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Positron Range Correction Helps Enhance the Image Quality of Cardiac 82Rb PET/CT J Nucl. Med. (IF 9.1) Pub Date : 2025-02-06 Martin Lyngby Lassen, Hunor Kertész, Ivo Rausch, Vladimir Panin, Maurizio Conti, Sven Zuehlsdorff, Jorge Cabello, Deepak Bharkhada, Robert DeKemp, Andreas Kjaer, Thomas Beyer, Philip Hasbak
Visual Abstract
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Exploring the Flare Phenomenon in Patients with Castration-Resistant Prostate Cancer: Enzalutamide-Induced PSMA Upregulation Observed on PSMA PET J Nucl. Med. (IF 9.1) Pub Date : 2025-02-06 Suzanne van der Gaag, André N. Vis, Imke H. Bartelink, Josephina C.C. Koppes, Marina Hodolic, Harry Hendrikse, Daniela E. Oprea-Lager
Androgen receptor–targeting agents, particularly enzalutamide, show promise in enhancing prostate cancer diagnostic and therapeutic strategies by modulating prostate-specific membrane antigen (PSMA). Methods: A retrospective clinical cohort study investigated 9 men with metastatic castration-resistant prostate cancer on enzalutamide. PSMA PET/CT scans were obtained before and after enzalutamide initiation
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177Lu-Labeled Anticlaudin 6 Monoclonal Antibody for Targeted Therapy in Esophageal Cancer J Nucl. Med. (IF 9.1) Pub Date : 2025-02-06 Huan Du, Xiaofei Hao, Binwei Lin, Mingming Tang, Decai Wang, Xia Yang, Jing Wang, Liling Qin, Yuchuan Yang, Xiaobo Du
Visual Abstract
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Molecular Imaging in Cancer Chemoresistance: What’s Brewing? J Nucl. Med. (IF 9.1) Pub Date : 2025-02-06 Luca Urso, Licia Uccelli, Alessandra Boschi, Orazio Schillaci, Luca Filippi
Cancer therapy has advanced with molecularly targeted approaches and immunotherapy, yet chemotherapy remains essential for many aggressive cancers, including breast, lung, ovarian, pancreatic, bladder, sarcoma, and lymphomas. A major challenge is chemoresistance, in which cancer cells evade chemotherapy’s cytotoxic effects. Overexpression of adenosine triphosphate–binding cassette transporters, especially
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Safety, Dosimetry, and Feasibility of [68Ga]Ga-PSMA-R2 as an Imaging Agent in Patients with Biochemical Recurrence or Metastatic Prostate Cancer J Nucl. Med. (IF 9.1) Pub Date : 2025-02-06 Liza Lindenberg, Thomas A. Hope, Frank I. Lin, Steven P. Rowe, Darko Pucar, Noella Gilbert, Daniela Chicco, Beilei He, Benedikt Feuerecker, Elena Castaldi, Lilja B. Solnes
Visual Abstract
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Evaluation of Surgical Margins with Intraoperative PSMA PET/CT and Their Prognostic Value in Radical Prostatectomy J Nucl. Med. (IF 9.1) Pub Date : 2025-02-06 Alexandros Moraitis, Theresa Kahl, Jens Kandziora, Walter Jentzen, David Kersting, Lukas Püllen, Henning Reis, Jens Köllermann, Claudia Kesch, Ulrich Krafft, Boris A. Hadaschik, Habib Zaidi, Ken Herrmann, Francesco Barbato, Wolfgang P. Fendler, Christopher Darr, Pedro Fragoso Costa
Detection of positive resection margins in surgical procedures of high-risk prostate cancer is key for minimizing the risk of recurrence. This study aimed at evaluating the accuracy of functional tumor-volume segmentation in intraoperative ex vivo PET/CT for margin assessment in prostate cancer patients undergoing radical prostatectomy. Methods: Seven high-risk prostate cancer patients received [18F]PSMA-1007
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Collagen Hybridizing Peptide–Based Radiotracers for Molecular Imaging of Collagen Turnover in Pulmonary Fibrosis J Nucl. Med. (IF 9.1) Pub Date : 2025-02-06 Azmi A. Ahmad, Mean Ghim, Gunjan Kukreja, Afarin Neishabouri, Zhengxing Zhang, Jie Li, Mani Salarian, Jakub Toczek, Kiran Gona, Keshvad Hedayatyanfard, Tian Morrison, Jiasheng Zhang, Yiyun Henry Huang, Chi Liu, S. Michael Yu, Mehran M. Sadeghi
Pulmonary fibrosis is a characteristic feature of interstitial lung disease. Current clinical diagnostic methods provide a snapshot of the lung structure without information on disease activity. Collagen hybridizing peptides offer the opportunity to detect collagen remodeling through their hybridization with denatured collagen. Here, we sought to develop a 99mTc-labeled collagen hybridizing tracer
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99mTc-MIP-1404 SPECT/CT Companion Diagnostic for 177Lu-PSMA Therapy in Metastatic Castration-Resistant Prostate Cancer J Nucl. Med. (IF 9.1) Pub Date : 2025-02-06 Thorsten Derlin, Liam Widjaja, Nina Natascha Harke, Christoph Czerner, Desiree Weiberg, Tobias L. Ross, Frank M. Bengel
Our objective was to determine the feasibility, diagnostic performance, and predictive value of 99mTc-MIP-1404 SPECT in patients undergoing baseline staging and assessment of eligibility for prostate-specific membrane antigen (PSMA)–targeted radiopharmaceutical therapy (RPT) for metastatic castration-resistant prostate cancer. Methods: Data of 46 patients undergoing 99mTc-MIP-1404 planar scintigraphy
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Total-Body PET System Designs with Axial and Transverse Gaps: A Study of Lesion Quantification and Detectability J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Min Gao, Margaret E. Daube-Witherspoon, Joel S. Karp, Suleman Surti
High-sensitivity total-body PET enables faster scans, lower doses, and dynamic multiorgan imaging. However, the higher system cost of a scanner with a long axial field of view (AFOV) hinders its wider application. This paper investigates the impact on the lesion quantification and detectability of cost-effective total-body PET sparse designs. Methods: Using the PennPET Explorer (PPEx) as a model, 3
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A Method for Validating PET and SPECT Cameras for Quantitative Clinical Imaging Trials Using Novel Radionuclides J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Dale L. Bailey, Kathy P. Willowson, Graeme O’Keefe, Steven Goodman, Shaun Patford, George McGill, David A. Pattison, Andrew M. Scott
Our aim is to report methodology that has been developed to calibrate and verify PET and SPECT quantitative image accuracy and quality assurance for use with nonstandard radionuclides, especially with longer half-lives, in clinical imaging trials. Methods: Procedures have been developed for quantitative PET and SPECT image calibration for use in clinical trials. The protocol uses a 3-step approach:
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Preserved Serotonin Transporter Availability in Parkinson Disease Measured with Either [11C]MADAM or [11C]DASB: A Study Including 2 Separate Cohorts of Nondepressed Patients J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Minyoung Oh, Joachim Brumberg, Vesna Sossi, Andrea Varrone
Serotonin transporter (SERT) availability was assessed using 2 tracers, [11C]N,N-dimethyl-2-(2-amino-4-cyanophenylthio)benzylamine ([11C]DASB) and [11C]N,N-dimethyl-2-(2-amino-4-fluoromethylphenylthio)benzylamine) ([11C]MADAM), in independent cohorts of patients and controls. This study aimed to independently confirm whether SERT remains intact in nondepressed individuals with early-stage Parkinson
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First-in-Human Study of [11C]NCGG401 for Imaging Colony-Stimulating Factor 1 Receptors in the Brain J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Aya Ogata, Hiroshi Ikenuma, Fumihiko Yasuno, Takashi Nihashi, Saori Hattori, Yayoi Sato, Masanori Ichise, Kengo Ito, Takashi Kato, Yasuyuki Kimura
Microglia, the immune cells in the brain, play a significant role in the pathophysiology of neurodegenerative diseases. To visualize these cells in the living brain, we developed a PET ligand, [11C]NCGG401 (4-{2-[((1R,2R)-2-hydroxycyclohexyl)(methyl)amino]benzothiazol-6-yloxy}-N-methylpicolinamide, NCGG401), that targets colony-stimulating factor 1 receptor (CSF1R). In this study, we present the first-in-human
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Imaging Demyelinated Axons After Spinal Cord Injuries with PET Tracer [18F]3F4AP J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Karla M. Ramos-Torres, Sara Conti, Yu-Peng Zhou, Amal Tiss, Celine Caravagna, Kazue Takahashi, Miao He, Moses Q. Wilks, Sophie Eckl, Yang Sun, Jason Biundo, Kuang Gong, Zhigang He, Clas Linnman, Pedro Brugarolas
Spinal cord injuries (SCIs) often lead to lifelong disability. Among the various types of injuries, incomplete and discomplete injuries, where some axons remain intact, offer potential for recovery. However, demyelination of these spared axons can worsen disability. Demyelination is a reversible phenomenon, and drugs such as 4-aminopyridine (4AP), which target K+ channels in demyelinated axons, show
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Longitudinal Trajectory of Dopamine and Serotonin Transporters in Parkinson Disease J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Yujin Song, Jae-Hyeok Lee, Han-Kyeol Kim, Jae Hoon Lee, Young Hoon Ryu, Han Soo Yoo, Chul Hyoung Lyoo
Parkinson disease (PD) is a multisystem disorder marked by progressive dopaminergic neuronal degeneration in the substantia nigra, as well as nondopaminergic systems. Our aim was to investigate longitudinal changes in N-(3-[18F]fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane (18F-FP-CIT) binding at the putamen, substantia nigra, and raphe nuclei in PD. Methods: This retrospective cohort study
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In Vivo Head-to-Head Comparison of [18F]GTP1 with [18F]MK-6240 and [18F]PI-2620 in Alzheimer Disease J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Emily Olafson, Matteo Tonietto, Gregory Klein, Edmond Teng, Andrew W. Stephens, David S. Russell, Karen Pickthorn, Sandra Sanabria Bohorquez
Alzheimer disease (AD) is characterized by the accumulation of tau neurofibrillary tangles that can be labeled with PET tracers. Multiple tau PET tracers have been used in clinical studies, including [18F]GTP1, [18F]PI-2620, and [18F]MK-6240. Standardized harmonization scales for comparing tau PET signals across tracers are currently under development and can be informed by comparisons of signals between
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Cardiac Presynaptic Sympathetic Nervous Function Evaluated by Cardiac PET in Patients with Chronotropic Incompetence Without Heart Failure J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Toshihiko Goto, Shohei Kikuchi, Yomei Sakurai, Yoshiro Tsuruta, Kento Mori, Tatsuya Mizoguchi, Yu Kawada, Yasuhiro Shintani, Masashi Yokoi, Sayuri Yamabe, Tsuyoshi Ito, Shuichi Kitada, Hidekatsu Fukuta, Kyoko Matsui, Hitomi Narita, Sumire Nankou, Yoshihiro Seo
Chronotropic incompetence (CTI), the inability of the heart to increase its rate with increased activity, leads to exercise intolerance and predicts overall mortality. We previously reported that cardiac β-adrenergic receptor downregulation occurs in patients with CTI without heart failure (HF), indicating postsynaptic sympathetic nervous dysfunction. However, cardiac presynaptic sympathetic nervous
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PET/CT with Myocardial Blood Flow Assessment Is Prognostic of Cardiac Allograft Vasculopathy Progression and Clinical Outcomes J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Nikil Prasad, Erin Harris, Ersilia M. DeFilippis, Gabriel Sayer, Margarita Chernovolenko, Paolo C. Colombo, Justin Fried, David Bae, Kyung Taek Oh, Jayant Raikhelkar, Sambhavi Sneha Kumar, Melana Yuzefpolskaya, Veli K. Topkara, Michelle Castillo, Elaine Y. Lam, Farhana Latif, Koji Takeda, Nir Uriel, Andrew J. Einstein, Kevin J. Clerkin
Cardiac allograft vasculopathy (CAV) causes impaired blood flow in both epicardial vessels and microvasculature and remains a leading cause of posttransplant morbidity and mortality. This study examined the prognostic value and outcomes of CAV, assessed by 13N-ammonia PET/CT myocardial perfusion imaging in heart transplant recipients. Methods: PET/CT and invasive coronary angiography (ICA) were graded
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Safety, Biodistribution, and Radiation Dosimetry of the 68Ga-Labeled Minigastrin Analog DOTA-MGS5 in Patients with Advanced Medullary Thyroid Cancer and Other Neuroendocrine Tumors J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Elisabeth von Guggenberg, Gianpaolo di Santo, Christian Uprimny, Steffen Bayerschmidt, Boris Warwitz, Anton A. Hörmann, Taraneh S. Zavvar, Christine Rangger, Clemens Decristoforo, Anna Sviridenko, Bernhard Nilica, Giulia Santo, Irene J. Virgolini
Several exploratory studies have demonstrated the feasibility of cholecystokinin-2 receptor (CCK2R) targeting in patients with medullary thyroid carcinoma (MTC) and other neuroendocrine tumors (NETs). We report the results of a prospective phase I/IIA pilot study (clinicaltrials.gov NCT06155994) conducted at our center with the 68Ga-labeled peptide analog DOTA-DGlu-Ala-Tyr-Gly-Trp-(N-Me)Nle-Asp-1-Nal-Phe-NH2
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Preclinical Evaluation of 68Ga/177Lu-Labeled FAP-Targeted Peptide for Tumor Radiopharmaceutical Imaging and Therapy J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Rang Wang, Mingxing Huang, Weichen Wang, Mufeng Li, Yingwei Wang, Rong Tian
Fibroblast activation protein (FAP) has been considered a promising target for tumor imaging and therapy. This study designed a novel peptide, FAP-HXN, specifically targeting FAP and exhibiting significant potential as a radionuclide-labeled theranostic agent. Preclinical studies were conducted to evaluate the potency, selectivity, and efficacy of FAP-HXN. Methods: FAP-HXN was synthesized and characterized
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Comprehensive Characterization via Molecular Imaging, Longitudinal Multisite Sampling, and Autoptic Work-up in Advanced Small Cell Lung Cancer Undergoing SSTR-Directed Radiopharmaceutical Therapy J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Johanna S. Enke, Nic G. Reitsam, Sebastian Dintner, Friederike Liesche-Starnecker, Tina Schaller, Josua A. Decker, Angela Langer, Eva Sipos, Ana Antic Nikolic, Thomas Kröncke, Martin Trepel, Constantin Lapa, Rainer Claus, Bruno Märkl, Ralph A. Bundschuh
Despite the addition of immune checkpoint blockade to first-line chemotherapy, the prognosis for patients with small cell lung cancer (SCLC) is still devastating. For the subset of SCLC with somatostatin receptor (SSTR) overexpression, radiopharmaceutical therapy (RPT) might be an effective future treatment option. Methods: Here, we present the case of a heavily pretreated stage IV SCLC patient showing
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177Lu-DOTATATE Plus Capecitabine Versus 177Lu-DOTATATE Alone in Patients with Advanced Grade 1/2 Gastroenteropancreatic Neuroendocrine Tumors (LuCAP): A Randomized, Phase 2 Trial J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Swayamjeet Satapathy, Piyush Aggarwal, Ashwani Sood, Kunal R. Chandekar, Chandan K. Das, Rajesh Gupta, Divya Khosla, Namrata Das, Rakesh Kapoor, Rajender Kumar, Harmandeep Singh, Jaya Shukla, Ajay Kumar, Bhagwant Rai Mittal
177Lu-DOTATATE has emerged as a viable treatment strategy for advanced well-differentiated grade 1/2 gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Few retrospective studies have shown concomitant 177Lu-DOTATATE with radiosensitizing low-dose capecitabine to be effective in advanced NETs. However, this has not been validated in prospective randomized-controlled trials. Methods: In this i
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Diuresis During 18F-Flotufolastat (rhPSMA-7.3) PET/CT Improves Recurrence Detection After Prostatectomy: A Prospective Phase II Trial J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Ismaheel O. Lawal, Aliza Mushtaq, Ashesh B. Jani, Manali Rupji, Vishal R. Dhere, Sagar A. Patel, Mehmet A. Bilen, Pretesh R. Patel, Nikhil T. Sebastian, Jeffrey M. Switchenko, David M. Schuster, Charles Marcus
Radiopharmaceuticals targeting prostate-specific membrane antigen (PSMA) have emerged as a sensitive tool for PET imaging of prostate cancer (PCa) recurrence. Yet urinary bladder activity may obscure the visualization of prostate bed recurrence. Among the Food and Drug Administration–approved PSMA radiopharmaceuticals, 18F-flotufolastat (rhPSMA-7.3) has the lowest urinary excreted activity. We investigated
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Prospective Head-to-Head Comparison of 18F-PSMA PET/CT and 18F-NaF PET/CT for Assessing Bone Metastases in 160 Patients with Newly Diagnosed High-Risk Prostate Cancer J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Claus Madsen, Dan Fuglø, Maria Pedersen, Rikke Broholm, Peter B. Østergren, Rasmus Bisbjerg, Per Kongsted, Kayalvili Nielsen, Christian Haarmark, Helle Zacho
Prostate-specific membrane antigen (PSMA) PET/CT is increasingly used for primary staging in prostate cancer (PC), mainly because of its improved accuracy in detecting lymph node metastases compared with conventional imaging. However, the diagnostic benefit of PSMA PET/CT for detecting bone metastases is less well established. This study compares the diagnostic accuracy of 18F-PSMA PET/CT and 18F-NaF
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RadioFlow Cytometry Reveals That [18F]FDG Uptake in K-RAS Lung Cancer Is Driven by Immune Cells: An Analysis on a Single-Cell Level J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Chrysoula Vraka, Monika Homolya, Öykü Özer, Andreas Spittler, Michael Machtinger, Herwig P. Moll, Emilio Casanova, Claudia Kuntner, Stefan Grünert, Marcus Hacker, Cécile Philippe
Tumor metabolism is a hallmark of cancer, yet cellular heterogeneity within the tumor microenvironment presents a significant challenge, as bulk analysis masks the diverse metabolic profiles of individual cell populations. This complexity complicates our understanding of [18F]FDG uptake by distinct cell types in the tumor microenvironment. This study aims to investigate [18F]FDG uptake at the single-cell
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PET-Based Risk Stratification in Primary Mediastinal B-Cell Lymphoma: A Comparative Analysis of Different Segmentation Methods in the IELSG37 Trial Patient Cohort J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Luca Ceriani, Lisa Milan, Maria Cristina Pirosa, Maurizio Martelli, Teresa Ruberto, Luciano Cascione, Peter W.M. Johnson, Andrew J. Davies, Giovannino Ciccone, Emanuele Zucca
Standardizing tumor measurement on 18F-FDG PET is crucial for the routine clinical use of powerful PET-derived lymphoma prognostic factors such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG). The recent proposal of an SUV of 4 as a new reference segmentation threshold for most aggressive lymphomas may homogenize volume-based metrics and facilitate their clinical application. Methods:
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Head-to-Head Comparison of [68Ga]Ga-NOTA-RM26 and [18F]FDG PET/CT in Patients with Gastrointestinal Stromal Tumors: A Prospective Study J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Rongxi Wang, Weiming Kang, Zhen Liu, Yumin Zheng, Huimin Sui, Linlin Li, Jiarou Wang, Jialin Xiang, Xingtong Peng, Xiaoyuan Chen, Zhaohui Zhu, Jingjing Zhang
Gastrointestinal stromal tumors (GISTs) are the most common stromal tumors in the gastrointestinal tract. This study was designed to evaluate a gastrin-releasing peptide receptor antagonist PET tracer, [68Ga]Ga-NOTA-RM26, and compare it with [18F]FDG PET/CT in the assessment of patients with GISTs. Methods: With institutional review board approval and informed consent, 30 patients with suspected or
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Intrapatient 16α-[18F]Fluoro-17β-Estradiol PET Heterogeneity as a Prognostic Factor for Endocrine Therapy Response and Survival in Patients with Estrogen Receptor–Positive Metastatic Breast Cancer J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Jasper J.L. van Geel, Jasmine Moustaquim, Jorianne Boers, Sjoerd G. Elias, Esther M.M. Smeets, Jelijn J. Knip, Andor W.J.M. Glaudemans, Erik F.J. de Vries, Geke A.P. Hospers, Michel van Kruchten, Marcel Stokkel, Daniela E. Oprea-Lager, Willemien C. Menke-van der Houven van Oordt, Elisabeth G.E. de Vries, Carolina P. Schröder
Intrapatient heterogeneity of estrogen receptor (ER) expression on 16α-[18F]fluoro-17β-estradiol ([18F]FES) PET is related to outcome in patients with ER-positive metastatic breast cancer (MBC), but a validated and practical method to support clinical decision-making is lacking. Therefore, the [18F]FES PET heterogeneity score (i.e., percentage of [18F]FES-positive metastases) was validated as a prognostic
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Borderline Findings in O-(2-[18F]-Fluoroethyl)-l-Tyrosine PET of Patients with Suspected Glioma Relapse: Role in Clinical Practice J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Karl-Josef Langen, Gabriele Stoffels, Christian P. Filss, Martin Kocher, Christoph Lerche, Michael Sabel, Marion Rapp, Hosai Noltemeier, Jan-Michael Werner, Garry Ceccon, Michael M. Wollring, Jurij Rosen, Joachim P. Steinbach, Elke Hattingen, Martin R. Weinzierl, Michael Stoffel, Hans Clusmann, N. Jon Shah, Felix M. Mottaghy, Norbert Galldiks, Philipp Lohmann
One of the most common clinical indications for amino acid PET using the tracer O-(2-[18F]-fluoroethyl)-l-tyrosine (18F-FET) is the differentiation of tumor relapse from treatment-related changes in patients with gliomas. A subset of patients may present with an uptake of 18F-FET close to recommended threshold values. The goal of this study was to investigate the frequency of borderline cases and the
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Large Language Models and Large Multimodal Models in Medical Imaging: A Primer for Physicians J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Tyler J. Bradshaw, Xin Tie, Joshua Warner, Junjie Hu, Quanzheng Li, Xiang Li
Large language models (LLMs) are poised to have a disruptive impact on health care. Numerous studies have demonstrated promising applications of LLMs in medical imaging, and this number will grow as LLMs further evolve into large multimodal models (LMMs) capable of processing both text and images. Given the substantial roles that LLMs and LMMs will have in health care, it is important for physicians
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Dosimetry Software for Theranostic Applications: Current Capabilities and Future Prospects J Nucl. Med. (IF 9.1) Pub Date : 2025-02-01 Adam L. Kesner, Julia Brosch-Lenz, Jonathan Gear, Michael Lassmann
Dosimetry is integral to informed implementation of radiopharmaceutical therapies, enabling personalized treatment planning and ensuring patient safety by calculating absorbed doses to organs and tumors. As the therapeutic radiopharmaceutical field continues to expand, dosimetry software has emerged as a crucial tool for optimization of treatment efficacy. This review discusses key features and capabilities
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Side-by-Side Comparison of the In Vivo Performance of [212Pb]Pb-DOTAMTATE and Other SSTR2-Targeting Compounds J Nucl. Med. (IF 9.1) Pub Date : 2025-01-30 Amal Saidi, Tania A. Stallons, Amy G. Wong, Aaron T. Schatzmann, Ugur Soysal, Julien J. Torgue
Visual Abstract
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Dopaminergic Mechanisms of Cognitive Flexibility: An [18F]Fallypride PET Study J Nucl. Med. (IF 9.1) Pub Date : 2025-01-30 Isabelle Miederer, Hans-Georg Buchholz, Lena Rademacher, Cindy Eckart, Dominik Kraft, Markus Piel, Christian J. Fiebach, Mathias Schreckenberger
Cognitive flexibility is the ability to appropriately adapt one’s thinking and behavior to changing environmental demands and is conceptualized as an aspect of executive function. The dopamine system has been implicated in cognitive flexibility; however, a direct, that is, neurochemical, link to cognitive flexibility has not been shown yet. The aim of this study was, therefore, to investigate how cognitive
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A Phase I/IIa Clinical Trial to Evaluate Safety and Adrenal Uptake of Para-Chloro-2-[18F]Fluoroethyletomidate in Healthy Volunteers and Patients with Primary Aldosteronism J Nucl. Med. (IF 9.1) Pub Date : 2025-01-30 Daniel Gillett, Russell Senanayake, James MacFarlane, Waiel Bashari, August Palma, Lihua Hu, Ines Harper, Iosif A. Mendichovszky, Gunnar Antoni, Per Hellman, Anders Sundin, Matthew Hird, István Boros, Morris J. Brown, Heok Cheow, Luigi Aloj, Franklin Aigbirhio, Mark Gurnell
Primary aldosteronism (PA) is a common, potentially reversible, cause of hypertension. Distinguishing unilateral from bilateral PA is critical when deciding who should be offered surgery (unilateral adrenalectomy). Recent studies have shown that PET/CT with [11C]metomidate can accurately identify unilateral PA, with localization of the causative aldosterone-producing adenoma (APA). However, the availability
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DNA-Dependent Protein Kinase Inhibitor Peposertib Enhances Efficacy of 177Lu-Based Radioimmunotherapy in Preclinical Models of Prostate and Renal Cell Carcinoma J Nucl. Med. (IF 9.1) Pub Date : 2025-01-30 Cameron N. Johnstone, Laura D. Osellame, Zhipeng Cao, Alexander F. McDonald, Angela Rigopoulos, Ingrid J.G. Burvenich, Christian W. Wichmann, Nancy Guo, Alesia N. Ivashkevich, Michael P. Wheatcroft, Edwin B. Yan, Astrid Zimmermann, Frank T. Zenke, Christian Sirrenberg, Fiona E. Scott, Andrew M. Scott
Novel radiation sensitizers, including inhibitors targeting DNA damage response, have been developed to enhance the efficacy of anticancer treatments that induce DNA damage in cancer cells. Peposertib, a potent, selective, and orally administered inhibitor of DNA-dependent protein kinase, impedes the nonhomologous end-joining mechanism for DNA double-strand break (DSB) repair. We investigated radioimmunotherapy
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MIRD Pamphlet No. 32: A MIRD Recovery Coefficient Model for Resolution Characterization and Shape-Specific Partial-Volume Correction J Nucl. Med. (IF 9.1) Pub Date : 2025-01-30 Harry Marquis, C. Ross Schmidtlein, Robin de Nijs, Pablo Mínguez Gabiña, Johan Gustafsson, Gunjan Kayal, Juan C. Ocampo Ramos, Lukas M. Carter, Dale L. Bailey, Adam L. Kesner
Accurate quantification in emission tomography is essential for internal radiopharmaceutical therapy dosimetry. Mean activity concentration measurements in objects with diameters less than 10 times the full width at half maximum of the imaging system’s spatial resolution are significantly affected (>10%) by the partial-volume effect. This study develops a framework for PET and SPECT spatial resolution
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PET Quantification in Healthy Humans of Cyclooxygenase-2, a Potential Biomarker of Neuroinflammation J Nucl. Med. (IF 9.1) Pub Date : 2025-01-23 Xuefeng Yan, Martin Noergaard, Cheryl L. Morse, Jeih-San Liow, Jinsoo Hong, Douglas Greve, Sanjay Telu, Min-Jeong Kim, Jose A. Montero Santamaria, Anthony Galassi, Ningping Feng, Sarah K. Williams Avram, Ted B. Usdin, Shawn Wu, Andrea Zhang, Lester S. Manly, Madeline Jenkins, Maia Van Buskirk, Adrian Lee, Sami S. Zoghbi, Victor W. Pike, Paolo Zanotti-Fregonara, Robert B. Innis
Cyclooxygenase-2 (COX-2) is present in a healthy brain at low densities but can be markedly upregulated by excitatory input and by inflammogens. This study evaluated the sensitivity of the PET radioligand [11C]-6-methoxy-2-(4-(methylsulfonyl)phenyl)-N-(thiophen-2-ylmethyl)pyrimidin-4-amine ([11C]MC1) to detect COX-2 density in a healthy human brain. Methods: The specificity of [11C]MC1 was confirmed
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Computational Nuclear Oncology Toward Precision Radiopharmaceutical Therapies: Ethical, Regulatory, and Socioeconomic Dimensions of Theranostic Digital Twins J Nucl. Med. (IF 9.1) Pub Date : 2025-01-23 Lidia Strigari, Jazmin Schwarz, Tyler Bradshaw, Julia Brosch-Lenz, Geoffrey Currie, Georges El-Fakhri, Abhinav K. Jha, Signe Mežinska, Neeta Pandit-Taskar, Emilie Roncali, Kuangyu Shi, Carlos Uribe, Tahir Yusufaly, Habib Zaidi, Arman Rahmim, Babak Saboury
Computational nuclear oncology for precision radiopharmaceutical therapy (RPT) is a new frontier for theranostic treatment personalization. A key strategy relies on the possibility to incorporate clinical, biomarker, image-based, and dosimetric information in theranostic digital twins (TDTs) of patients to move beyond a one-size-fits-all approach. The TDT framework enables treatment optimization by
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Green Nuclear Medicine and Radiotheranostics J Nucl. Med. (IF 9.1) Pub Date : 2025-01-23 Patrick Veit-Haibach, Ken Herrmann, Richard Zimmermann, Roland Hustinx
There is a significantly growing interest in diagnostic and therapeutic radiopharmaceuticals, and it is foreseeable that an unprecedented number of patients will need to be treated with new nuclear medicine therapies. This predicted increase will have potentially significant environmental impacts. In this discussion, we show different areas of impact, as well as possible measures to reduce such impact
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Updated Appropriate Use Criteria for Amyloid and Tau PET: A Report from the Alzheimer’s Association and Society for Nuclear Medicine and Molecular Imaging Workgroup J Nucl. Med. (IF 9.1) Pub Date : 2025-01-08 Gil D. Rabinovici, David S. Knopman, Javier Arbizu, Tammie L.S. Benzinger, Kevin J. Donohoe, Oskar Hansson, Peter Herscovitch, Phillip H. Kuo, Jennifer H. Lingler, Satoshi Minoshima, Melissa E. Murray, Julie C. Price, Stephen P. Salloway, Christopher J. Weber, Maria C. Carrillo, Keith A. Johnson
The Alzheimer’s Association and the Society of Nuclear Medicine and Molecular Imaging convened a multidisciplinary workgroup to update appropriate use criteria (AUC) for amyloid positron emission tomography (PET) and to develop AUC for tau PET. Methods: The workgroup identified key research questions that guided a systematic literature review on clinical amyloid/tau PET. Building on this review, the
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2024 SNMMI Highlights Lecture: General Clinical Specialties J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Twyla Bartel
The Highlights Lecture, presented at the closing session of each SNMMI Annual Meeting, was originated and presented for more than 30 y by Henry N. Wagner, Jr., MD. Beginning in 2010, the duties of summarizing selected significant presentations at the meeting were divided annually among 4 distinguished nuclear and molecular medicine subject matter experts. The 2024 Highlights Lectures were delivered
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Quantitative Accuracy Assessment of the NeuroEXPLORER for Diverse Imaging Applications: Moving Beyond Standard Evaluations J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Negar Omidvari, Ekaterina Shanina, Edwin K. Leung, Xishan Sun, Yusheng Li, Tim Mulnix, Paul Gravel, Shannan Henry, David Matuskey, Tommaso Volpi, Terry Jones, Ramsey D. Badawi, Hongdi Li, Richard E. Carson, Jinyi Qi, Simon R. Cherry
Quantitative molecular imaging with PET can offer insights into physiologic and pathologic processes and is widely used for studying brain disorders. The NeuroEXPLORER is a recently developed dedicated brain PET system offering high spatial resolution and high sensitivity with an extended axial length. This study evaluated the quantitative precision and accuracy of the NeuroEXPLORER with phantom and
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Effect of Acute Hypoxia Exposure on the Availability of A1 Adenosine Receptors and Perfusion in the Human Brain J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Manuel Michno, Jan Schmitz, Anna L. Foerges, Simone Beer, Jens Jordan, Bernd Neumaier, Alexander Drzezga, Daniel Aeschbach, Andreas Bauer, Jens Tank, Henning Weis, Eva-Maria Elmenhorst, David Elmenhorst
In animal studies it has been observed that the inhibitory neuromodulator adenosine is released into the cerebral interstitial space during hypoxic challenges. Adenosine’s actions on the A1 adenosine receptor (A1AR) protect the brain from oxygen deprivation and overexertion through adjustments in cerebral blood flow, metabolism, and electric activity. Methods: Using 8-cyclopentyl-3-(3-[18F]fluorop
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Myelin Imaging of the Spinal Cord in Animal Models and Patients with Multiple Sclerosis Using [11C]MeDAS PET: A Translational Study J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Chris W.J. van der Weijden, Ahmed K.M.A. Ahmed, Anouk van der Hoorn, Junqing Zhu, Chunying Wu, Yanming Wang, Gilles N. Stormezand, Rudi A.J.O. Dierckx, Jan F. Meilof, Erik F.J. de Vries
Multiple sclerosis (MS) is a neurodegenerative disease characterized by demyelinated lesions in the brain and spinal cord. A few clinical studies using PET to image myelin in the brain have been performed, but none investigated the spinal cord. Because clinically relevant motor symptoms are primarily due to spinal cord damage, this translational study evaluated [11C]N-methyl-4,4'-diaminostilbene (MeDAS)
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Antibody-Based PET Imaging of Misfolded Superoxide Dismutase 1 in an Amyotrophic Lateral Sclerosis Mouse Model J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Jacques A. Rousseau, Marcel Maier, Samia Ait-Mohand, Véronique Dumulon-Perreault, Otman Sarrhini, Sébastien Tremblay, Etienne Rousseau, Michael Salzmann, Brigitte Guérin
Amyotrophic lateral sclerosis (ALS) is a rare neurodegenerative disease characterized by motor neuron loss in the motor cortex, brain stem, and spinal cord. Mutations in the superoxide dismutase 1 (SOD1) gene, resulting in misfolding of its protein product, are a common cause of ALS. Currently, there is no approved ALS diagnostic tool. Here, we present the development of a PET radiotracer, [89Zr]Zr-desferoxamine
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Comparison Between Brain and Cerebellar Autoradiography Using [18F]Flortaucipir, [18F]MK6240, and [18F]PI2620 in Postmortem Human Brain Tissue J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Antonio Aliaga, Joseph Therriault, Kely Monica Quispialaya, Arturo Aliaga, Robert Hopewell, Nesrine Rahmouni, Arthur C. Macedo, Peter Kunach, Jean-Paul Soucy, Gassan Massarweh, Aida Abreu Diaz, Tharick A. Pascoal, Andreia Rocha, Marie-Christine Guiot, Luiza S. Machado, Marco Antônio De Bastiani, Débora Guerini de Souza, Diogo O. Souza, Serge Gauthier, Eduardo R. Zimmer, Pedro Rosa-Neto
Our objective was to evaluate the in vitro binding properties of [18F]flortaucipir, 6-(fluoro-18F)-3-(1H-pyrrolo[2,3-c]pyridin-1-yl)isoquinolin-5-amine ([18F]MK6240), and 2-(2-([18F]fluoro)pyridin-4-yl)-9H-pyrrolo[2,3-b:4,5c′]dipyridine ([18F]PI2620) head-to-head in postmortem human brain tissue. Methods: Autoradiography was used to assess uptake of [18F]flortaucipir, [18F]MK6240, and [18F]PI2620 in
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[11C]PS13 Demonstrates Pharmacologically Selective and Substantial Binding to Cyclooxygenase-1 in the Human Brain J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Nafiseh Ghazanfari, Jeih-San Liow, Min-Jeong Kim, Raven Cureton, Adrian Lee, Carson Knoer, Madeline Jenkins, Jinsoo Hong, Jose A. Montero Santamaria, H. Umesha Shetty, Anthony Galassi, Paul Wighton, Martin Nørgaard, Douglas N. Greve, Sami S. Zoghbi, Victor W. Pike, Robert B. Innis, Paolo Zanotti-Fregonara
Our laboratory recently developed [11C]PS13 as a PET radioligand to selectively measure cyclooxygenase-1 (COX-1). The cyclooxygenase enzyme family converts arachidonic acid into prostaglandins and thromboxanes, which mediate inflammation. The total brain uptake of [11C]PS13, which is composed of both specific binding and background uptake, can be accurately quantified with gold standard methods of
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Quantification Supports Amyloid PET Visual Assessment of Challenging Cases: Results from the AMYPAD Diagnostic and Patient Management Study J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Lyduine E. Collij, Gérard N. Bischof, Daniele Altomare, Ilse Bader, Mark Battle, David Vállez García, Isadora Lopes Alves, Robin Wolz, Rossella Gismondi, Andrew Stephens, Zuzana Walker, Philip Scheltens, Agneta Nordberg, Juan Domingo Gispert, Alexander Drzezga, Andrés Perissinotti, Silvia Morbelli, Christopher Buckley, Valentina Garibotto, Giovanni B. Frisoni, Gill Farrar, Frederik Barkhof
Several studies have demonstrated strong agreement between routine clinical visual assessment and quantification, suggesting that quantification approaches could support assessment by less experienced readers or in challenging cases. However, all studies to date have implemented a retrospective case collection, and challenging cases were generally underrepresented. Methods: We included all participants
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Comparability of Quantifying Relative Lung Ventilation with Inhaled 99mTc-Technegas and 133Xe in Patients Undergoing Evaluation for Lung Transplantation J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Ashwin Singh Parihar, Joyce C. Mhlanga, Henry D. Royal, Barry A. Siegel
99mTc-Technegas was recently approved by the U.S. Food and Drug Administration as a radiopharmaceutical for ventilation scintigraphy. However, there are currently no data comparing the quantification of relative lung ventilation with 99mTc-Technegas with that performed using the standard approach with inhaled 133Xe. Methods: We performed a secondary analysis of data from prospectively recruited participants
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Targeting Fibroblast Activation Protein for Molecular Imaging of Fibrotic Remodeling in Pulmonary Arterial Hypertension J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Peng Hou, Haiming Chen, Sihao Liang, Wenliang Guo, Ruiyue Zhao, Huailu Pan, Haimin Liu, Youcai Li, Jie Lv, Kaixiang Zhong, Miao Ke, Yimin Fu, Huizhen Zhong, Xinlu Wang, Cheng Hong
The purpose of this study was to investigate the feasibility of using 18F-labeled fibroblast activation protein inhibitor (FAPI) PET/CT in assessing the fibrotic remodeling of the pulmonary artery (PA) and the right ventricle (RV) in pulmonary arterial hypertension (PAH). Methods: In a rat model of monocrotaline-induced PAH, rats were euthanized at different time points for tissue analysis (fibroblast
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Localized In Vivo Prodrug Activation Using Radionuclides J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Jeremy M. Quintana, Fangchao Jiang, Mikyung Kang, Victor Valladolid Onecha, Arda Könik, Lei Qin, Victoria E. Rodriguez, Huiyu Hu, Nicholas Borges, Ishaan Khurana, Leou I. Banla, Mariane Le Fur, Peter Caravan, Jan Schuemann, Alejandro Bertolet, Ralph Weissleder, Miles A. Miller, Thomas S.C. Ng
Radionuclides used for imaging and therapy can show high molecular specificity in the body with appropriate targeting ligands. We hypothesized that local energy delivered by molecularly targeted radionuclides could chemically activate prodrugs at disease sites while avoiding activation in off-target sites of toxicity. As proof of principle, we tested whether this strategy of radionuclide-induced drug
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Mathematic Modeling of Tumor Growth During [177Lu]Lu-PSMA Therapy: Insights into Treatment Optimization J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Nouran R.R. Zaid, Remco Bastiaannet, Rob Hobbs, George Sgouros
The treatment regimen for [177Lu]Lu-prostate-specific membrane antigen (PSMA) 617 therapy follows that of chemotherapy: 6 administrations of a fixed activity, each separated by 6 wk. Mathematic modeling can be used to test the hypothesis that the current treatment regimen for a radiopharmaceutical modality is suboptimal. Methods: A mathematic model was developed to describe tumor growth during [177Lu]Lu-PSMA
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Rates of PSMA PET Staging and Positivity in Newly Diagnosed Prostate Cancer in a National Health Care System J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Sean R. Miller, Rachel Tucker Gonzalez, William C. Jackson, Megan E.V. Caram, Phoebe A. Tsao, Kristian Stensland, Yashesh Shah, Daniel Wale, Ka Kit Wong, Benjamin L. Viglianti, David Elliott, Tanner Caverly, Timothy P. Hofer, Sameer Saini, Michael D. Green, Matthew Schipper, Robert T. Dess, Alex K. Bryant
Prostate-specific membrane antigen (PSMA) PET was approved by the U.S. Food and Drug Administration in 2020 for the staging of newly diagnosed prostate cancer, yet rates of adoption and real-world positivity rates are unknown. We characterized patients undergoing PSMA PET staging and describe positive findings in a large national cohort. Methods: We identified all newly diagnosed prostate cancer patients
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Pattern of Failure in Patients with Biochemical Recurrence After PSMA Radioguided Surgery J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Lilit Schweiger, Tobias Maurer, Ricarda Simon, Thomas Horn, Matthias Heck, Wolfgang A. Weber, Matthias Eiber, Isabel Rauscher
Prostate-specific membrane antigen (PSMA)–targeted radioguided surgery (RGS) is evolving as a new treatment modality for patients with early biochemical recurrence of prostate cancer and disease limited to locoregional lymph nodes on PSMA-ligand PET/CT. Nevertheless, the pattern of failure (locoregional vs. systemic) after PSMA RGS remains unknown. Therefore, the aim of this retrospective analysis
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Real-World Comparison of Cabazitaxel Versus 177Lu-PSMA Radiopharmaceutical Therapy in Metastatic Castration-Resistant Prostate Cancer J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Mike Wenzel, Florestan Koll, Benedikt Hoeh, Clara Humke, Carolin Siech, Nicolai Mader, Amir Sabet, Daniel Groener, Thomas Steuber, Markus Graefen, Tobias Maurer, Christian Brandts, Severine Banek, Felix K.H. Chun, Philipp Mandel
177Lu-vipivotide tetraxetan prostate-specific membrane antigen (177Lu-PSMA) therapy is under current scientific investigation and aims to become established in the treatment of metastatic castration-resistant prostate cancer (mCRPC). However, real-world evidence in treatment comparison is scant. Methods: We relied on the FRAMCAP database and compared cabazitaxel versus 177Lu-PSMA therapy in mCRPC patients
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Low- and High-Volume Disease in Metastatic Hormone-Sensitive Prostate Cancer: From CHAARTED to PSMA PET—An International Multicenter Retrospective Study J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Lena M. Unterrainer, Thomas A. Hope, Wolfgang P. Fendler, Tristan Grogan, Honest Ndlovu, Wesley Armstrong, Francesco Barbato, Matthias R. Benz, Matthew B. Rettig, Amar U. Kishan, Mike Sathekge, Ken Herrmann, Johannes Czernin, Jeremie Calais
High-volume disease (HVD) and low-volume disease (LVD) definitions in metastatic hormone-sensitive prostate cancer (mHSPC) patients are based on conventional imaging (CI) (CT/MRI with bone scan [BS]) according to CHAARTED criteria. HVD and LVD definitions are associated with overall survival and are used for treatment decisions. It remains unknown how these definitions transfer to prostate-specific
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PET-Based TheraP Eligibility and Outcomes of VISION-Eligible Patients with Metastatic Castration-Resistant Prostate Cancer Who Received 177Lu-PSMA-617: Importance of 18F-FDG–Avid Discordant Findings J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Ridvan Arda Demirci, Alireza Ghodsi, Roman Gulati, Sanaz Behnia, Peter S. Nelson, Heather H. Cheng, Todd A. Yezefski, Michael C. Haffner, Jessica E. Hawley, Robert B. Montgomery, Evan Y. Yu, Michael T. Schweizer, Delphine L. Chen, Amir Iravani
The VISION and TheraP trials introduced different PET-based criteria for patient selection for treatment with 177Lu-PSMA-617 (LuPSMA). TheraP used a higher prostate-specific membrane antigen (PSMA) uptake threshold than VISION and required 18F-FDG PET to exclude patients with discordant findings. Although the screen-failed patients had shorter overall survival (OS) than those treated with LuPSMA, it
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Preclinical Evaluation and Pilot Clinical Study of CD137 PET Radiotracer for Noninvasive Monitoring Early Responses of Immunotherapy J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Kai Cheng, Luna Ge, Miaomiao Song, Wanhu Li, Jinsong Zheng, Jingru Liu, Yuxi Luo, Pengfei Sun, Shengnan Xu, Zhen Cheng, Jinming Yu, Jie Liu
Given the variability in the effectiveness of immune checkpoint blocking therapy among patients and tumor types, development of noninvasive methods for longitudinal assessment of immune cell function and early tumor response is crucial for precision immunotherapy. CD137 (4-1BB), a marker of activated T cells, plays a significant role in immunotherapy. However, its potential as an imaging biomarker
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[18F]Fluorthanatrace PET in Ovarian Cancer: Comparison with [18F]FDG PET, Lesion Location, Tumor Grade, and Breast Cancer Gene Mutation Status J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Joanna K. Weeks, Austin R. Pantel, Sarah B. Gitto, Fang Liu, Erin K. Schubert, Daniel A. Pryma, Michael D. Farwell, David A. Mankoff, Robert H. Mach, Fiona Simpkins, Lilie L. Lin
Poly(adenosine diphosphate–ribose) polymerase-1 (PARP1) inhibitors have improved ovarian cancer treatment outcomes. However, clinical response remains heterogeneous. Existing biomarkers, mainly breast cancer susceptibility genes 1 and 2 (BRCA1/2), are suboptimal. New tools are needed to guide patient selection. In this study, [18F]fluorthanatrace ([18F]FTT), a PET radiotracer for imaging PARP1, was
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Molecular Imaging of Cancer Stem Cells and Their Role in Therapy Resistance J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Sofia N. dos Santos, Timothy H. Witney
Despite recent therapeutic breakthroughs, cancer patients continue to face high recurrence and mortality rates due to treatment resistance. Cancer stem cells (CSCs), a subpopulation with self-renewal capabilities, are key drivers of refractive disease. This review explores the application of molecular imaging techniques, such as PET and SPECT, for the noninvasive detection of CSCs. By providing real-time
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Nuclear Cardiology Surrogate Biomarkers in Clinical Trials J Nucl. Med. (IF 9.1) Pub Date : 2025-01-01 Robert J.H. Miller, Krishna K. Patel, Jacek Kwiecinski, Leandro Slipczuk, Marc Dweck, David E. Newby, Panithaya Chareonthaitawee, Piotr Slomka
Nuclear cardiology offers a diverse range of imaging tools that provide valuable insights into myocardial perfusion, inflammation, metabolism, neuroregulation, thrombosis, and microcalcification. These techniques are crucial not only for diagnosing and managing cardiovascular conditions but also for gaining pathophysiologic insights. Surrogate biomarkers in nuclear cardiology, represented by detectable