 VOI 的分析显示,回归线的斜率更接近 1(Ki 的 P = 0.0019),截距更小(V 的 P = 0.0085)。所提出的方法能够利用海绵窦 BIF 和短轴 PET 扫描实现精确的脑药代动力学参数成像。这将有助于该成像技术在脑疾病临床诊断中的应用。
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引用次数: 0
Radiomics-based model for prediction of TGF-β1 expression in head and neck squamous cell carcinoma. 基于放射组学的头颈部鳞状细胞癌 TGF-β1 表达预测模型
IF 2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-25 eCollection Date: 2024-01-01 DOI: 10.62347/JMKV7596
Kai Qin, Chen Gong, Yi Cheng, Li Li, Chengxia Liu, Feng Yang, Jie Rao, Qianxia Li

Objective: To explore the connection between TGF-β1 expression and the survival of patients with head and neck squamous cell carcinoma (HNSCC), as well as whether non-invasive CT-based Radiomics can predict TGF-β1 expression in HNSCC patients.

Methods: Data on transcriptional profiling and clinical information were acquired from the TCGA database and subsequently categorized based on the TGF-β1 expression cutoff value. Based on the completeness of enhanced arterial phase CT scans, 139 HNSCC patients were selected. The PyRadiomics package was used to extract radiomic features, and the 3D Slicer software was used for image segmentation. Using the mRMR_RFE and Repeat LASSO algorithms, the optimal features for establishing the corresponding gradient enhancement prediction models were identified.

Results: A survival analysis was performed on 483 patients, who were divided into two groups based on the TGF-β1 expression cut-off. The Kaplan-Meier curve indicated that TGF-β1 was a significant independent risk factor that reduced patient survival. To construct gradient enhancement prediction models, we used the mRMR_RFE algorithm and the Repeat_LASSO algorithm to obtain two features (glrlm and ngtdm) and three radiation features (glrlm, first order_10percentile, and gldm). In both the training and validation cohorts, the two established models demonstrated strong predictive potential. Furthermore, there was no statistically significant difference in the calibration curve, DCA diagram, or AUC values between the mRMR_RFE_GBM model and the LASSO_GBM model, suggesting that both models fit well.

Conclusion: Based on these findings, TGF-β1 was shown to be significantly associated with a poor prognosis and to be a potential risk factor for HNSCC. Furthermore, by employing the mRMR_RFE_GBM and Repeat_LASSO_GBM models, we were able to effectively predict TGF-β1 expression levels in HNSCC through non-invasive CT-based Radiomics.

目的探讨TGF-β1表达与头颈部鳞状细胞癌(HNSCC)患者生存期的关系,以及基于CT的无创放射组学能否预测HNSCC患者的TGF-β1表达:方法:从 TCGA 数据库中获取转录谱分析数据和临床信息,然后根据 TGF-β1 表达截断值进行分类。根据增强动脉期CT扫描的完整性,选择了139例HNSCC患者。使用 PyRadiomics 软件包提取放射学特征,并使用 3D Slicer 软件进行图像分割。利用 mRMR_RFE 和 Repeat LASSO 算法,确定了建立相应梯度增强预测模型的最佳特征:对 483 例患者进行了生存分析,根据 TGF-β1 表达截断值将患者分为两组。Kaplan-Meier曲线显示,TGF-β1是降低患者生存率的重要独立风险因素。为了构建梯度增强预测模型,我们使用了 mRMR_RFE 算法和 Repeat_LASSO 算法,获得了两个特征(glrlm 和 ngtdm)和三个辐射特征(glrlm、first order_10percentile 和 gldm)。在训练组和验证组中,这两个已建立的模型都表现出很强的预测潜力。此外,mRMR_RFE_GBM 模型和 LASSO_GBM 模型的校准曲线、DCA 图或 AUC 值在统计学上没有显著差异,这表明这两个模型拟合良好:基于这些发现,TGF-β1 被证明与不良预后显著相关,是 HNSCC 的潜在风险因素。此外,通过使用 mRMR_RFE_GBM 和 Repeat_LASSO_GBM 模型,我们能够通过基于 CT 的无创放射组学有效预测 HNSCC 中 TGF-β1 的表达水平。
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引用次数: 0
Analysis of bone single-photon emission CT/CT and diffusion-weighted MR imaging in medication-related osteonecrosis of the jaw: focusing on the correlation between standardized uptake values and apparent diffusion coefficient values. 与药物相关的颌骨骨坏死的骨单光子发射 CT/CT 和弥散加权 MR 成像分析:重点关注标准化摄取值与表观弥散系数值之间的相关性。
IF 2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-25 eCollection Date: 2024-01-01 DOI: 10.62347/FFPG9819
Yasuhito Tezuka, Ichiro Ogura

The purpose of this study is to investigate bone SPECT/CT and diffusion-weighted MR imaging (DWI) in medication-related osteonecrosis of the jaw (MRONJ), focusing on the correlation between standardized uptake values (SUVs) and apparent diffusion coefficient (ADC) values. Twenty-nine patients with MRONJ who underwent SPECT/CT and DWI were included in this study. SUVs (maximum and mean) with SPECT/CT, and ADC values (maximum, mean and minimum) with DWI were analyzed on characteristics in MRONJ, such as stage, location, medication and underlying disease, by Mann-Whitney U test. Furthermore, the correlation between SUVs and ADC values for characteristics in MRONJ were assessed by Spearman's rank correlation test for nonparametric data. A p-value lower than 0.05 was considered as statistically significant. SUVs and ADC values have no significant differences for all characteristics in MRONJ. Negative correlations were found in all cases and in stage 2 cases, and no correlations were found in stage 3 cases. In addition, negative correlations were found in maxillary cases, mandibular cases, non-bisphosphonate cases, osteoporosis cases, and malignant tumor cases. In conclusion, this study found multiple correlations between SUVs and ADC values in MRONJ, especially in stage 2. Suggesting that ADC values and SUVs may change with disease progression and the possibility of predicting MRONJ progression by SUVs and ADC values.

本研究的目的是对药物相关性颌骨坏死(MRONJ)的骨SPECT/CT和弥散加权磁共振成像(DWI)进行研究,重点是标准化摄取值(SUV)和表观弥散系数(ADC)值之间的相关性。本研究纳入了 29 例接受 SPECT/CT 和 DWI 检查的 MRONJ 患者。通过 Mann-Whitney U 检验分析了 SPECT/CT 的 SUV 值(最大值和平均值)和 DWI 的 ADC 值(最大值、平均值和最小值)与 MRONJ 的分期、位置、药物治疗和基础疾病等特征的关系。此外,SUV 和 ADC 值与 MRONJ 特征之间的相关性还通过非参数数据的斯皮尔曼秩相关检验进行了评估。P 值小于 0.05 视为具有统计学意义。在 MRONJ 的所有特征中,SUV 和 ADC 值均无明显差异。所有病例和二期病例均呈负相关,三期病例无相关性。此外,在上颌骨病例、下颌骨病例、非双磷酸盐病例、骨质疏松症病例和恶性肿瘤病例中也发现了负相关。总之,本研究发现 SUV 与 ADC 值在 MRONJ 中存在多种相关性,尤其是在 2 期病例中。这表明 ADC 值和 SUV 值可能会随着疾病的进展而变化,并有可能通过 SUV 值和 ADC 值预测 MRONJ 的进展。
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引用次数: 0
A radioactive and fluorescent dual modality cysteine cathepsin-B activity-based probe for the detection and treatment evaluation in rheumatoid arthritis. 基于半胱氨酸酪蛋白酶-B 活性的放射性和荧光双模式探针,用于类风湿性关节炎的检测和治疗评估。
IF 2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-25 eCollection Date: 2024-01-01 DOI: 10.62347/IAED6442
Honghui Guo, Yanjing Chen, Lianbo Zhou, Xin Xiang, Feng He, Xingdou Chen, Wenjie Fu, Yu Long, Yunhua Wang, Xiaowei Ma

Activated macrophages are key effector cells and specific markers in patients with rheumatoid arthritis (RA). Cysteine cathepsin B (CTS-B) is highly expressed in macrophages and positively associated with RA activity and severity. This study aims to evaluate an activity-based multi-modality diagnostic agent, 68Ga-BMX2, which targets CTS-B to visualize the arthritis activity and evaluate the treatment efficacy. A CTS-B activity-based probe, BMX2, was labeled efficiently with 68Ga to produce 68Ga-BMX2 for fluorescent and positron emission tomography (PET) multi-modality imaging. The affinity and specificity of BMX2 binding with the CTS-B enzyme in macrophages were determined by radioactive experiment using RAW 264.7 cell lines, with CA074 and BMX5 as the inhibitors to test the specificity of the binding. Then, PET and fluorescence imaging were acquired on collagen-induced arthritis (CIA) mice. Additionally, the treatment monitoring capability of 68Ga-BMX2 PET/CT imaging was tested with methotrexate (MTX). RAW 264.7 macrophage cells showed significant uptake of 68Ga-BMX2. The binding of BMX2 with CTS-B in RAW 264.7 macrophage cells is time-dependent and could be blocked by CA074 and BMX5. In vivo optical and PET imaging showed high signals in the right hind arthritis in CIA mice from 68Ga-BMX2 and BMX2 accumulated for at least 120 h. Additionally, 68Ga-BMX2 signals were significantly reduced in the MTX-treated CIA mice compared to the control group. The 68Ga-BMX2, a radioactive and fluorescent dual-modality diagnostic agent targeting CTS-B, demonstrated a practical approach for CIA PET and fluorescence imaging. The 68Ga-BMX2 multimodality imaging could significantly monitor the treatment response in the CIA mice.

活化的巨噬细胞是类风湿性关节炎(RA)患者的关键效应细胞和特异性标志物。半胱氨酸酪蛋白酶 B(CTS-B)在巨噬细胞中高度表达,与 RA 的活性和严重程度呈正相关。本研究旨在评估一种以CTS-B为靶点的基于活性的多模态诊断试剂68Ga-BMX2,以观察关节炎的活动性并评估治疗效果。一种基于 CTS-B 活性的探针 BMX2 被 68Ga 高效标记,生成 68Ga-BMX2 用于荧光和正电子发射断层扫描(PET)多模态成像。以 RAW 264.7 细胞系为研究对象,通过放射性实验测定了 BMX2 与巨噬细胞中 CTS-B 酶结合的亲和力和特异性,并以 CA074 和 BMX5 作为抑制剂测试了结合的特异性。然后,对胶原诱导的关节炎(CIA)小鼠进行 PET 和荧光成像。此外,还测试了 68Ga-BMX2 PET/CT 成像与甲氨蝶呤(MTX)的治疗监测能力。RAW 264.7 巨噬细胞显示出对 68Ga-BMX2 的显著摄取。在 RAW 264.7 巨噬细胞中,BMX2 与 CTS-B 的结合具有时间依赖性,并可被 CA074 和 BMX5 阻断。体内光学和 PET 成像显示,68Ga-BMX2 和 BMX2 在 CIA 小鼠右后关节炎中的高信号累积至少 120 小时。68Ga-BMX2是一种针对CTS-B的放射性和荧光双模态诊断剂,为CIA PET和荧光成像提供了一种实用的方法。68Ga-BMX2 多模态成像可显著监测 CIA 小鼠的治疗反应。
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引用次数: 0
The comparative utility of FAPI-based PET radiotracers over [18F]FDG in the assessment of malignancies. 基于 FAPI 的 PET 放射性同位素与[18F]FDG 在评估恶性肿瘤方面的效用比较。
IF 2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-25 eCollection Date: 2024-01-01 DOI: 10.62347/JXZI9315
Shashi B Singh, Bimash B Shrestha, Om H Gandhi, Rajendra P Shah, Vaibhavi Mukhtiar, Cyrus Ayubcha, Vineet Desai, Christine E Eberts, Pranita Paudyal, Goody Jha, Anurag Singh, Yangyang Shi, Tushar Kumar

Fibroblast activation protein (FAP) is a type II transmembrane serine protease overexpressed in cancer-associated fibroblasts (CAFs) and has been associated with poor prognosis. PET/CT imaging with radiolabeled FAP inhibitors (FAPI) is currently being studied for various malignancies. This review identifies the uses and limitations of FAPI PET/CT in malignancies and compares the advantages and disadvantages of FAPI and 18F-fluorodeoxyglucose ([18F]FDG). Due to high uptake, rapid clearance from the circulation, and limited uptake in normal tissue, FAPI tumor-to-background contrast ratios are equivalent to or better than [18F]FDG in most applications. In several settings, FAPI has shown greater uptake specificity than [18F]FDG and improved sensitivity in detecting lymph node, bone, and visceral tissue metastases. Therefore, FAPI PET/CT may be complementary in distinguishing pathological lesions with conventional imaging, determining the primary site of malignancy, improving tumor staging, and detecting disease recurrence, especially in patients with inconclusive [18F]FDG PET/CT findings. Nevertheless, FAPI has limitations, including certain settings with non-specific uptake, modified uptake with age and menopause status, challenges with clinical access, and limited clinical evidence.

成纤维细胞活化蛋白(FAP)是一种在癌症相关成纤维细胞(CAF)中过度表达的 II 型跨膜丝氨酸蛋白酶,与不良预后有关。目前正在研究使用放射性标记的 FAP 抑制剂(FAPI)进行 PET/CT 成像,以治疗各种恶性肿瘤。本综述指出了 FAPI PET/CT 在恶性肿瘤中的用途和局限性,并比较了 FAPI 和 18F-氟脱氧葡萄糖([18F]FDG)的优缺点。由于摄取率高、从血液循环中清除快、在正常组织中摄取有限,在大多数应用中,FAPI 的肿瘤与背景对比度相当于或优于[18F]FDG。在一些情况下,FAPI 的摄取特异性高于[18F]FDG,在检测淋巴结、骨和内脏组织转移方面的灵敏度也有所提高。因此,FAPI PET/CT 在与常规成像区分病理病变、确定恶性肿瘤的原发部位、改善肿瘤分期和检测疾病复发方面可起到补充作用,尤其是在 [18F]FDG PET/CT 结果不确定的患者中。然而,FAPI 也有其局限性,包括某些情况下的非特异性摄取、随年龄和绝经状态而改变的摄取、临床应用方面的挑战以及有限的临床证据。
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引用次数: 0
Recent advances in imaging and artificial intelligence (AI) for quantitative assessment of multiple myeloma. 用于多发性骨髓瘤定量评估的成像和人工智能(AI)的最新进展。
IF 2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-25 eCollection Date: 2024-01-01 DOI: 10.62347/NLLV9295
Yongshun Liu, Wenpeng Huang, Yihan Yang, Weibo Cai, Zhaonan Sun

Multiple myeloma (MM) is a malignant blood disease, but there have been significant improvements in the prognosis due to advancements in quantitative assessment and targeted therapy in recent years. The quantitative assessment of MM bone marrow infiltration and prognosis prediction is influenced by imaging and artificial intelligence (AI) quantitative parameters. At present, the primary imaging methods include computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). These methods are now crucial for diagnosing MM and evaluating myeloma cell infiltration, extramedullary disease, treatment effectiveness, and prognosis. Furthermore, the utilization of AI, specifically incorporating machine learning and radiomics, shows great potential in the field of diagnosing MM and distinguishing between MM and lytic metastases. This review discusses the advancements in imaging methods, including CT, MRI, and PET/CT, as well as AI for quantitatively assessing MM. We have summarized the key concepts, advantages, limitations, and diagnostic performance of each technology. Finally, we discussed the challenges related to clinical implementation and presented our views on advancing this field, with the aim of providing guidance for future research.

多发性骨髓瘤(MM)是一种恶性血液疾病,但近年来由于定量评估和靶向治疗的进步,其预后有了显著改善。多发性骨髓瘤骨髓浸润的定量评估和预后预测受到影像学和人工智能(AI)定量参数的影响。目前,主要的成像方法包括计算机断层扫描(CT)、磁共振成像(MRI)和正电子发射断层扫描(PET)。这些方法对于诊断骨髓瘤、评估骨髓瘤细胞浸润、髓外疾病、治疗效果和预后至关重要。此外,人工智能的应用,特别是机器学习和放射组学的结合,在诊断MM和区分MM与溶解性转移瘤方面显示出巨大的潜力。本综述讨论了成像方法(包括 CT、MRI 和 PET/CT)以及人工智能在定量评估 MM 方面的进展。我们总结了每种技术的关键概念、优势、局限性和诊断性能。最后,我们讨论了与临床实施相关的挑战,并提出了我们对推进这一领域发展的看法,旨在为未来研究提供指导。
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引用次数: 0
Hemodynamic characteristics of vertebrobasilar artery fenestration combined with vertebrobasilar dolichoectasia: a study based on magnetic resonance angiography. 椎-基底动脉瘘合并椎-基底动脉栓塞的血流动力学特征:基于磁共振血管造影的研究。
IF 2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-25 eCollection Date: 2024-01-01 DOI: 10.62347/TLNN8316
Xiao-Qin Chen, Jie Jiang, Jian Xing, Zhao-Kai Ming, Min Zhu, Quan Bao, Ming-Cheng Hu

Purpose: This study delves into the hemodynamic characteristics of Vertebrobasilar Artery Fenestration (VBAF) combined with Vertebrobasilar Dolichoectasia (VBD) using Magnetic Resonance Angiography (MRA). By summarizing the hemodynamic features and identifying high-risk populations, we aim to provide insights for clinical treatment.

Methods: Utilizing MRA images as a foundation, arterial three-dimensional geometric models were constructed. A total of 22 cases were categorized into control, S, L, U, and Spiral groups, and numerical simulation analysis of the vessels was conducted using computational fluid dynamics methods.

Results: Hemodynamic parameters of the VBAF combined with the VBD model were obtained, including blood flow velocity, oscillatory shear stress (OSI), wall shear stress (WSS), and aneurysm formation indicator (AFI). The V, OSI, and WSS indices of the L, U, and Spiral groups were significantly higher than those of the control group (P < 0.05). High-speed blood flow, elevated WSS, and increased OSI in these groups were concentrated at the fenestration site, with scattered distribution along the tortuous vertebral artery and basilar artery segments, accompanied by significant differences in the parameters of the bilateral vertebral arteries.

Conclusion: This preliminary investigation identifies the L, U, and Spiral groups as high-risk populations. Abnormal hemodynamics may lead to a vicious cycle in vascular wall pathology, increasing the likelihood of adverse events such as cerebral infarction. Clinical attention should focus on individuals within these groups and their corresponding vascular regions.

目的:本研究利用磁共振血管造影术(MRA)深入研究椎基底动脉狭窄(VBAF)合并椎基底动脉狭窄(VBD)的血液动力学特征。通过总结血液动力学特征和识别高危人群,我们旨在为临床治疗提供见解:方法:以 MRA 图像为基础,构建动脉三维几何模型。方法:以 MRA 图像为基础,构建动脉三维几何模型,将 22 例患者分为对照组、S 组、L 组、U 组和螺旋组,并采用计算流体动力学方法对血管进行数值模拟分析:结果:获得了 VBAF 结合 VBD 模型的血流动力学参数,包括血流速度、振荡剪应力(OSI)、壁剪应力(WSS)和动脉瘤形成指标(AFI)。L组、U组和螺旋组的V、OSI和WSS指数明显高于对照组(P<0.05)。这些组的高速血流、升高的 WSS 和增加的 OSI 都集中在椎动脉瓣膜部位,沿迂曲的椎动脉和基底动脉段分散分布,同时双侧椎动脉的参数也存在显著差异:这项初步调查将 L 组、U 组和螺旋组确定为高危人群。异常的血液动力学可能会导致血管壁病理学的恶性循环,增加发生脑梗塞等不良事件的可能性。临床应重点关注这些群体中的个体及其相应的血管区域。
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引用次数: 0
Current uses and understanding of PET imaging in cardiac sarcoidosis. PET 成像在心脏肉瘤病中的当前用途和理解。
IF 2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-06-15 eCollection Date: 2024-01-01 DOI: 10.62347/NANX3492
Alekhya Madiraju, Abhijit Bhattaru, Truongan Pham, Anish Pundyavana, Krishna Vamsi Rojulpote, William Y Raynor, Thomas J Werner, Abass Alavi

Sarcoidosis is a systemic disease with unclear etiology characterized by the accumulation of noncaseating, immune granulomas in affected tissues. In cardiac sarcoidosis (CS), white blood cells build up within the heart muscles, causing cardiac abnormalities. Accurate and early diagnosis of CS proves challenging. However, usage of positron emission tomography (PET) imaging, namely 18F-FDG-PET, has proven successful in diagnosing inflammatory cardiomyopathy. This review seeks to examine the role of PET in managing ventricular tachycardia in cardiac sarcoidosis. PET, in conjunction with cardiac magnetic resonance imaging (CMR) is also endorsed as the premier method for diagnosis and management of arrhythmias associated with CS by The Heart Rhythm Society. After a CS diagnosis, risk stratification of ventricular arrhythmias is a necessity given the potential for sudden cardiac death. 18F-FDG-PET has been successful in monitoring disease advancement and treatment responses in CS patients. Early stages of CS are often treated with immunosuppression drugs if there are additional signs of VT. Currently, corticosteroid and anti-arrhythmia compounds: methotrexate, cyclophosphamide, infliximab, amiodarone, and azathioprine are used to suppress inflammation. 18F-FDG-PET has certainly proven to be an incredibly useful and accurate diagnostic tool of CS. While late gadolinium enhancement by CMR is efficient in detecting myocardial necrosis and/or advanced fibrosis scarring, 18F-FDG portrays the increased uptake level of glucose metabolism. In combination PET/MRI has proven to be more successful in improving the efficacy of both scans, addressing their drawbacks, and highlighting their advantages. Managing CS patients is highly involved in detecting inflammatory regions of the heart. Early recognition prevents cardiac abnormality, mainly VT and VF in CS patients, and extends lifespan.

肉样瘤病是一种病因不明的全身性疾病,其特征是受影响组织中积累非酪氨酸化的免疫性肉芽肿。在心脏肉样瘤病(CS)中,白细胞在心肌内积聚,导致心脏异常。准确和早期诊断 CS 具有挑战性。然而,使用正电子发射断层扫描(PET)成像,即 18F-FDG-PET 已被证明能成功诊断炎症性心肌病。本综述旨在探讨 PET 在治疗心脏肉样瘤病室性心动过速中的作用。正电子发射计算机断层显像(PET)与心脏磁共振成像(CMR)相结合,也被心律失常协会认可为诊断和治疗 CS 相关心律失常的主要方法。CS 诊断后,鉴于可能导致心脏性猝死,必须对室性心律失常进行风险分层。18F-FDG-PET 在监测 CS 患者的疾病进展和治疗反应方面取得了成功。如果出现 VT 的其他征兆,CS 早期患者通常会接受免疫抑制药物治疗。目前,皮质类固醇和抗心律失常化合物:甲氨蝶呤、环磷酰胺、英夫利昔单抗、胺碘酮和硫唑嘌呤被用于抑制炎症。18F-FDG-PET 已被证明是一种非常有用且准确的 CS 诊断工具。CMR 的晚期钆增强可有效检测心肌坏死和/或晚期纤维化瘢痕,而 18F-FDG 则可显示葡萄糖代谢摄取水平的增加。事实证明,PET/MRI 联合扫描能更成功地提高这两种扫描的效果,解决它们的缺点,并突出它们的优点。管理 CS 患者与检测心脏炎症区域密切相关。早期识别可预防心脏异常,主要是 CS 患者的 VT 和 VF,并延长寿命。
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引用次数: 0
Fluoroestradiol PET-MRI imaging for detection of endometriosis lesions and symptom correlation. 用于检测子宫内膜异位症病灶和症状相关性的氟雌二醇 PET-MRI 成像。
IF 2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-06-15 eCollection Date: 2024-01-01 DOI: 10.62347/JOQM7920
Jorge D Oldan, Yueh Z Lee, Kristen OIinger, Thad S Benefield, Erin T Carey, Noor D Abu-Alnadi, Steven L Young

Endometriosis is a common cause of infertility, pelvic pain, and dysmenorrhea and there are prior case reports of lesion detection using an 18F-fluoroestradiol (FES) tracer with positron emission tomography (PET). We aimed to further investigate the use of the FES tracer in the context of PET-magnetic resonance (PET-MR) imaging. We administered FES to 6 patients and then imaged them using a Siemens mMR PET-MR scanner. Each patient was taken to surgery within 30 days after imaging, and surgical visualization served as the gold-standard for diagnosis. PET did not prove to be as sensitive as MR (50% per-patient sensitivity versus 67% per-patient and 35% versus 48% per-lesion), and did not show any additional sites over and above MR. When MR was used to localize lesions on PET after imaging, there was insufficient evidence of an association between total tracer uptake and reported pain intensity (P=0.25). FES PET-MR offers no additional value to MR for endometriosis.

子宫内膜异位症是导致不孕、盆腔疼痛和痛经的常见原因之一,之前有病例报告称使用 18F-氟雌二醇(FES)示踪剂和正电子发射断层扫描(PET)检测病灶。我们旨在进一步研究在 PET-MR 成像中使用 FES 示踪剂的情况。我们为 6 名患者注射了 FES,然后使用西门子 mMR PET-MR 扫描仪对他们进行了成像。每位患者都在成像后 30 天内接受了手术,手术可视化是诊断的金标准。事实证明,正电子发射计算机断层显像的灵敏度不如核磁共振(每位患者的灵敏度为 50%,而核磁共振为 67%;每个病灶的灵敏度为 35%,而核磁共振为 48%),而且在核磁共振的基础上没有显示任何额外的部位。在成像后使用 MR 在 PET 上定位病灶时,没有足够证据表明示踪剂摄取总量与报告的疼痛强度之间存在关联(P=0.25)。对子宫内膜异位症而言,FES PET-MR 没有 MR 的额外价值。
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引用次数: 0
Radiosynthesis and preclinical evaluations of [18F]AlF-RESCA-5F7 as a novel molecular probe for HER2 tumor imaging. 作为 HER2 肿瘤成像的新型分子探针,[18F]AlF-RESCA-5F7 的放射合成和临床前评估。
IF 2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-06-15 eCollection Date: 2024-01-01 DOI: 10.62347/BVPK1360
Ruhua Tian, Jinping Kong, Yingfang He, Guoqiang Xu, Tengxiang Chen, Junbin Han

HER2 overexpression is associated with various tumor types and prompted the development of targeted therapies. Previously, iso-[211At]SGMAB-5F7 was developed as a HER2-targeted alpha therapy agent, demonstrating promising therapeutic efficacy in the preclinical stage. Aiming for an 18F-labeled tracer for companion diagnostics in clinical translation, we employed the Al18F-RESCA strategy in our current work and investigated whether [18F]AlF-RESCA-5F7 could visualize HER2 expression in vivo. [18F]AlF-RESCA-5F7 was attained with high radiochemical purity (> 99%) and molar activity in the range of 16.5 ± 8.8 GBq/μmol (n = 8). Compared to previously reported radiotracers that contained 5F7 as the HER2-targeting carrier and fluorine-18 as the positron-emitting isotope, the radiosynthesis was simplified to one single step within 30 min. The dissociation constant of [18F]AlF-RESCA-5F7 was determined as 3.3 nM via saturation binding assay using SKOV3 ovarian carcinoma cells. Tumor uptake of the novel tracer in Balb/c nude mice bearing SKOV3 xenografts was 4.69 ± 1.51, 3.34 ± 0.82 and 3.77 ± 0.99 %ID/g at 1, 2, and 4 h post-injection. Even though high retention of radioactivity was seen in the kidneys, micro-PET/CT imaging of [18F]AlF-RESCA-5F7 delineated the tumor up to 4 h post-injection with minimal activity in the gallbladder, intestines, and bone. This study suggests that [18F]AlF-RESCA-5F7 is a promising HER2 PET radiotracer with an eased radiolabeling method. Whether [18F]AlF-RESCA-5F7 could work as a companion diagnostic agent to assist in patient stratification and treatment monitoring of iso-[211At]SGMAB-5F7 warrants further investigation.

HER2 过表达与多种肿瘤类型有关,促使人们开发靶向疗法。此前,异[211At]SGMAB-5F7 被开发为 HER2 靶向α治疗药物,在临床前阶段显示出良好的疗效。为了寻找一种 18F 标记的示踪剂用于临床转化中的辅助诊断,我们在目前的工作中采用了 Al18F-RESCA 策略,并研究了[18F]AlF-RESCA-5F7 是否能在体内观察到 HER2 的表达。[18F]AlF-RESCA-5F7的放射化学纯度很高(> 99%),摩尔活性在16.5 ± 8.8 GBq/μmol(n = 8)之间。与之前报道的含有 5F7 作为 HER2 靶向载体和氟-18 作为正电子发射同位素的放射性racers 相比,该放射性合成简化为 30 分钟内的一个步骤。通过使用 SKOV3 卵巢癌细胞进行饱和结合试验,确定[18F]AlF-RESCA-5F7 的解离常数为 3.3 nM。注射后 1、2 和 4 h,SKOV3 异种移植的 Balb/c 裸鼠对这种新型示踪剂的肿瘤摄取率分别为 4.69 ± 1.51、3.34 ± 0.82 和 3.77 ± 0.99 %ID/g。尽管肾脏的放射性保留率很高,但[18F]AlF-RESCA-5F7的显微PET/CT成像可在注射后4小时内描绘出肿瘤的轮廓,而胆囊、肠道和骨骼的放射性活性极低。这项研究表明,[18F]AlF-RESCA-5F7 是一种很有前途的 HER2 PET 放射性示踪剂,其放射性标记方法简单易行。至于[18F]AlF-RESCA-5F7能否作为辅助诊断药物,协助患者分层和监测异[211At]SGMAB-5F7的治疗情况,还有待进一步研究。
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引用次数: 0
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American journal of nuclear medicine and molecular imaging
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