Pub Date : 2025-09-23DOI: 10.1016/j.remnie.2025.500213
D Huang, X Yang, Y Chen, J Gong
{"title":"Intrapulmonary Castleman disease mimicking locally advanced primary lung cancer on <sup>18</sup>F-FDG PET/CT.","authors":"D Huang, X Yang, Y Chen, J Gong","doi":"10.1016/j.remnie.2025.500213","DOIUrl":"10.1016/j.remnie.2025.500213","url":null,"abstract":"","PeriodicalId":94197,"journal":{"name":"Revista espanola de medicina nuclear e imagen molecular","volume":" ","pages":"500213"},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-12DOI: 10.1016/j.remnie.2025.500234
P Dauden-Onate, L F León-Ramírez, G Cuesta-Domingo, M Vaillant-Lopez, C González-Roiz, M N Cabrera-Martín
{"title":"Acute descending necrotizing mediastinitis as a complication of a retropharyngeal abscess: Diagnosis with [<sup>18</sup>F]FDG PET/CT.","authors":"P Dauden-Onate, L F León-Ramírez, G Cuesta-Domingo, M Vaillant-Lopez, C González-Roiz, M N Cabrera-Martín","doi":"10.1016/j.remnie.2025.500234","DOIUrl":"10.1016/j.remnie.2025.500234","url":null,"abstract":"","PeriodicalId":94197,"journal":{"name":"Revista espanola de medicina nuclear e imagen molecular","volume":" ","pages":"500234"},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-05-20DOI: 10.1016/j.remnie.2025.500162
A. Ricaurte-Fajardo , V. Marulanda-Corzo , S. Ruder , D.R. Cardoza-Ochoa , C.E. Granados , D. Yadav , D. López-Delgado , M. Fatima , S. Dutruel , E. O’Dwyer , J.R. Osborne , S.T. Tagawa , S. Huicochea Castellanos
Prostate-specific membrane antigen (PSMA)-targeted radionuclide therapy has reshaped the treatment landscape for metastatic castration-resistant prostate cancer (mCRPC), offering new therapeutic possibilities beyond conventional approaches. Among the most promising strategies is lutetium-177 PSMA-617, which has shown significant benefits in overall survival and durable PSA responses, as demonstrated in several clinical trials.
At the same time, the development of novel radionuclides such as actinium-225 has opened the door to more potent treatments capable of overcoming prior resistance, particularly in patients previously exposed to beta emitters. The use of PSMA PET imaging and the identification of predictive biomarkers have helped refine patient selection, contributing to a more personalized approach. Comparative studies with agents like cabazitaxel have further supported the safety and effectiveness of this strategy.
This article provides a critical overview of clinical advances in PSMA-targeted radionuclide therapy, examines emerging combination treatments, reviews the development of alpha-emitting agents, and highlights the role of personalized dosimetry in clinical practice, underlining the growing importance of this therapeutic modality across different stages of prostate cancer.
{"title":"Revolutionizing prostate cancer treatment: PSMA-targeted therapy in modern therapeutics","authors":"A. Ricaurte-Fajardo , V. Marulanda-Corzo , S. Ruder , D.R. Cardoza-Ochoa , C.E. Granados , D. Yadav , D. López-Delgado , M. Fatima , S. Dutruel , E. O’Dwyer , J.R. Osborne , S.T. Tagawa , S. Huicochea Castellanos","doi":"10.1016/j.remnie.2025.500162","DOIUrl":"10.1016/j.remnie.2025.500162","url":null,"abstract":"<div><div><span><span>Prostate-specific membrane antigen (PSMA)-targeted radionuclide therapy has reshaped the treatment landscape for metastatic castration-resistant </span>prostate cancer (mCRPC), offering new therapeutic possibilities beyond conventional approaches. Among the most promising strategies is lutetium-177 PSMA-617, which has shown significant benefits in </span>overall survival<span> and durable PSA<span> responses, as demonstrated in several clinical trials.</span></span></div><div><span>At the same time, the development of novel radionuclides<span> such as actinium-225 has opened the door to more potent treatments capable of overcoming prior resistance, particularly in patients previously exposed to beta emitters. The use of PSMA PET imaging and the identification of predictive biomarkers have helped refine patient selection, contributing to a more personalized approach. Comparative studies with agents like </span></span>cabazitaxel have further supported the safety and effectiveness of this strategy.</div><div>This article provides a critical overview of clinical advances in PSMA-targeted radionuclide therapy, examines emerging combination treatments, reviews the development of alpha-emitting agents, and highlights the role of personalized dosimetry<span><span> in clinical practice, underlining the growing importance of this therapeutic modality across different stages of </span>prostate cancer.</span></div></div>","PeriodicalId":94197,"journal":{"name":"Revista espanola de medicina nuclear e imagen molecular","volume":"44 5","pages":"Article 500162"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-04-19DOI: 10.1016/j.remnie.2025.500129
E. Campaña Díaz , F. Gómez-Caminero López , J. Manuel Álvarez Pérez , C. Montes Fuentes , S. Rama Alonso , J. Ángel Badell Martínez , P. García-Talavera San Miguel
Objective
To assess the usefulness of performing a dual-time-point protocol in the acquisition of 18F-choline (18F-FCH) PET/CT in the pre-surgical localization of PHPT, and to demonstrate the impact of this imaging technique on the management and outcome-based surgical decision making, compared to other imaging techniques. To evaluate the diagnostic performance of the test to discriminate between pathological parathyroid gland and cervical lymph node, as well as to establish its correlation with other imaging techniques (scintigraphy, ultrasound, CT and MRI).
Patients and methods
We included 39 patients who underwent surgery for PHPT, in whom dual-time-point 18F-FCH PET/CT was performed. Metabolic index of parathyroid (P-SUVmax; P-SUVpeak), lymph node (N-SUVpeak), thyroid (T-SUVpeak) and mediastinum (M-SUVpeak) uptake were analyzed visually and semiquantitatively in both images. PET/CT results were correlated with 99mTc-MIBI scintigraphy, ultrasound, MRI and CT.
Results
In 36 patients (92%), PET/CT was positive, localizing 38 pathological glands. The sensitivity (S) of PET/CT was 97% and positive predictive value (PPV) 94%. In the visual analysis, dual-time-point protocol was necessary in 61% of the cases. Correlation between PET/CT with MRI was 80%, with 4D-CT 50%, and with the other techniques <50%. P-SUVmax shows correlation with adenoma weight and size, and with presurgical PTH. The best cutoff point for SUVpeak to differentiate parathyroid vs. lymph node was 2.6 in early images (S = 70%; specificity = 75%; p = 0.007) and 0.86 for SUVpeak/T-SUVpeak index (S = 73%; specificity = 69%; p = 0.001).
Conclusion
18F-FCH PET/CT is an excellent preoperative localization technique in patients with HPTP with negative, doubtful or inconclusive imaging techniques, being of vital importance in guiding minimally invasive surgery. The dual-time-point protocol was necessary in more than half of the cases (61%). The SUVpeak cut-off points to discriminate between parathyroid gland and lymph nodes were statistically significant.
{"title":"18F-choline PET/CT in the study of primary hyperparathyroidism: Evaluation of the technique, visual and semi-quantitative analysis and correlation with other imaging techniques","authors":"E. Campaña Díaz , F. Gómez-Caminero López , J. Manuel Álvarez Pérez , C. Montes Fuentes , S. Rama Alonso , J. Ángel Badell Martínez , P. García-Talavera San Miguel","doi":"10.1016/j.remnie.2025.500129","DOIUrl":"10.1016/j.remnie.2025.500129","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the usefulness of performing a dual-time-point protocol in the acquisition of <sup>18</sup>F-choline (<sup>18</sup><span><span><span><span>F-FCH) PET/CT in the pre-surgical localization of PHPT, and to demonstrate the impact of this </span>imaging technique<span> on the management and outcome-based surgical decision making, compared to other imaging techniques. To evaluate the diagnostic performance of the test to discriminate between pathological </span></span>parathyroid gland and </span>cervical lymph node, as well as to establish its correlation with other imaging techniques (scintigraphy, ultrasound, CT and MRI).</span></div></div><div><h3>Patients and methods</h3><div>We included 39 patients who underwent surgery for PHPT, in whom dual-time-point <sup>18</sup><span>F-FCH PET/CT was performed. Metabolic index of parathyroid<span> (P-SUVmax; P-SUVpeak), lymph node (N-SUVpeak), thyroid (T-SUVpeak) and mediastinum (M-SUVpeak) uptake were analyzed visually and semiquantitatively in both images. PET/CT results were correlated with </span></span><sup>99m</sup><span>Tc-MIBI scintigraphy, ultrasound, MRI and CT.</span></div></div><div><h3>Results</h3><div><span>In 36 patients (92%), PET/CT was positive, localizing 38 pathological glands. The sensitivity (S) of PET/CT was 97% and positive predictive value (PPV) 94%. In the visual analysis, dual-time-point protocol was necessary in 61% of the cases. Correlation between PET/CT with MRI was 80%, with 4D-CT 50%, and with the other techniques <50%. P-SUVmax shows correlation with adenoma weight and size, and with presurgical </span>PTH. The best cutoff point for SUVpeak to differentiate parathyroid vs. lymph node was 2.6 in early images (S = 70%; specificity = 75%; p = 0.007) and 0.86 for SUVpeak/T-SUVpeak index (S = 73%; specificity = 69%; p = 0.001).</div></div><div><h3>Conclusion</h3><div><sup>18</sup><span>F-FCH PET/CT is an excellent preoperative localization technique in patients with HPTP with negative, doubtful or inconclusive imaging techniques, being of vital importance in guiding minimally invasive surgery. The dual-time-point protocol was necessary in more than half of the cases (61%). The SUVpeak cut-off points to discriminate between parathyroid gland and lymph nodes were statistically significant.</span></div></div>","PeriodicalId":94197,"journal":{"name":"Revista espanola de medicina nuclear e imagen molecular","volume":"44 5","pages":"Article 500129"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We evaluated the influence of baseline volumetric 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) parameters and inflammatory prognostic markers on complete response (CR) in patients with locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (nCRT).
Materials and Methods
In total, 90 patients with LARC, including those with and without CR, were evaluated based on baseline volumetric PET/CT parameters, such as maximum standard uptake value, metabolic tumor volume (MTV), tumor lesion glycolysis, and inflammatory prognostic markers, including the lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio.
Results
Of the 90 patients, 62 (68.9%) were male and 28 (31.1%) were female. The median age was 61 (31–81) years. A complete response was observed in 20 (22%) patients following nCRT. Of these, 5 demonstrated a clinical complete response, whereas 15 exhibited a complete response after surgery. A low pretreatment PLR, low MTV levels, and stage 2 disease were identified as significant predictors of complete response. The optimal cutoff values were 16.5 for MTV (sensitivity 80%, specificity 62%) and 121 for PLR (sensitivity 73%, specificity 65%).
Conclusion
Our findings suggest that stage 2 disease, low pretreatment MTV, and low PLR levels may be predictive of a CR to nCRT in patients with LARC.
{"title":"Predicting complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer: The role of baseline volumetric 18F-FDG PET/CT parameters and inflammatory markers","authors":"Gokmen Umut Erdem , Ozge Vural Topuz , Esranur Acar , Tanju Kapagan , Esma Yetim , Aykut Ozmen , Simay Gurocak , Gamze Usul , Sercan Yuksel , Aytul Hande Yardimci , Nilufer Bulut","doi":"10.1016/j.remnie.2025.500113","DOIUrl":"10.1016/j.remnie.2025.500113","url":null,"abstract":"<div><h3>Objectives</h3><div>We evaluated the influence of baseline volumetric 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) parameters and inflammatory prognostic markers on complete response (CR) in patients with locally advanced rectal cancer<span> (LARC) treated with neoadjuvant chemoradiotherapy (nCRT).</span></div></div><div><h3>Materials and Methods</h3><div>In total, 90 patients with LARC, including those with and without CR, were evaluated based on baseline volumetric PET/CT parameters, such as maximum standard uptake value, metabolic tumor volume (MTV), tumor lesion glycolysis, and inflammatory prognostic markers, including the lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio.</div></div><div><h3>Results</h3><div>Of the 90 patients, 62 (68.9%) were male and 28 (31.1%) were female. The median age was 61 (31–81) years. A complete response was observed in 20 (22%) patients following nCRT. Of these, 5 demonstrated a clinical complete response, whereas 15 exhibited a complete response after surgery. A low pretreatment PLR, low MTV levels, and stage 2 disease were identified as significant predictors of complete response. The optimal cutoff values were 16.5 for MTV (sensitivity 80%, specificity 62%) and 121 for PLR (sensitivity 73%, specificity 65%).</div></div><div><h3>Conclusion</h3><div>Our findings suggest that stage 2 disease, low pretreatment MTV, and low PLR levels may be predictive of a CR to nCRT in patients with LARC.</div></div>","PeriodicalId":94197,"journal":{"name":"Revista espanola de medicina nuclear e imagen molecular","volume":"44 5","pages":"Article 500113"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143375017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-04-06DOI: 10.1016/j.remnie.2025.500138
A. Piñeiro Donis , L. Menéndez-Muros , J.L. Villa-Palacios , E. Triviño-Ibáñez , M.A. Muros-Fuentes
Objective
To analyze the prognostic value of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and other biomarkers of inflammation in patients with neuroendocrine tumors (NETs) treated with [177Lu]Lu-DOTA-TATE (Lutathera®). The prognostic value of histological characteristics of the tumor was also analyzed.
Patients and methods
Prospective study of a cohort of patients with advanced and metastatic NETs treated with [177Lu]Lu-DOTA-TATE. Before the administration of doses, NT-proBNP, hemoglobin, hematocrit, C-reactive protein, leukocytes, lymphocytes, neutrophils, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have been determined. Overall survival (OS) and progression free survival (PFS) were calculated, using the Kaplan-Meier method, and curves were compared with a log-rank test. To determine the predictor variables of OS, a Cox regression model was fitted.
Results
48 NET patients treated with [177Lu]Lu-DOTA-TATE. Median OS was 96 months and PFS was 29 months. Factors associated with lower OS were: NTproBNP values>300 pg/mL (HR: 10,5; p = 0,005) in the subgroup of patients with grades 2–3, in addition to inflammatory indices NLR > 2 (HR: 3,87; p = 0,049) and PLR > 300 (HR: 11,88; p = 0,01) and higher tumor grade (HR: 6,45; p = 0,011). PLR > 300 (HR: 5,506; p = 0,003) was also associated with lower PFS. In contrast, higher levels of lymphocytes (HR: 0,21; p = 0,002), hemoglobin (HR: 0,65; p = 0,041) and hematocrit (HR: 0,862; p = 0,031) were associated with higher OS, without significant changes in PFS.
Conclusion
In patients with NETs treated with [177Lu]Lu-DOTA-TATE, the determination of natriuretic factors (NT-ProBNP) and other inflammatory biomarkers may be useful as predictors of survival and prognostic factors.
{"title":"Natriuretic factors and inflammation biomarkers as predictors of survival in [177Lu]Lu-DOTA-TATE therapy of neuroendocrine tumors","authors":"A. Piñeiro Donis , L. Menéndez-Muros , J.L. Villa-Palacios , E. Triviño-Ibáñez , M.A. Muros-Fuentes","doi":"10.1016/j.remnie.2025.500138","DOIUrl":"10.1016/j.remnie.2025.500138","url":null,"abstract":"<div><h3>Objective</h3><div><span><span>To analyze the prognostic value of N-terminal prohormone of </span>brain natriuretic peptide<span> (NT-proBNP) and other biomarkers of inflammation in patients with neuroendocrine tumors (NETs) treated with [</span></span><sup>177</sup>Lu]Lu-DOTA-TATE (Lutathera®). The prognostic value of histological characteristics of the tumor was also analyzed.</div></div><div><h3>Patients and methods</h3><div>Prospective study of a cohort of patients with advanced and metastatic NETs treated with [<sup>177</sup><span>Lu]Lu-DOTA-TATE. Before the administration of doses, NT-proBNP, hemoglobin, hematocrit, C-reactive protein, leukocytes, lymphocytes, neutrophils<span>, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have been determined. Overall survival<span> (OS) and progression free survival<span> (PFS) were calculated, using the Kaplan-Meier method, and curves were compared with a log-rank test. To determine the predictor variables of OS, a Cox regression model was fitted.</span></span></span></span></div></div><div><h3>Results</h3><div>48 NET patients treated with [177Lu]Lu-DOTA-TATE. Median OS was 96 months and PFS was 29 months. Factors associated with lower OS were: NTproBNP values>300 pg/mL (HR: 10,5; p = 0,005) in the subgroup of patients with grades 2–3, in addition to inflammatory indices NLR > 2 (HR: 3,87; p = 0,049) and PLR > 300 (HR: 11,88; p = 0,01) and higher tumor grade (HR: 6,45; p = 0,011). PLR > 300 (HR: 5,506; p = 0,003) was also associated with lower PFS. In contrast, higher levels of lymphocytes (HR: 0,21; p = 0,002), hemoglobin (HR: 0,65; p = 0,041) and hematocrit (HR: 0,862; p = 0,031) were associated with higher OS, without significant changes in PFS.</div></div><div><h3>Conclusion</h3><div>In patients with NETs treated with [<sup>177</sup><span>Lu]Lu-DOTA-TATE, the determination of natriuretic factors<span> (NT-ProBNP) and other inflammatory biomarkers may be useful as predictors of survival and prognostic factors.</span></span></div></div>","PeriodicalId":94197,"journal":{"name":"Revista espanola de medicina nuclear e imagen molecular","volume":"44 5","pages":"Article 500138"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-02-05DOI: 10.1016/j.remnie.2025.500112
G.B. Babacan , M. Öner Tamam , S. Saraçoğlu , M.N. Acar Tayyar , M.C. Şahin , H. Özçevik , G. Kulduk , Ö.B. Ekinci , E. Çelik
Objective
This study aimed to investigate the relationship between semiquantitative positron emission tomography (PET) parameters and intratumoral heterogeneity (ITH) on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) imaging and survival data of non-metastatic triple-negative breast cancer (TNBC) patients.
Methods
Sixty-two consecutive female patients who underwent pretreatment 18F-FDG PET/CT with non-metastatic TNBC were enrolled. Heterogeneity index (HI) variables derived from the metabolic tumor volume (MTV) and standardized uptake value (SUV) parameters of primary lesions were evaluated. A novel modified method introducing a percentage-based (30–40–50%) MTV slope comparison was proposed. The association between conventional 18F-FDG PET/CT parameters, HI values, and survival results was analyzed retrospectively.
Results
Tumors with higher HI values were associated with shorter survival times. For overall survival (OS), HI2 and HI3 were statistically significant (p = 0.009, p = 0.016). Regarding radiological progression-free survival (rPFS), HI1 and HI3 were statistically significant (p = 0.01, p = 0.025). A significant weak correlation between HI1 (p = 0.005, ρ = 0.34) and a strong correlation was found for HI2 (p < 0.0001, ρ = 0.89), HI3 and tumor size were not statistically significantly correlated (p = 0.063, ρ = 0.23). T stage was statistically significantly associated with rPFS and OS ((p = 0.038, p = 0.003). In contrast, no statistically significant difference was found for the N stage, anatomical, and clinical staging (p > 0.05).
Conclusion
This study concluded that ITH predicts survival for non-metastatic TNBC patients. This conclusion was reached with the heterogeneity index variables obtained by different methods. However, our results revealed that HI2 depends on tumor size. Our modified method (HI3) predicts survival independently of tumor size.
{"title":"Novel heterogeneity method for predicting survival in non-metastatic triple-negative breast cancer","authors":"G.B. Babacan , M. Öner Tamam , S. Saraçoğlu , M.N. Acar Tayyar , M.C. Şahin , H. Özçevik , G. Kulduk , Ö.B. Ekinci , E. Çelik","doi":"10.1016/j.remnie.2025.500112","DOIUrl":"10.1016/j.remnie.2025.500112","url":null,"abstract":"<div><h3>Objective</h3><div><span>This study aimed to investigate the relationship between semiquantitative positron emission tomography (PET) parameters and intratumoral heterogeneity (ITH) on </span><sup>18</sup>F-fluorodeoxyglucose positron emission tomography/computed tomography (<sup>18</sup>F-FDG PET/CT) imaging and survival data of non-metastatic triple-negative breast cancer (TNBC) patients.</div></div><div><h3>Methods</h3><div>Sixty-two consecutive female patients who underwent pretreatment <sup>18</sup><span>F-FDG PET/CT with non-metastatic TNBC were enrolled. Heterogeneity index<span> (HI) variables derived from the metabolic tumor volume<span> (MTV) and standardized uptake value (SUV) parameters of primary lesions were evaluated. A novel modified method introducing a percentage-based (30–40–50%) MTV slope comparison was proposed. The association between conventional </span></span></span><sup>18</sup>F-FDG PET/CT parameters, HI values, and survival results was analyzed retrospectively.</div></div><div><h3>Results</h3><div><span>Tumors with higher HI values were associated with shorter survival times<span>. For overall survival (OS), HI2 and HI3 were statistically significant (</span></span><em>p</em> <!-->=<!--> <!-->0.009, <em>p</em> <!-->=<!--> <!-->0.016). Regarding radiological progression-free survival (rPFS), HI1 and HI3 were statistically significant (<em>p</em> <!-->=<!--> <!-->0.01, <em>p</em> <!-->=<!--> <!-->0.025). A significant weak correlation between HI1 (<em>p</em> <!-->=<!--> <!-->0.005, <em>ρ</em> <!-->=<!--> <!-->0.34) and a strong correlation was found for HI2 (<em>p</em> <!--><<!--> <!-->0.0001, <em>ρ</em> <!-->=<!--> <!-->0.89), HI3 and tumor size were not statistically significantly correlated (<em>p</em> <!-->=<!--> <!-->0.063, <em>ρ</em> <!-->=<!--> <!-->0.23). T stage was statistically significantly associated with rPFS and OS ((<em>p</em> <!-->=<!--> <!-->0.038, <em>p</em> <!-->=<!--> <!-->0.003). In contrast, no statistically significant difference was found for the N stage, anatomical, and clinical staging (<em>p</em> <!-->><!--> <!-->0.05).</div></div><div><h3>Conclusion</h3><div>This study concluded that ITH predicts survival for non-metastatic TNBC patients. This conclusion was reached with the heterogeneity index variables obtained by different methods. However, our results revealed that HI2 depends on tumor size. Our modified method (HI3) predicts survival independently of tumor size.</div></div>","PeriodicalId":94197,"journal":{"name":"Revista espanola de medicina nuclear e imagen molecular","volume":"44 5","pages":"Article 500112"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143375011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Coronary artery disease is a complex, multifactorial process with high prevalence and morbidity-mortality. Single photon emission computed tomography (SPECT) myocardial perfusion imaging synchronized with the electrocardiogram (gated-SPECT) is a non-invasive imaging technique that has demonstrated high sensitivity and specificity for diagnosis and staging.
To better predict the risk of adverse events, it is necessary to analyze the simultaneous behavior of clinical elements and diagnostic tests, a type of study that is scarce in the current literature.
This research evaluated the relationship between clinical characteristics and gated-SPECT myocardial perfusion parameters with progression to cardiac death; subsequently, a model was built to predict the risk of such an outcome.
Methods
An observational, longitudinal, and retrospective study was conducted with 2 230 patients who underwent this test due to suspected coronary artery disease.
Clinical characteristics, test parameters, and progression to cardiac death were collected and the relationships between them were studied.
A logistic regression model was built to study the relationships between the variables and their influence on the probability of progression to cardiac death.
Results
Clinical characteristics associated with a higher probability of cardiac death were male sex (OR = 5.104, p = 0.004), peripheral arterial disease (OR = 7.175, p < 0.001), and diabetes mellitus (OR = 3.159, p = 0.013). The gated-SPECT parameters associated with a higher risk of this outcome were VTS ≥70 ml (OR = 12.257, p < 0.001), EF < 50% (OR = 10.757, p < 0.001), VTD ≥140 ml (OR = 8.884, p < 0.001), ventricular dilation (OR = 8.959, p < 0.001), and reversible defects (OR = 7.454, p = 0.001). Fixed defects, parietal motility abnormalities, the presence of both reversible and fixed defects, and the hyperdynamic gated state were also associated with a higher risk of cardiac death but with lower ORs.
The logistic regression model showed good overall performance and high ability to determine progression to cardiac death, close to perfect predictive capacity (AUC = 0.9656).
{"title":"Model to predict the risk of cardiac death based on clinical characteristics and Gated-SPECT parameters","authors":"Grethel Rodríguez Cabalé , Eduardo Rodríguez Cabalé , Virginia Pubul Núñez , Álvaro Ruibal Morell","doi":"10.1016/j.remnie.2025.500132","DOIUrl":"10.1016/j.remnie.2025.500132","url":null,"abstract":"<div><h3>Background</h3><div><span>Coronary artery disease<span> is a complex, multifactorial process with high prevalence and morbidity-mortality. Single photon emission computed tomography (SPECT) </span></span>myocardial perfusion<span> imaging synchronized with the electrocardiogram (gated-SPECT) is a non-invasive imaging technique that has demonstrated high sensitivity and specificity for diagnosis and staging.</span></div><div>To better predict the risk of adverse events, it is necessary to analyze the simultaneous behavior of clinical elements and diagnostic tests, a type of study that is scarce in the current literature.</div><div>This research evaluated the relationship between clinical characteristics and gated-SPECT myocardial perfusion parameters with progression to cardiac death; subsequently, a model was built to predict the risk of such an outcome.</div></div><div><h3>Methods</h3><div>An observational, longitudinal, and retrospective study was conducted with 2 230 patients who underwent this test due to suspected coronary artery disease.</div><div>Clinical characteristics, test parameters, and progression to cardiac death were collected and the relationships between them were studied.</div><div>A logistic regression model was built to study the relationships between the variables and their influence on the probability of progression to cardiac death.</div></div><div><h3>Results</h3><div>Clinical characteristics associated with a higher probability of cardiac death were male sex (OR = 5.104, p = 0.004), peripheral arterial disease (OR = 7.175, p < 0.001), and diabetes mellitus (OR = 3.159, p = 0.013). The gated-SPECT parameters associated with a higher risk of this outcome were VTS ≥70 ml (OR = 12.257, p < 0.001), EF < 50% (OR = 10.757, p < 0.001), VTD ≥140 ml (OR = 8.884, p < 0.001), ventricular dilation (OR = 8.959, p < 0.001), and reversible defects (OR = 7.454, p = 0.001). Fixed defects, parietal motility abnormalities, the presence of both reversible and fixed defects, and the hyperdynamic gated state were also associated with a higher risk of cardiac death but with lower ORs.</div><div>The logistic regression model showed good overall performance and high ability to determine progression to cardiac death, close to perfect predictive capacity (AUC = 0.9656).</div></div>","PeriodicalId":94197,"journal":{"name":"Revista espanola de medicina nuclear e imagen molecular","volume":"44 5","pages":"Article 500132"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-04-19DOI: 10.1016/j.remnie.2025.500130
K. Oksuzoglu, N. Zumbul
{"title":"Mycotic aortitis caused by intravesical BCG and concomitant lung cancer identified via FDG PET/CT","authors":"K. Oksuzoglu, N. Zumbul","doi":"10.1016/j.remnie.2025.500130","DOIUrl":"10.1016/j.remnie.2025.500130","url":null,"abstract":"","PeriodicalId":94197,"journal":{"name":"Revista espanola de medicina nuclear e imagen molecular","volume":"44 5","pages":"Article 500130"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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