Annals of Nuclear Medicine最新文献_第7页

Response to the comment on the impact of anti-HER2 therapy on the accuracy of 68 Ga-HER2-affibody PET/CT imaging in metastatic breast cancer 关于抗her2治疗对转移性乳腺癌68ga - her2粘附体PET/CT成像准确性影响的评论

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Annals of Nuclear Medicine

Pub Date : 2025-09-23 DOI: 10.1007/s12149-025-02110-y

Cheng Liu, Shaoli Song

引用次数: 0

Association between technetium-99 m albumin scintigraphy-based severity of protein-losing enteropathy and patient characteristics and laboratory data. 基于锝- 99m白蛋白显像的蛋白丢失性肠病严重程度与患者特征和实验室数据之间的关系。

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Annals of Nuclear Medicine

Pub Date : 2025-09-22 DOI: 10.1007/s12149-025-02109-5

Takahiro Hosokawa, Mayuki Uchiyama, Sakie Namba, Yutaka Tanami, Yumiko Sato, Yasuharu Wakabayashi, Eiji Oguma

Objective: This study aimed to demonstrate the differences in Technetium-99 m albumin scintigraphy findings for patients with protein-losing enteropathy (PLE) associated with their characteristics and laboratory data.

Methods: Eighteen patients with PLE were grouped into two based on two mechanisms: direct mucosal damage and failed lymph drainage. Scintigraphy images were divided based on the timing of acquisition: images obtained at 1, 2, 4, 6, and 24 h after starting the examination. The intensity of tracer uptake was graded as follows: 3 (marked uptake equal to or greater than the liver level), 2 (moderate uptake less than liver and greater than kidney levels), 1 (mild uptake less than kidney level), and 0 (negative). The grades at each timepoint for the two groups were compared using the Mann-Whitney U test. The associations between the grades and fecal alpha-1-antitrypsin and serum total protein concentrations were evaluated using Pearson correlation coefficients.

Results: Of 18 patients, 7 had PLE due to failed lymph drainage. The direct mucosal damage and failed lymph drainage groups had significantly different fecal alpha-1-antitrypsin concentrations [43.5 ± 29.6 (range 11-115) vs. 208.7 ± 66.0 (range 124-311), respectively; P < 0.001] and scintigraphy-based severity at 24 h [1.2 ± 0.8 (range 1-3) vs. 2.8 ± 0.4 (range 2-3), respectively; P = 0.007]. The fecal alpha-1-antitrypsin concentration was positively correlated with the scintigraphy-based severity at 6 h (r = 0.499, P = 0.049) and 24 h (r = 0.747, P = 0.002). However, the serum protein concentration was negatively correlated with the scintigraphy-based severity at 6 h (r = - 0.587, P = 0.017).

Conclusions: The scintigraphy-based severity at 6 and 24 h and the fecal alpha-1-antitrypsin concentrations were higher for patients with PLE due to failed lymph drainage mechanisms than for those with PLE due to direct mucosal damage. Scintigraphy can help localize the leakage point and determine disease severity to guide PLE management.

目的：本研究旨在证明蛋白质丢失性肠病（PLE）患者的锝-99 m白蛋白显像结果与他们的特征和实验室数据的差异。方法：18例PLE患者根据直接粘膜损伤和淋巴引流失败两种机制分为两组。根据采集时间对闪烁成像图像进行划分：开始检查后1、2、4、6和24小时获得的图像。示踪剂摄取强度分为3级（明显摄取等于或大于肝脏水平），2级（中度摄取小于肝脏水平，大于肾脏水平），1级（轻度摄取小于肾脏水平），0级（阴性）。采用Mann-Whitney U检验比较两组在各时间点的成绩。使用Pearson相关系数评估分级与粪便α -1抗胰蛋白酶和血清总蛋白浓度之间的关系。结果：18例患者中，7例因淋巴引流失败发生PLE。直接粘膜损伤组和淋巴引流失败组的粪便α -1-抗胰蛋白酶浓度差异显著[分别为43.5±29.6（范围11-115）和208.7±66.0（范围124-311）]；结论：与直接粘膜损伤的PLE患者相比，淋巴引流机制失败的PLE患者在6和24 h时基于scigtix的严重程度和粪便α -1-抗胰蛋白酶浓度更高。闪烁显像可以帮助定位渗漏点，确定病情严重程度，指导PLE的治疗。

{"title":"Association between technetium-99 m albumin scintigraphy-based severity of protein-losing enteropathy and patient characteristics and laboratory data.","authors":"Takahiro Hosokawa, Mayuki Uchiyama, Sakie Namba, Yutaka Tanami, Yumiko Sato, Yasuharu Wakabayashi, Eiji Oguma","doi":"10.1007/s12149-025-02109-5","DOIUrl":"10.1007/s12149-025-02109-5","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to demonstrate the differences in Technetium-99 m albumin scintigraphy findings for patients with protein-losing enteropathy (PLE) associated with their characteristics and laboratory data.</p><p><strong>Methods: </strong>Eighteen patients with PLE were grouped into two based on two mechanisms: direct mucosal damage and failed lymph drainage. Scintigraphy images were divided based on the timing of acquisition: images obtained at 1, 2, 4, 6, and 24 h after starting the examination. The intensity of tracer uptake was graded as follows: 3 (marked uptake equal to or greater than the liver level), 2 (moderate uptake less than liver and greater than kidney levels), 1 (mild uptake less than kidney level), and 0 (negative). The grades at each timepoint for the two groups were compared using the Mann-Whitney U test. The associations between the grades and fecal alpha-1-antitrypsin and serum total protein concentrations were evaluated using Pearson correlation coefficients.</p><p><strong>Results: </strong>Of 18 patients, 7 had PLE due to failed lymph drainage. The direct mucosal damage and failed lymph drainage groups had significantly different fecal alpha-1-antitrypsin concentrations [43.5 ± 29.6 (range 11-115) vs. 208.7 ± 66.0 (range 124-311), respectively; P < 0.001] and scintigraphy-based severity at 24 h [1.2 ± 0.8 (range 1-3) vs. 2.8 ± 0.4 (range 2-3), respectively; P = 0.007]. The fecal alpha-1-antitrypsin concentration was positively correlated with the scintigraphy-based severity at 6 h (r = 0.499, P = 0.049) and 24 h (r = 0.747, P = 0.002). However, the serum protein concentration was negatively correlated with the scintigraphy-based severity at 6 h (r = - 0.587, P = 0.017).</p><p><strong>Conclusions: </strong>The scintigraphy-based severity at 6 and 24 h and the fecal alpha-1-antitrypsin concentrations were higher for patients with PLE due to failed lymph drainage mechanisms than for those with PLE due to direct mucosal damage. Scintigraphy can help localize the leakage point and determine disease severity to guide PLE management.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The prognostic value of ¹⁸F-FDG PET-derived whole-body feature in patients with lung adenocarcinoma treated with EGFR-targeted therapy. 18F-FDG pet衍生的全身特征在egfr靶向治疗肺腺癌患者中的预后价值

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Annals of Nuclear Medicine

Pub Date : 2025-09-22 DOI: 10.1007/s12149-025-02108-6

Kun-Han Lue, Yung-Hsuan Wang, Yu-Hung Chen, Sung-Chao Chu, Chih-Bin Lin, Shu-Hsin Liu

Objective: To evaluate the prognostic values of ¹⁸F-FDG PET-derived whole-body imaging features in patients with metastatic lung adenocarcinoma treated with EGFR-targeted therapies.

Methods: We retrospectively analyzed 249 patients with lung adenocarcinoma who underwent pre-treatment ¹⁸F-FDG PET and were treated with EGFR-targeted agents. The patients were divided into analog (n = 150) and digital (n = 99) PET cohorts. Whole-body and primary tumor respiratory-stable imaging features were extracted. The prognostic values of the study variables for progression-free (PFS) and overall survival (OS) were assessed using univariate and multivariate Cox regression analyses across the analog and digital PET cohorts.

Results: Total sphericity and primary tumor inverse difference normalized were independent predictors of both PFS and OS. The total metabolic tumor volume was another independent predictor of OS. Combined models integrating these imaging biomarkers with clinical variables outperformed the traditional staging system (c-indices for PFS: 0.649 versus 0.550 for analog and 0.668 versus 0.583 for digital PET cohorts; for OS: 0.694 versus 0.562 for analog and 0.728 versus 0.579 for digital PET cohorts). Our models showed consistent predictive values across subgroups based on sex, EGFR mutation subtype, and clinical stage.

Conclusions: Our results indicate that models integrating whole-body ¹⁸F-FDG PET features with traditional variables can enhance survival prediction and may support personalized treatment strategies for patients with lung adenocarcinoma treated with EGFR-targeted therapies.

目的：评价18F-FDG pet衍生的全身显像特征在egfr靶向治疗的转移性肺腺癌患者中的预后价值。方法：我们回顾性分析249例接受18F-FDG PET治疗前并接受egfr靶向药物治疗的肺腺癌患者。患者被分为模拟（n = 150）和数字（n = 99） PET队列。提取全身和原发肿瘤呼吸稳定成像特征。在模拟和数字PET队列中，使用单变量和多变量Cox回归分析评估无进展（PFS）和总生存（OS）的研究变量的预后价值。结果：总球形度和原发肿瘤逆差归一化是PFS和OS的独立预测因子。总代谢肿瘤体积是OS的另一个独立预测因子。将这些成像生物标志物与临床变量相结合的联合模型优于传统的分期系统（PFS的c指数为0.649，模拟组为0.550，数字PET组为0.668，数字PET组为0.583；OS为0.694，模拟组为0.562，数字PET组为0.728，数字PET组为0.579）。我们的模型显示基于性别、EGFR突变亚型和临床分期的亚组具有一致的预测值。结论：我们的研究结果表明，将全身18F-FDG PET特征与传统变量相结合的模型可以增强生存预测，并可能支持接受egfr靶向治疗的肺腺癌患者的个性化治疗策略。

{"title":"The prognostic value of <sup>18</sup>F-FDG PET-derived whole-body feature in patients with lung adenocarcinoma treated with EGFR-targeted therapy.","authors":"Kun-Han Lue, Yung-Hsuan Wang, Yu-Hung Chen, Sung-Chao Chu, Chih-Bin Lin, Shu-Hsin Liu","doi":"10.1007/s12149-025-02108-6","DOIUrl":"https://doi.org/10.1007/s12149-025-02108-6","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the prognostic values of <sup>18</sup>F-FDG PET-derived whole-body imaging features in patients with metastatic lung adenocarcinoma treated with EGFR-targeted therapies.</p><p><strong>Methods: </strong>We retrospectively analyzed 249 patients with lung adenocarcinoma who underwent pre-treatment <sup>18</sup>F-FDG PET and were treated with EGFR-targeted agents. The patients were divided into analog (n = 150) and digital (n = 99) PET cohorts. Whole-body and primary tumor respiratory-stable imaging features were extracted. The prognostic values of the study variables for progression-free (PFS) and overall survival (OS) were assessed using univariate and multivariate Cox regression analyses across the analog and digital PET cohorts.</p><p><strong>Results: </strong>Total sphericity and primary tumor inverse difference normalized were independent predictors of both PFS and OS. The total metabolic tumor volume was another independent predictor of OS. Combined models integrating these imaging biomarkers with clinical variables outperformed the traditional staging system (c-indices for PFS: 0.649 versus 0.550 for analog and 0.668 versus 0.583 for digital PET cohorts; for OS: 0.694 versus 0.562 for analog and 0.728 versus 0.579 for digital PET cohorts). Our models showed consistent predictive values across subgroups based on sex, EGFR mutation subtype, and clinical stage.</p><p><strong>Conclusions: </strong>Our results indicate that models integrating whole-body <sup>18</sup>F-FDG PET features with traditional variables can enhance survival prediction and may support personalized treatment strategies for patients with lung adenocarcinoma treated with EGFR-targeted therapies.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of body weight on arterial partition coefficient estimation in 123I-IMP SPECT: a comparison between ARG and no-arterial sampling methods 体重对123I-IMP SPECT动脉分割系数估计的影响：ARG和非动脉采样方法的比较。

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Annals of Nuclear Medicine

Pub Date : 2025-09-19 DOI: 10.1007/s12149-025-02104-w

Masamichi Imai, Yusuke Ochiai, Yuki Kosaka, Kazuaki Mori

Objective

To evaluate the impact of body weight on the estimation of the arterial blood-to-whole-body partition coefficient in 123I-iodoamphetamine (IMP) SPECT using a no-arterial sampling method (validation method) and to compare it with the autoradiographic (ARG) method.

Methods

A total of 172 123I-IMP SPECT scans from clinical patients were retrospectively analyzed. To investigate systematic differences between the partition coefficients obtained by the ARG method and those estimated by the validation method in the QSPECT/DTARG package, a Bland–Altman plot was used. The distribution of differences was further visualized across body weights. Observing a trend related to body weight, we then performed regression analysis using body weight as a predictor of the difference between the two methods. The improvement in fit achieved by incorporating body weight was evaluated using the residual sum of squares (RSS).

Results

The validation method systematically underestimated the partition coefficient when the actual value by the ARG method is high, and overestimated it when the true value is low. On the Bland–Altman plot, samples with light body weight were more likely to fall into the region of lower partition coefficients, whereas samples with heavy body weight tended to fall into the region of higher partition coefficients. After correction of body weight, the distribution of partition coefficients more closely approximated an ideal pattern across all body weight groups. Regression analysis revealed that the weight-corrected model provided a significantly better fit than the assumption of a constant partition coefficient (F = 51.36, p < 0.001). The RSS was reduced by 25% following weight correction, supporting the utility of this adjustment.

Conclusions

The assumption of a constant arterial partition coefficient in the validation method may not be valid for individuals with light or heavy body weight. Incorporating body weight into the estimation process significantly improves even without arterial sampling. The validation method adding body weight correction may reduce variability in cerebral blood flow (CBF) estimates derived from these coefficients, which may improve the accuracy of CBF quantification even without arterial sampling.

目的：评价体重对125i -碘安非他命（IMP） SPECT无动脉采样法（验证法）估计动脉血-全身分配系数的影响，并与放射自显影（ARG）法进行比较。方法：回顾性分析172例临床患者的123I-IMP SPECT扫描图。为了研究ARG方法获得的分割系数与QSPECT/DTARG包中验证方法估计的分割系数之间的系统差异，使用Bland-Altman图。不同体重的差异分布进一步可视化。观察到与体重相关的趋势，然后我们使用体重作为两种方法之间差异的预测因子进行回归分析。采用残差平方和（RSS）评价纳入体重后的拟合改善情况。结果：验证方法在ARG法实际值较高时系统地低估了分割系数，在真实值较低时系统地高估了分割系数。在Bland-Altman图上，体重轻的样本更容易落入分配系数较低的区域，而体重大的样本则倾向于落入分配系数较高的区域。在校正体重后，分配系数的分布更接近于所有体重组的理想模式。回归分析显示，体重校正模型的拟合效果明显优于假设动脉分配系数恒定的模型（F = 51.36, p）。结论：验证方法中动脉分配系数恒定的假设可能对体重较轻或较重的个体无效。即使没有动脉采样，将体重纳入估计过程也能显著改善。添加体重校正的验证方法可以减少由这些系数得出的脑血流量（CBF）估计值的变异性，这可能提高CBF量化的准确性，即使没有动脉采样。

{"title":"Impact of body weight on arterial partition coefficient estimation in 123I-IMP SPECT: a comparison between ARG and no-arterial sampling methods","authors":"Masamichi Imai, Yusuke Ochiai, Yuki Kosaka, Kazuaki Mori","doi":"10.1007/s12149-025-02104-w","DOIUrl":"10.1007/s12149-025-02104-w","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the impact of body weight on the estimation of the arterial blood-to-whole-body partition coefficient in 123I-iodoamphetamine (IMP) SPECT using a no-arterial sampling method (validation method) and to compare it with the autoradiographic (ARG) method.</p><h3>Methods</h3><p>A total of 172 123I-IMP SPECT scans from clinical patients were retrospectively analyzed. To investigate systematic differences between the partition coefficients obtained by the ARG method and those estimated by the validation method in the QSPECT/DTARG package, a Bland–Altman plot was used. The distribution of differences was further visualized across body weights. Observing a trend related to body weight, we then performed regression analysis using body weight as a predictor of the difference between the two methods. The improvement in fit achieved by incorporating body weight was evaluated using the residual sum of squares (RSS).</p><h3>Results</h3><p>The validation method systematically underestimated the partition coefficient when the actual value by the ARG method is high, and overestimated it when the true value is low. On the Bland–Altman plot, samples with light body weight were more likely to fall into the region of lower partition coefficients, whereas samples with heavy body weight tended to fall into the region of higher partition coefficients. After correction of body weight, the distribution of partition coefficients more closely approximated an ideal pattern across all body weight groups. Regression analysis revealed that the weight-corrected model provided a significantly better fit than the assumption of a constant partition coefficient (<i>F</i> = 51.36, <i>p</i> < 0.001). The RSS was reduced by 25% following weight correction, supporting the utility of this adjustment.</p><h3>Conclusions</h3><p>The assumption of a constant arterial partition coefficient in the validation method may not be valid for individuals with light or heavy body weight. Incorporating body weight into the estimation process significantly improves even without arterial sampling. The validation method adding body weight correction may reduce variability in cerebral blood flow (CBF) estimates derived from these coefficients, which may improve the accuracy of CBF quantification even without arterial sampling.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 1","pages":"60 - 65"},"PeriodicalIF":2.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Interobserver and intraobserver agreement for equivocal lesions in Ga-68 PSMA PET/CT according to PSMA-RADS 2.0 criteria 根据PSMA- rads 2.0标准，Ga-68 PSMA PET/CT对模糊性病变的观察者间和观察者内一致。

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Annals of Nuclear Medicine

Pub Date : 2025-09-10 DOI: 10.1007/s12149-025-02103-x

Khanim Niftaliyeva, Selin Kesim, Nuh Filizoglu, Zeynep Ceren Balaban Genc, Salih Ozguven, Feyza Cagliyan, Tunc Ones, Fuat Dede, Halil Turgut Turoglu, Tanju Yusuf Erdil

Objective

This study aims to systematically evaluate the inter- and intra-observer agreement regarding lesions with uncertain malignancy potential in Ga-68 PSMA PET/CT imaging of prostate cancer patients, utilizing the PSMA-RADS 2.0 classification system, and to emphasize the malignancy evidence associated with these lesions.

Methods

We retrospectively reviewed Ga-68 PSMA PET/CT images of patients diagnosed with prostate cancer via histopathology between December 2016 and November 2023. Seventy-six patients and 98 target lesions, classified with PSMA-RADS scores 3A–3D by an experienced nuclear medicine specialist, were included. Three observers (two experienced and one less experienced nuclear medicine physician) evaluated the lesions at two different time points, three months apart, in a blinded manner. Intra-observer agreement was assessed using Cohen’s kappa, while inter-observer agreement was analyzed using Fleiss’ kappa.

Results

All observers demonstrated significant intra-observer agreement, with percentages ranging from 67.3 to 80.6% and kappa values between 0.62 and 0.76. The highest intra-observer agreement was noted for bone lesions, while non-regional lymph nodes exhibited the lowest agreement. For inter-observer assessments, moderate agreement was observed across all lesions (Fleiss k = 0.51), with the highest agreement in regional lymph nodes and the lowest in non-regional lymph nodes and bone lesions. Follow-up results indicated malignancy detection rates of 63.4% for 3A, 47% for 3B, 44.5% for 3C, and 41.4% for 3D scored lesions.

Conclusions

The PSMA-RADS classification system demonstrated substantial intra-observer agreement and moderate inter-observer agreement for lesions with uncertain malignancy potential, supporting its clinical applicability. However, notable variability and limitations in reporting bone lesions, non-regional lymph nodes, and lung lesions were observed among readers. The ambiguous nature and management of PSMA-RADS 3 lesions underscore the need for further research to enhance risk stratification.

目的：本研究旨在利用PSMA- rads 2.0分类系统，系统评价Ga-68 PSMA PET/CT对前列腺癌患者恶性潜能不确定病变的观察者间和观察者内一致性，并强调与这些病变相关的恶性证据。方法：回顾性分析2016年12月至2023年11月经组织病理学诊断为前列腺癌患者的Ga-68 PSMA PET/CT图像。76名患者和98个靶病变，由经验丰富的核医学专家按PSMA-RADS评分3A-3D进行分类。三名观察员（两名经验丰富的核医学医生和一名经验不足的核医学医生）以盲法在两个不同的时间点评估病变，间隔三个月。观察员内部协议使用Cohen的kappa进行评估，而观察员之间的协议使用Fleiss的kappa进行分析。结果：所有观察者都表现出显著的观察者内部一致性，百分比范围从67.3到80.6%，kappa值在0.62到0.76之间。观察者内部一致性最高的是骨病变，而非区域淋巴结表现出最低的一致性。对于观察者间评估，在所有病变中观察到中度一致性（Fleiss k = 0.51），区域淋巴结一致性最高，非区域淋巴结和骨病变一致性最低。随访结果显示，3A级病变的恶性检出率为63.4%，3B级为47%，3C级为44.5%，3D级病变为41.4%。结论：PSMA-RADS分类系统对潜在恶性肿瘤不确定的病变具有较高的观察者内一致性和中度的观察者间一致性，支持其临床适用性。然而，在报告骨骼病变、非区域淋巴结和肺部病变方面，读者中观察到显著的差异和局限性。PSMA-RADS 3病变的模糊性质和管理强调了进一步研究以加强风险分层的必要性。

{"title":"Interobserver and intraobserver agreement for equivocal lesions in Ga-68 PSMA PET/CT according to PSMA-RADS 2.0 criteria","authors":"Khanim Niftaliyeva, Selin Kesim, Nuh Filizoglu, Zeynep Ceren Balaban Genc, Salih Ozguven, Feyza Cagliyan, Tunc Ones, Fuat Dede, Halil Turgut Turoglu, Tanju Yusuf Erdil","doi":"10.1007/s12149-025-02103-x","DOIUrl":"10.1007/s12149-025-02103-x","url":null,"abstract":"<div><h3>Objective</h3><p>This study aims to systematically evaluate the inter- and intra-observer agreement regarding lesions with uncertain malignancy potential in Ga-68 PSMA PET/CT imaging of prostate cancer patients, utilizing the PSMA-RADS 2.0 classification system, and to emphasize the malignancy evidence associated with these lesions.</p><h3>Methods</h3><p>We retrospectively reviewed Ga-68 PSMA PET/CT images of patients diagnosed with prostate cancer via histopathology between December 2016 and November 2023. Seventy-six patients and 98 target lesions, classified with PSMA-RADS scores 3A–3D by an experienced nuclear medicine specialist, were included. Three observers (two experienced and one less experienced nuclear medicine physician) evaluated the lesions at two different time points, three months apart, in a blinded manner. Intra-observer agreement was assessed using Cohen’s kappa, while inter-observer agreement was analyzed using Fleiss’ kappa.</p><h3>Results</h3><p>All observers demonstrated significant intra-observer agreement, with percentages ranging from 67.3 to 80.6% and kappa values between 0.62 and 0.76. The highest intra-observer agreement was noted for bone lesions, while non-regional lymph nodes exhibited the lowest agreement. For inter-observer assessments, moderate agreement was observed across all lesions (Fleiss <i>k</i> = 0.51), with the highest agreement in regional lymph nodes and the lowest in non-regional lymph nodes and bone lesions. Follow-up results indicated malignancy detection rates of 63.4% for 3A, 47% for 3B, 44.5% for 3C, and 41.4% for 3D scored lesions.</p><h3>Conclusions</h3><p>The PSMA-RADS classification system demonstrated substantial intra-observer agreement and moderate inter-observer agreement for lesions with uncertain malignancy potential, supporting its clinical applicability. However, notable variability and limitations in reporting bone lesions, non-regional lymph nodes, and lung lesions were observed among readers. The ambiguous nature and management of PSMA-RADS 3 lesions underscore the need for further research to enhance risk stratification.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 1","pages":"50 - 59"},"PeriodicalIF":2.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145028772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Establishment of National Diagnostic Reference Levels 2025 for nuclear medicine in Japan 日本核医学国家诊断参考水平2025的建立。

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Annals of Nuclear Medicine

Pub Date : 2025-09-03 DOI: 10.1007/s12149-025-02102-y

Koichiro Abe, Shingo Baba, Reo Etani, Takahiro Fujimto, Makoto Hosono, Takashi Iimori, Anri Inaki, Masanobu Ishiguro, Noriaki Miyaji, Atsutaka Okizaki, Takeshi Sasaki, Hiroyuki Tsushima, Hiroshi Watanabe, Masanori Watanabe, Nobuhiro Yada

Diagnostic reference levels (DRLs) are practical benchmarks for optimizing patient radiation exposure in medical imaging. In Japan, national DRLs, including those for nuclear medicine together and other radiological procedures, were first established in 2015 and revised in 2020. In this study, we revised the DRL values of nuclear medicine for the establishment of DRLs2025, based on data collected from institutions nationwide throughout Japan. Data were collected via an online survey from facilities performing nuclear medicine procedures, including SPECT, PET, and hybrid CT imaging. Information on dose activity of the administered radiopharmaceuticals and CT parameters (CTDIvol and DLP) were collected. DRL values were determined through analysis of the submitted data, supplemented by panel discussions among experts taking into account the clinical appropriateness of the values and various technological factors. Overall, the newly established DRLs2025 demonstrated a decreasing trend in administered radiopharmaceutical activities, CTDIvol, and DLP compared with the previous surveys. This trend reflects ongoing efforts toward the optimization of radiation exposure and radiopharmaceutical dose reduction, likely driven by the introduction of image reconstruction methods based on newer technologies. However, substantial interfacility variations were observed, particularly in the CT parameters, suggesting disparities in equipment, imaging protocols, and the balance between image quality and radiation dose. The establishment of DRLs2025 underscores continued progress in optimizing radiation exposure in nuclear medicine practice in Japan. Although issues regarding data variability and quality remain, DRLs continue to be a key tool in radiation protection and quality assurance. Ongoing efforts to improve data collection systems and to align procedures with international standards are essential for the future refinement of DRLs.

诊断参考水平（drl）是优化医学成像中患者辐射暴露的实用基准。在日本，包括核医学和其他放射程序在内的国家drl于2015年首次建立，并于2020年进行了修订。在本研究中，我们根据日本全国各机构收集的数据，修订核医学的DRL值，以建立DRLs2025。数据通过在线调查从执行核医学程序的设施收集，包括SPECT， PET和混合CT成像。收集了放射性药物的剂量活性信息和CT参数（CTDIvol和DLP）。DRL值是通过分析提交的数据确定的，辅以专家小组讨论，考虑到这些值的临床适宜性和各种技术因素。总体而言，与之前的调查相比，新建立的DRLs2025在给药放射性药物活性、CTDIvol和DLP方面显示出下降趋势。这一趋势反映了对优化辐射暴露和减少放射性药物剂量的持续努力，可能是由基于新技术的图像重建方法的引入所推动的。然而，观察到大量的设施间差异，特别是在CT参数方面，表明设备，成像方案以及图像质量和辐射剂量之间的平衡存在差异。DRLs2025的建立强调了日本核医学实践中在优化辐射暴露方面的持续进展。虽然关于数据变异性和质量的问题仍然存在，但drl仍然是辐射防护和质量保证的关键工具。正在进行的改进数据收集系统和使程序与国际标准保持一致的努力，对于今后改进drl至关重要。

{"title":"Establishment of National Diagnostic Reference Levels 2025 for nuclear medicine in Japan","authors":"Koichiro Abe, Shingo Baba, Reo Etani, Takahiro Fujimto, Makoto Hosono, Takashi Iimori, Anri Inaki, Masanobu Ishiguro, Noriaki Miyaji, Atsutaka Okizaki, Takeshi Sasaki, Hiroyuki Tsushima, Hiroshi Watanabe, Masanori Watanabe, Nobuhiro Yada","doi":"10.1007/s12149-025-02102-y","DOIUrl":"10.1007/s12149-025-02102-y","url":null,"abstract":"<div><p>Diagnostic reference levels (DRLs) are practical benchmarks for optimizing patient radiation exposure in medical imaging. In Japan, national DRLs, including those for nuclear medicine together and other radiological procedures, were first established in 2015 and revised in 2020. In this study, we revised the DRL values of nuclear medicine for the establishment of DRLs2025, based on data collected from institutions nationwide throughout Japan. Data were collected via an online survey from facilities performing nuclear medicine procedures, including SPECT, PET, and hybrid CT imaging. Information on dose activity of the administered radiopharmaceuticals and CT parameters (CTDIvol and DLP) were collected. DRL values were determined through analysis of the submitted data, supplemented by panel discussions among experts taking into account the clinical appropriateness of the values and various technological factors. Overall, the newly established DRLs2025 demonstrated a decreasing trend in administered radiopharmaceutical activities, CTDIvol, and DLP compared with the previous surveys. This trend reflects ongoing efforts toward the optimization of radiation exposure and radiopharmaceutical dose reduction, likely driven by the introduction of image reconstruction methods based on newer technologies. However, substantial interfacility variations were observed, particularly in the CT parameters, suggesting disparities in equipment, imaging protocols, and the balance between image quality and radiation dose. The establishment of DRLs2025 underscores continued progress in optimizing radiation exposure in nuclear medicine practice in Japan. Although issues regarding data variability and quality remain, DRLs continue to be a key tool in radiation protection and quality assurance. Ongoing efforts to improve data collection systems and to align procedures with international standards are essential for the future refinement of DRLs.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"39 10","pages":"1027 - 1036"},"PeriodicalIF":2.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12149-025-02102-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

SPECT reconstruction using preprocessing masking for extra-cardiac uptake versus standard processing in 99mTc-sestamibi myocardial perfusion imaging 在99mTc-sestamibi心肌灌注成像中，使用预处理掩蔽对心外摄取的SPECT重建与标准处理。

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Annals of Nuclear Medicine

Pub Date : 2025-08-26 DOI: 10.1007/s12149-025-02085-w

Keiko Tanimoto, Yoshifumi Kawamura, Satoshi Kimura, Yumi Hasuike, Erina Tachibana, Ayako Kudo, Tadao Aikawa, Koji Murakami, Shinichiro Fujimoto

Objective

In ^99mTc myocardial perfusion SPECT, extra-cardiac accumulation from organs such as the liver or gastrointestinal tract may overlap with the inferior wall, causing artifacts that interfere with image interpretation. This study aimed to quantitatively evaluate the effectiveness of a novel image reconstruction method, the masking process on unsmoothed images (MUS method; CardioMUSk®, PDRadiopharma Inc., Tokyo, Japan), in reducing the influence of extra-cardiac accumulation using both phantom and clinical images.

Methods

This retrospective study included 200 patients (400 scans) who underwent a one-day stress-rest protocol using ^99mTc-sestamibi (MIBI) with pharmacologic stress administered first. Image reconstruction was performed using filtered back projection (FBP) and ordered subset expectation maximization with resolution recovery (OS-EM-RR), both with and without the MUS method. First, visual classification of extra-cardiac accumulation patterns relative to the inferior wall was performed, and the separation capability of each reconstruction method was assessed. Next, phantom experiments were conducted to investigate the effects of extra-cardiac accumulation volume, proximity, and concentration on contrast in the inferior wall. Furthermore, quantitative comparison of relative contrast between the inferior wall and the lateral and septal walls was performed using clinical data.

Results

The MUS method reduced the proportion of visually unseparated cases from 15.5% to 3.5% compared with the conventional method. In phantom studies, larger extra-cardiac accumulation and closer proximity to the myocardium resulted in greater degradation of inferior wall contrast. When a distance of 2 cm was maintained between extra-cardiac accumulation and the myocardium, the effect was substantially reduced. In clinical images, the MUS method significantly improved relative contrast in the inferolateral/inferior wall at the mid-ventricular level (Wilcoxon p = 0.030) and in the inferoseptal/inferior wall at the basal level (Wilcoxon p < 0.001), while no significant improvement was observed in the basal inferolateral/inferior wall region (Wilcoxon p = 0.605).

Conclusion

The MUS method demonstrated enhanced separation of extra-cardiac accumulation and improved contrast in the inferior myocardial wall compared with conventional methods. It was particularly effective in cases where extra-cardiac accumulation overlapped or closely contacted the myocardium, indicating its potential clinical utility in ^99mTc myocardial perfusion SPECT.

目的：在99mTc心肌灌注SPECT中，来自肝脏或胃肠道等器官的心外积聚可能与下壁重叠，造成干扰图像解释的伪影。本研究旨在定量评估一种新的图像重建方法的有效性，即对非平滑图像进行掩蔽处理（MUS方法；CardioMUSk®，pradiopharma Inc., Tokyo, Japan），在使用幻影和临床图像时减少心外积聚的影响。方法：这项回顾性研究包括200例患者（400次扫描），他们接受了为期一天的压力休息方案，使用99mTc-sestamibi (MIBI)，先给药。使用和不使用MUS方法，分别使用滤波后投影（FBP）和带分辨率恢复的有序子集期望最大化（OS-EM-RR）进行图像重建。首先，进行了相对于下壁的心外积聚模式的视觉分类，并评估了每种重建方法的分离能力。接下来，进行幻像实验，研究心外积聚量、接近度和浓度对下壁造影剂的影响。此外，利用临床资料定量比较下壁与侧壁和间隔壁的相对对比度。结果：与常规方法相比，MUS法将视觉未分离病例的比例由15.5%降低至3.5%。在幻象研究中，更大的心外堆积和更接近心肌导致下壁造影剂更大的退化。当心外蓄积物与心肌之间保持2cm的距离时，这种作用就会大大降低。在临床图像中，MUS方法显著提高了心室中水平的外壁/下壁的相对造影剂（Wilcoxon p = 0.030）和基底水平的间隔间/下壁的相对造影剂（Wilcoxon p = 0.030）。结论：与常规方法相比，MUS方法增强了心外堆积的分离，改善了心肌下壁的造影剂。在心外积聚与心肌重叠或紧密接触的情况下特别有效，表明其在99mTc心肌灌注SPECT中的潜在临床应用。

{"title":"SPECT reconstruction using preprocessing masking for extra-cardiac uptake versus standard processing in 99mTc-sestamibi myocardial perfusion imaging","authors":"Keiko Tanimoto, Yoshifumi Kawamura, Satoshi Kimura, Yumi Hasuike, Erina Tachibana, Ayako Kudo, Tadao Aikawa, Koji Murakami, Shinichiro Fujimoto","doi":"10.1007/s12149-025-02085-w","DOIUrl":"10.1007/s12149-025-02085-w","url":null,"abstract":"<div><h3>Objective</h3><p>In <sup>99m</sup>Tc myocardial perfusion SPECT, extra-cardiac accumulation from organs such as the liver or gastrointestinal tract may overlap with the inferior wall, causing artifacts that interfere with image interpretation. This study aimed to quantitatively evaluate the effectiveness of a novel image reconstruction method, the masking process on unsmoothed images (MUS method; CardioMUSk®, PDRadiopharma Inc., Tokyo, Japan), in reducing the influence of extra-cardiac accumulation using both phantom and clinical images.</p><h3>Methods</h3><p>This retrospective study included 200 patients (400 scans) who underwent a one-day stress-rest protocol using <sup>99m</sup>Tc-sestamibi (MIBI) with pharmacologic stress administered first. Image reconstruction was performed using filtered back projection (FBP) and ordered subset expectation maximization with resolution recovery (OS-EM-RR), both with and without the MUS method. First, visual classification of extra-cardiac accumulation patterns relative to the inferior wall was performed, and the separation capability of each reconstruction method was assessed. Next, phantom experiments were conducted to investigate the effects of extra-cardiac accumulation volume, proximity, and concentration on contrast in the inferior wall. Furthermore, quantitative comparison of relative contrast between the inferior wall and the lateral and septal walls was performed using clinical data.</p><h3>Results</h3><p>The MUS method reduced the proportion of visually unseparated cases from 15.5% to 3.5% compared with the conventional method. In phantom studies, larger extra-cardiac accumulation and closer proximity to the myocardium resulted in greater degradation of inferior wall contrast. When a distance of 2 cm was maintained between extra-cardiac accumulation and the myocardium, the effect was substantially reduced. In clinical images, the MUS method significantly improved relative contrast in the inferolateral/inferior wall at the mid-ventricular level (Wilcoxon <i>p</i> = 0.030) and in the inferoseptal/inferior wall at the basal level (Wilcoxon <i>p</i> < 0.001), while no significant improvement was observed in the basal inferolateral/inferior wall region (Wilcoxon <i>p</i> = 0.605).</p><h3>Conclusion</h3><p>The MUS method demonstrated enhanced separation of extra-cardiac accumulation and improved contrast in the inferior myocardial wall compared with conventional methods. It was particularly effective in cases where extra-cardiac accumulation overlapped or closely contacted the myocardium, indicating its potential clinical utility in <sup>99m</sup>Tc myocardial perfusion SPECT.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"39 11","pages":"1267 - 1277"},"PeriodicalIF":2.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of previous 177Lu-DOTATATE treatment on 90Y-microsphere treatment response in neuroendocrine tumor patients with liver metastasis 177Lu-DOTATATE治疗对肝转移性神经内分泌肿瘤患者90y -微球治疗反应的影响

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Annals of Nuclear Medicine

Pub Date : 2025-08-25 DOI: 10.1007/s12149-025-02101-z

Fuad Aghazada, Lebriz Uslu-Besli, Ali Kibar, Onur Erdem Sahin, Nami Yeyin, Eren Ertek, Ahmet Bas, Haluk Burcak Sayman

Objective

This study evaluates the impact of prior PRRT with Lu-177 DOTATATE on the response to TARE in NET patients with liver metastases.

Methods

Twenty-one patients who underwent TARE after PRRT between 2015 and 2022 were retrospectively analyzed. Tumor-specific cumulative Lu-177 DOTATATE counts were calculated from SPECT/CT images. Treatment planning was conducted with a standard target dose of 150 Gy to the tumoral tissue. Treatment response was assessed using changes in SUVmax, SUVmean, and somatostatin receptor-expressing tumor volume (SRE-TV) values derived from Ga-68 DOTATATE PET/CT before and 2–4 months after TARE. Lesion size was evaluated using RECIST v1.1 criteria. Dosimetry calculations were performed on Tc-99 m MAA SPECT/CT and Y-90 microsphere PET/MRI using Simplicit90Y™. Statistical analyses included Spearman correlation and Kruskal–Wallis tests.

Results

The median age of patients was 56 years (range 36–78 years). PRRT involved a mean cumulative Lu-177 DOTATATE dose of 43.5 ± 13.4 GBq (1175 ± 362 mCi). Post-TARE reductions in SUVmax (38.49 ± 20.46 to 19.94 ± 10.43 g/mL), SUVmean (9.51 ± 5.60 to 5.39 ± 3.64 g/mL), and SRE-TV (217.43 ± 155.87 to 175.62 ± 147.77 cm³) were observed. No significant correlation was found between cumulative Lu-177 DOTATATE counts and changes in SUV parameters, SRE-TV values, or lesion size after TARE. Similarly, no correlation was detected between tumor-to-normal liver activity ratios, calculated using either the partition model or voxel-based dosimetry and cumulative Lu-177 DOTATATE counts.

Conclusion

Prior PRRT does not significantly affect TARE response in NET patients with liver metastases. Radioembolization planning should prioritize factors like tumor, target, or healthy liver doses over previous PRRT.

目的：本研究评估既往PRRT加Lu-177 DOTATATE对NET肝转移患者TARE疗效的影响。方法：回顾性分析2015 - 2022年间21例PRRT术后TARE患者。通过SPECT/CT图像计算肿瘤特异性累积lu177 DOTATATE计数。治疗计划以150戈瑞的标准靶剂量照射肿瘤组织。通过TARE前和TARE后2-4个月Ga-68 DOTATATE PET/CT的SUVmax、SUVmean和生长抑素受体表达肿瘤体积（SRE-TV）值的变化来评估治疗效果。病变大小采用RECIST v1.1标准评估。使用Simplicit90Y™对Tc-99 m MAA SPECT/CT和Y-90微球PET/MRI进行剂量学计算。统计分析包括Spearman相关检验和Kruskal-Wallis检验。结果：患者中位年龄56岁（范围36-78岁）。PRRT涉及平均累积lu177 DOTATATE剂量为43.5±13.4 GBq（1175±362 mCi）。经皮后SUVmax（38.49±20.46 ~ 19.94±10.43 g/mL）、SUVmean（9.51±5.60 ~ 5.39±3.64 g/mL）、SRE-TV（217.43±155.87 ~ 175.62±147.77 cm3）降低。累积lu177 DOTATATE计数与TARE后SUV参数、SRE-TV值或病变大小的变化无显著相关性。同样，使用分区模型或基于体素的剂量学和累积Lu-177 DOTATATE计数计算的肿瘤与正常肝脏活性比之间没有发现相关性。结论：先前的PRRT对NET肝转移患者的TARE反应没有显著影响。放射栓塞计划应优先考虑肿瘤、靶标或健康肝脏剂量等因素，而不是先前的PRRT。

{"title":"Effect of previous 177Lu-DOTATATE treatment on 90Y-microsphere treatment response in neuroendocrine tumor patients with liver metastasis","authors":"Fuad Aghazada, Lebriz Uslu-Besli, Ali Kibar, Onur Erdem Sahin, Nami Yeyin, Eren Ertek, Ahmet Bas, Haluk Burcak Sayman","doi":"10.1007/s12149-025-02101-z","DOIUrl":"10.1007/s12149-025-02101-z","url":null,"abstract":"<div><h3>Objective</h3><p>This study evaluates the impact of prior PRRT with Lu-177 DOTATATE on the response to TARE in NET patients with liver metastases.</p><h3>Methods</h3><p>Twenty-one patients who underwent TARE after PRRT between 2015 and 2022 were retrospectively analyzed. Tumor-specific cumulative Lu-177 DOTATATE counts were calculated from SPECT/CT images. Treatment planning was conducted with a standard target dose of 150 Gy to the tumoral tissue. Treatment response was assessed using changes in SUVmax, SUVmean, and somatostatin receptor-expressing tumor volume (SRE-TV) values derived from Ga-68 DOTATATE PET/CT before and 2–4 months after TARE. Lesion size was evaluated using RECIST v1.1 criteria. Dosimetry calculations were performed on Tc-99 m MAA SPECT/CT and Y-90 microsphere PET/MRI using Simplicit90Y™. Statistical analyses included Spearman correlation and Kruskal–Wallis tests.</p><h3>Results</h3><p>The median age of patients was 56 years (range 36–78 years). PRRT involved a mean cumulative Lu-177 DOTATATE dose of 43.5 ± 13.4 GBq (1175 ± 362 mCi). Post-TARE reductions in SUVmax (38.49 ± 20.46 to 19.94 ± 10.43 g/mL), SUVmean (9.51 ± 5.60 to 5.39 ± 3.64 g/mL), and SRE-TV (217.43 ± 155.87 to 175.62 ± 147.77 cm<sup>3</sup>) were observed. No significant correlation was found between cumulative Lu-177 DOTATATE counts and changes in SUV parameters, SRE-TV values, or lesion size after TARE. Similarly, no correlation was detected between tumor-to-normal liver activity ratios, calculated using either the partition model or voxel-based dosimetry and cumulative Lu-177 DOTATATE counts.</p><h3>Conclusion</h3><p>Prior PRRT does not significantly affect TARE response in NET patients with liver metastases. Radioembolization planning should prioritize factors like tumor, target, or healthy liver doses over previous PRRT.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"40 1","pages":"41 - 49"},"PeriodicalIF":2.5,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advances in imaging-based diagnosis, prognosis, and response assessment in cardiac amyloidosis: a comprehensive multimodality review 基于影像的心脏淀粉样变诊断、预后和反应评估进展：一项综合多模式综述。

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Annals of Nuclear Medicine

Pub Date : 2025-08-25 DOI: 10.1007/s12149-025-02092-x

Osamu Manabe, Seitaro Oda, Takashi Norikane, Tadao Aikawa, Yuka Otaki, Nagara Tamaki

Cardiac amyloidosis, characterized by extracellular deposition of amyloid fibrils within the myocardium, is an increasingly recognized cause of heart failure. With the advent of disease-modifying therapies, imaging has become central to diagnosis, subtype differentiation, prognostication, and treatment monitoring. This review provides a comprehensive update on multimodality imaging in cardiac amyloidosis, emphasizing its clinical utility across the disease continuum. Echocardiography, technetium-labeled bone scintigraphy, amyloid-specific positron emission tomography, cardiac magnetic resonance, and cardiac computed tomography each contribute uniquely to detecting amyloid burden and assessing cardiac function. In addition to outlining a practical diagnostic approach, we highlight emerging imaging biomarkers for monitoring treatment response and predicting clinical outcomes. The integration of these modalities into clinical practice enhances diagnostic accuracy, enables individualized risk stratification, and supports optimized, evidence-based care for patients with cardiac amyloidosis.

心脏淀粉样变性，其特征是心肌内淀粉样原纤维的细胞外沉积，是一种越来越被认为是心力衰竭的原因。随着疾病改善疗法的出现，影像学已成为诊断、亚型分化、预后和治疗监测的核心。这篇综述提供了心脏淀粉样变性多模态影像学的全面更新，强调其在疾病连续体中的临床应用。超声心动图、技术标记骨显像、淀粉样蛋白特异性正电子发射断层扫描、心脏磁共振和心脏计算机断层扫描都对检测淀粉样蛋白负担和评估心功能有独特的贡献。除了概述一种实用的诊断方法外，我们还强调了用于监测治疗反应和预测临床结果的新兴成像生物标志物。将这些模式整合到临床实践中可以提高诊断准确性，实现个体化风险分层，并支持心脏淀粉样变性患者的优化循证护理。

{"title":"Advances in imaging-based diagnosis, prognosis, and response assessment in cardiac amyloidosis: a comprehensive multimodality review","authors":"Osamu Manabe, Seitaro Oda, Takashi Norikane, Tadao Aikawa, Yuka Otaki, Nagara Tamaki","doi":"10.1007/s12149-025-02092-x","DOIUrl":"10.1007/s12149-025-02092-x","url":null,"abstract":"<div><p>Cardiac amyloidosis, characterized by extracellular deposition of amyloid fibrils within the myocardium, is an increasingly recognized cause of heart failure. With the advent of disease-modifying therapies, imaging has become central to diagnosis, subtype differentiation, prognostication, and treatment monitoring. This review provides a comprehensive update on multimodality imaging in cardiac amyloidosis, emphasizing its clinical utility across the disease continuum. Echocardiography, technetium-labeled bone scintigraphy, amyloid-specific positron emission tomography, cardiac magnetic resonance, and cardiac computed tomography each contribute uniquely to detecting amyloid burden and assessing cardiac function. In addition to outlining a practical diagnostic approach, we highlight emerging imaging biomarkers for monitoring treatment response and predicting clinical outcomes. The integration of these modalities into clinical practice enhances diagnostic accuracy, enables individualized risk stratification, and supports optimized, evidence-based care for patients with cardiac amyloidosis.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"39 10","pages":"1037 - 1052"},"PeriodicalIF":2.5,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s12149-025-02092-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Safety of repeated trans-arterial radioembolization with multi-compartment dosimetry 多室剂量法反复经动脉放射栓塞的安全性。

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Annals of Nuclear Medicine

Pub Date : 2025-08-20 DOI: 10.1007/s12149-025-02094-9

Cigdem Soydal, Burak Demir, Mine Araz, Irem Mesci, Emre Can Çelebioğlu, Nuriye Ozlem Kucuk

<div><h3>Purpose</h3><p>Transarterial radioembolization (TARE) is one of the local treatment options for primary and metastatic liver tumors. However, our knowledge regarding the safety of repeated TARE remains limited. In this study, we aimed to evaluate the safety of repeated transarterial radioembolization with multi-compartment dosimetry.</p><h3>Methods</h3><p>In this retrospective single-center study, we analyzed the data of the patients who were treated with at least two separate sessions of radioembolization with <sup>90</sup>Y microspheres. Multi-compartment and voxel-wise dosimetry was performed for every treatment session and cumulative whole-liver normal tissue absorbed radiation dose (<i>D</i><sub>norm</sub>), V20-V100 values for whole-liver normal tissue were calculated. Toxicity was assessed with Common Terminology Criteria for Adverse Events (CTCAE) grading system for alanine aminotransferase (ALT)/aspartate aminotransferase (AST)/bilirubin levels and International Normalized Ratio (INR) before and after each treatment. In addition, albumin–bilirubin (ALBI) scores, grades, and changes in ALBI score (ΔALBI) were recorded. Difference between the ALBI scores before and after the treatment was compared with Wilcoxon tests, and relationships between ΔALBI and dosimetric variables were compared using linear regression analyses.</p><h3>Results</h3><p>A total of 24 patients (6 males, 18 females; median age: 57 years) were included in the analysis. The most common diagnosis was colorectal carcinoma liver metastases (46%). Seventeen patients (71%) underwent two TARE treatments, five (21%) underwent three, and two (8%) underwent four. The median interval between the first and second treatments was 138 days (range: 34–782), and between the second and third treatments was 210 days (range: 72–435). No CTCAE Grade 3 or 4 toxicities were observed. ALBI score analysis revealed no significant changes after the first two treatments, but a significant difference was noted after the third treatment (<i>P</i> = 0.043), with one patient progressing to ALBI Grade 3 with significant hypoalbuminemia. No significant relationship was found between ΔALBI and treatment intervals. ALT/AST elevations were mostly transient and mild, with only one case of Grade 2 hepatotoxicity in each of the first two treatments. In patients treated with glass microspheres in their first two treatments (<i>n</i> = 12), a significant linear correlation was found between cumulative <i>D</i><sub>norm</sub> and ΔALBI (<i>R</i><sup>2</sup> = 0.512, <i>P</i> = 0.007). Cumulative dose–volume histogram parameters, particularly V30, V40, and V50, showed significant correlations with ΔALBI. However, in patients treated with resin microspheres (<i>n</i> = 6), no statistically significant relationship was observed between cumulative <i>D</i><sub>norm</sub> and ΔALBI (<i>P</i> = 0.718).</p><h3>Conclusion</h3><p>Repeated TARE with a multi-compartment personalized dosimetric approach appears to

目的：经动脉放射栓塞（TARE）是原发性和转移性肝肿瘤的局部治疗选择之一。然而，我们对重复TARE安全性的了解仍然有限。在这项研究中，我们旨在评估多室剂量法反复经动脉放射栓塞的安全性。方法：在这项回顾性单中心研究中，我们分析了至少两次使用90Y微球进行放射栓塞治疗的患者的数据。每个疗程进行多室和体素剂量测定，计算全肝正常组织累积吸收辐射剂量（Dnorm）， V20-V100值。采用不良事件通用术语标准（CTCAE）评分系统对每次治疗前后丙氨酸转氨酶(ALT)/天冬氨酸转氨酶(AST)/胆红素水平和国际标准化比率（INR）进行毒性评估。此外，记录白蛋白-胆红素（ALBI）评分、分级和ALBI评分的变化（ΔALBI）。采用Wilcoxon检验比较治疗前后ALBI评分的差异，并采用线性回归分析比较ΔALBI与剂量学变量之间的关系。结果：共纳入24例患者，其中男性6例，女性18例，中位年龄57岁。最常见的诊断是大肠癌肝转移（46%）。17例患者（71%）接受了2次TARE治疗，5例（21%）接受了3次TARE治疗，2例（8%）接受了4次TARE治疗。第一次和第二次治疗之间的中位间隔为138天（范围：34-782），第二次和第三次治疗之间的中位间隔为210天（范围：72-435）。未见CTCAE 3级或4级毒性反应。ALBI评分分析显示，前两次治疗后无显著变化，但第三次治疗后差异显著（P = 0.043）， 1例患者进展为ALBI 3级，伴有明显的低白蛋白血症。ΔALBI与治疗间隔无显著关系。ALT/AST升高大多是短暂的和轻微的，在前两种治疗中各只有1例2级肝毒性。在前两次使用玻璃微球治疗的患者中（n = 12），累积Dnorm与ΔALBI之间存在显著的线性相关（R2 = 0.512, P = 0.007）。累积剂量-体积直方图参数，特别是V30、V40和V50，与ΔALBI有显著相关性。然而，在使用树脂微球治疗的患者中（n = 6），累积Dnorm与ΔALBI之间无统计学意义的关系（P = 0.718）。结论：重复TARE与多室个体化剂量学方法在前两个周期似乎是安全的，具有有限的低级别毒性。然而，观察到第三次治疗后ALBI评分显著增加。在接受玻璃微球治疗的患者中，第二次TARE后的ALBI评分变化与累积肝脏辐射暴露有关。需要更大规模的研究来进一步探索重复TARE的肝毒性预测因素。

{"title":"Safety of repeated trans-arterial radioembolization with multi-compartment dosimetry","authors":"Cigdem Soydal, Burak Demir, Mine Araz, Irem Mesci, Emre Can Çelebioğlu, Nuriye Ozlem Kucuk","doi":"10.1007/s12149-025-02094-9","DOIUrl":"10.1007/s12149-025-02094-9","url":null,"abstract":"<div><h3>Purpose</h3><p>Transarterial radioembolization (TARE) is one of the local treatment options for primary and metastatic liver tumors. However, our knowledge regarding the safety of repeated TARE remains limited. In this study, we aimed to evaluate the safety of repeated transarterial radioembolization with multi-compartment dosimetry.</p><h3>Methods</h3><p>In this retrospective single-center study, we analyzed the data of the patients who were treated with at least two separate sessions of radioembolization with <sup>90</sup>Y microspheres. Multi-compartment and voxel-wise dosimetry was performed for every treatment session and cumulative whole-liver normal tissue absorbed radiation dose (<i>D</i><sub>norm</sub>), V20-V100 values for whole-liver normal tissue were calculated. Toxicity was assessed with Common Terminology Criteria for Adverse Events (CTCAE) grading system for alanine aminotransferase (ALT)/aspartate aminotransferase (AST)/bilirubin levels and International Normalized Ratio (INR) before and after each treatment. In addition, albumin–bilirubin (ALBI) scores, grades, and changes in ALBI score (ΔALBI) were recorded. Difference between the ALBI scores before and after the treatment was compared with Wilcoxon tests, and relationships between ΔALBI and dosimetric variables were compared using linear regression analyses.</p><h3>Results</h3><p>A total of 24 patients (6 males, 18 females; median age: 57 years) were included in the analysis. The most common diagnosis was colorectal carcinoma liver metastases (46%). Seventeen patients (71%) underwent two TARE treatments, five (21%) underwent three, and two (8%) underwent four. The median interval between the first and second treatments was 138 days (range: 34–782), and between the second and third treatments was 210 days (range: 72–435). No CTCAE Grade 3 or 4 toxicities were observed. ALBI score analysis revealed no significant changes after the first two treatments, but a significant difference was noted after the third treatment (<i>P</i> = 0.043), with one patient progressing to ALBI Grade 3 with significant hypoalbuminemia. No significant relationship was found between ΔALBI and treatment intervals. ALT/AST elevations were mostly transient and mild, with only one case of Grade 2 hepatotoxicity in each of the first two treatments. In patients treated with glass microspheres in their first two treatments (<i>n</i> = 12), a significant linear correlation was found between cumulative <i>D</i><sub>norm</sub> and ΔALBI (<i>R</i><sup>2</sup> = 0.512, <i>P</i> = 0.007). Cumulative dose–volume histogram parameters, particularly V30, V40, and V50, showed significant correlations with ΔALBI. However, in patients treated with resin microspheres (<i>n</i> = 6), no statistically significant relationship was observed between cumulative <i>D</i><sub>norm</sub> and ΔALBI (<i>P</i> = 0.718).</p><h3>Conclusion</h3><p>Repeated TARE with a multi-compartment personalized dosimetric approach appears to ","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":"39 12","pages":"1306 - 1318"},"PeriodicalIF":2.5,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0