American journal of nuclear medicine and molecular imaging最新文献

Recombinant human endostatin (RHE) has been applied in treating non-small cell lung cancer via inhibiting tumor neovascularization. In this study, a controlled release of RHE was proposed and manifested in a fluorescent view. In a mice model with NSCLC xenografts, the prolonged pharmacokinetics curves and pharmaceutic concentrations in tumor contributed to the inhibition of neovascularization that was proved with ⁶⁸Ga-RGD PET, and finally reflected as the delayed tumor growth rate. Conclusively, the functional view on the basis of molecular imaging can exhibit the procedure and outcome of the controlled release of RHE, which can effectively enhance the therapeutic effects in treating NSCLC.

Infections of the musculoskeletal system contribute substantially to global morbidity and healthcare expenditure, and conventional imaging frequently falls short of providing the sensitivity and specificity required for early diagnosis in complicated presentations. In this review, we examine the clinical role of [¹⁸F]-fluorodeoxyglucose positron emission tomography paired with computed tomography (FDG-PET/CT) or magnetic resonance imaging (FDG-PET/MRI) in the workup of these infections. Drawing on the published literature, we summarize evidence across osteomyelitis, spondylodiscitis, septic arthritis, and prosthetic joint infection, with attention to reported diagnostic performance and to where each hybrid technique appears to be most useful. Across infection types, FDG-PET/CT consistently shows good diagnostic accuracy, is widely available, and tolerates metallic hardware well, whereas FDG-PET/MRI, though still investigational and confined to a small number of academic centers, offers improved soft-tissue contrast and lower cumulative radiation, which may be advantageous in selected cases such as spondylodiscitis or in patients requiring serial imaging. The available comparative evidence remains limited, much of it drawn from small, single-center cohorts. We therefore emphasize that current data should be viewed as preliminary. Modality choice in practice depends on the clinical question, patient factors, local availability, and cost, rather than on a one-size-fits-all preference.

Triple-negative breast cancer (TNBC) is an aggressive subtype accounting for 10-17% of all breast cancers, characterized by the absence of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 expression. TNBC is associated with high recurrence rates and poor prognosis, particularly after metastatic progression. Current surveillance guidelines rely on clinical evaluation and conventional imaging, which have limited sensitivity for detecting early recurrence. [¹⁸F]fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) offers the potential to detect metabolic changes indicative of disease activity before anatomical changes become apparent. This review examines the emerging role of FDG PET/CT in the post-treatment evaluation of TNBC in two distinct clinical contexts: (1) surveillance for recurrence after remission, with specific attention to hepatic, pulmonary, osseous, and cerebral metastases, and (2) treatment response assessment in advanced disease following chemotherapy and immunotherapy. Across both contexts, FDG PET/CT offers incremental diagnostic and prognostic value over conventional imaging. However, much of the available evidence is derived from general breast cancer populations and not from TNBC-specific cohorts. Dedicated recurrence-surveillance data in TNBC remain particularly scarce. FDG PET/CT demonstrated 98% sensitivity and 100% specificity for hepatic metastases in a mixed-malignancy cohort, PET Response Criteria in Solid Tumors (PERCIST) criteria showed higher predictive accuracy than Response Evaluation Criteria in Solid Tumors (RECIST) for both progression-free and disease-specific survival, and early interim PET/CT after two cycles of chemotherapy identified metabolic non-responders (<42% SUV_max decrease) who had a 100% rate of residual tumor at surgery in a small TNBC cohort. However, FDG PET/CT remains limited for sub-centimeter pulmonary nodules (due to partial volume effects and respiratory motion) and brain metastases (due to high physiological brain glucose uptake). Additionally, limitations of the current evidence include small study populations, short follow-up periods, cost considerations, and risks of false-positive findings due to post-treatment inflammation and immunotherapy-related pseudoprogression. Beyond FDG, emerging PET tracers, such as radiolabeled fluorothymidine (FLT), fibroblast activation protein inhibitor (FAPI), and prostate-specific membrane antigen (PSMA)-targeted agents, may offer complementary information for TNBC surveillance. Larger, TNBC-specific prospective studies with longer follow-up are needed to establish evidence-based guidelines for incorporating FDG PET/CT into routine TNBC surveillance and response-assessment protocols, alongside formal cost-effectiveness analyses.

Polyarteritis nodosa (PAN) is a rare systemic necrotizing vasculitis. It affects the medium-sized arteries. It attacks many parts of the body in very different ways. Therefore, it is difficult to diagnose and stage. ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) PET/CT combines anatomic and metabolic activity. This can show the complete extent of the disease in PAN very well. We report a 35-year-old man with fever, generalized myalgia, black stools and dry gangrene at the tip of his fingers. Laboratory tests revealed high C-reactive protein and high erythrocyte sedimentation rate. However, the anti-neutrophil cytoplasmic antibodies (ANCA) were negative. ¹⁸F-FDG PET/CT identifies multisystem lesions. The doctor thought that these lesions were there, but they could not be found by regular scanning. These lesions include high activity of many muscles, more absorption of the middle artery of the calf, local absorption of the skin between the toes, and absorption of the stomach wall. Tissue samples from many places confirmed necrotizing arteritis. After treatment with corticosteroids and targeted antibiotics, the patient's condition improved.

Background: Recurrent hypopharyngeal carcinoma is associated with poor prognosis, yet the prognostic utility of maximum standardized uptake value (SUVmax) from 18F-FDG PET/CT and its relation to recurrence site remain insufficiently characterized.

Objective: This study aimed to evaluate the association of SUVmax and recurrence site with overall survival (OS) in patients with recurrent hypopharyngeal carcinoma.

Methods: We retrospectively analyzed 69 patients with biopsy-confirmed recurrent hypopharyngeal carcinoma without distant metastasis treated at Viet Nam National Cancer Hospital between 2019 and 2024. PET/CT scans performed at recurrence diagnosis were used to measure SUVmax at the primary tumor and/or metastatic lymph nodes. Patients were classified by recurrence site: primary tumor only (Tumor-only), lymph nodes only (Node-only), or both (Tumor + Node). OS was assessed using Kaplan-Meier estimates and Cox proportional hazards regression, adjusted for age, ECOG, time to recurrence and type of treatment.

Results: Mean SUVmax was 12.3 ± 6.3. Patients with SUVmax > 12 had a median OS of 11.45 months (95% CI: 7.1-37.1) vs. 13.06 months (95% CI: 6.7-37.4) for SUVmax ≤ 12 (P < 0.01). Tumor + Node recurrence had a median OS of 11.2 months (95% CI: 6.8-37.4) vs. 13.6 months (95% CI: 6.7-34.5) for Tumor-only/Node-only (P = 0.009). In multivariate Cox regression, SUVmax > 12 (HR = 2.69, 95% CI: 1.37-5.30, P = 0.004), Tumor + Node recurrence (HR = 2.96, 95% CI: 1.45-6.06, P = 0.003), Non-surgery treatment (HR = 2.98, 95% CI: 1.23-7.23, P = 0.016) and ECOG PS ≥ 2 (HR = 2.22, 95% CI: 1.12-4.41, P = 0.023) independently predicted reduced OS.

Conclusion: Elevated SUVmax and combined tumor-nodal recurrence on PET/CT are significant predictors of reduced OS, supporting their role in prognostic stratification for recurrent hypopharyngeal carcinoma.

Fibroblast activation protein (FAP) is highly expressed in various sarcomas, including solitary fibrous tumors (SFTs). In recent years, radiolabeled FAPI tracers have emerged as potential therapeutic targets. In SFTs with high FAP expression, ⁹⁰Y-FAPI-46 demonstrated promising therapeutic efficacy. These findings highlight the potential of FAPα expression as a clinically relevant biomarker for patient selection and establish ⁹⁰Y-FAPI-46-based radiopharmaceutical therapy as a promising and meaningful therapeutic option for patients with malignant SFT.

Prostate cancer (PCa) remains a leading cause of cancer-related morbidity and mortality worldwide, underscoring the need for improved molecular imaging strategies. Although prostate-specific membrane antigen (PSMA) positron emission tomography (PET) has changed prostate cancer imaging and treatment, its clinical utility is limited in some settings by heterogeneous tumor expression and substantial off-target uptake in organs such as the kidneys and salivary glands. Acid phosphatase 3 (ACP3), also known as prostatic acid phosphatase, has regained attention as an alternative prostate-associated target because of its abundant expression in prostate cancer and comparatively low expression in several normal tissues. Recent advances in high-affinity small-molecule ligands, including radiolabeled OncoACP3 derivatives, have enabled the development of ACP3-targeted PET radiopharmaceuticals. Preclinical studies and early clinical investigations demonstrate favorable biodistribution, high tumor-to-background contrast, and the capacity to detect lesions in PSMA-low or PSMA-negative disease. Moreover, ACP3-directed radioligand strategies highlight its potential in theranostic applications. Overall, ACP3 radiopharmaceuticals may provide a complementary approach for precision prostate cancer imaging and therapy.

Objective: Immunotherapy plays a pivotal role in the treatment of colorectal cancer (CRC). PD-L1 has been identified to be a significant biomarker of response to treatment. The assessment of PD-L1 presently depends on biopsy samples - a problem that may be resolved with the help of a molecular imaging approach. This study devised and evaluated an ¹⁸F-and ⁸⁹Zr-labelled albumin-binding PD-L1-targeted VHH for potential diagnostic imaging in CRC models.

Methods: PD-L1 expression was initially validated in HCT-116 cell-derived xenografts and CRC20-PDX tumors. An albumin-binding moiety was conjugated to a PD-L1-targeted VHH to construct SN-2D01. The ¹⁸F-labeled SN-2D01 was prepared using the AlF-RESCA chelation strategy and the probe was modified with DFO for a ⁸⁹Zr radiolabeling process. The evaluation of [¹⁸F]F-SN-2D01 and [⁸⁹Zr]Zr-SN-2D01 through PET imaging was performed on the two tumor models and a quantitative analysis of tumor uptake for each tracer. Ultimately, a biodistribution study of [⁸⁹Zr]Zr-SN-2D01 at 120 h post-injection (p.i.) was performed in both tumor models.

Results: The HCT-116 cell-derived xenografts and CRC20-PDX tumors were both PD-L1-positive, with a higher expression observed in lesions from CRC20-PDX versus HCT-116 tumors. The 2 h p.i. of [¹⁸F]F-SN-2D01 PET showed clear visualization of HCT-116 and CRC20-PDX tumors, with tracer mostly cleared via hepatic and renal excretion. In PET imaging with [⁸⁹Zr]Zr-SN-2D01, the tumor uptake in both HCT-116 and CRC20-PDX slowly increased from 24 h to 120 h p.i, which peaked at 120 h. Biodistribution at 120 h showed tumor uptake of 11.49 ± 1.32 %ID/g for the CRC20-PDX model and 8.12 ± 1.54 %ID/g for the HCT-116 model.

Conclusion: In summary, we presented two PET probes to visualize PD-L1. Of these, [⁸⁹Zr]Zr-SN-2D01 was found to have significant capability to evaluate PD-L1 expression in CRC. The PD-L1-targeted SN-2D01 may provide a new approach in radionuclide therapy targeting PD-L1 in CRC.

T lymphocytes are central mediators of cardiovascular disease, driving myocardial injury in myocarditis, transplant rejection, post-infarct remodeling, atherosclerosis, and post-viral syndromes. Yet current imaging tools ([¹⁸F]FDG PET, somatostatin receptor tracers, CXCR4 PET, and cardiac MRI) offer only indirect or nonspecific measures of immune activity. The ability to noninvasively visualize and quantify T-cell infiltration and activation could transform diagnosis and management in cardio-immunology. Advances in immuno-PET have produced a growing arsenal of T-cell specific tracers. CD8-targeted agents (⁸⁹Zr-Df-IAB22M2C) and small-molecule probes such as [¹⁸F]F-AraG have entered early clinical trials, demonstrating feasibility and safety in humans. Other tracers, including CD4- and CD3-directed antibodies, IL-2R and OX40 probes, checkpoint tracers (PD-1, CTLA-4), and granzyme B ligands, remain largely preclinical but show strong potential for cardiovascular translation. Applications span acute myocarditis, noninvasive transplant rejection surveillance, assessment of post-MI immune remodeling, plaque vulnerability in atherosclerosis, and systemic immune activation in long COVID. Compared with existing imaging modalities, T-cell PET offers cell-type specificity, quantitative longitudinal monitoring, and the capacity for whole-body immune mapping, particularly when integrated with total-body PET or hybrid PET/MR. Challenges include low T-cell density in the myocardium, tracer specificity, radiation burden, and the need for histopathologic validation. Future directions involve repurposing oncology tracers for cardiology, engineering antibody fragments with improved kinetics, and establishing T-cell PET as a mechanistic biomarker in cardiovascular clinical trials. With further innovation and validation, T-cell PET has the potential to evolve from an experimental tool into a clinically actionable modality, reshaping the management of immune-mediated heart disease.

To predict bilateral renal curves and glomerular filtration rate (GFR) following unsuccessful tracer injection in SPECT renal dynamic imaging using a Transformer model, thereby obviating the need for repeat examinations. We retrospectively studied patients who underwent repeat imaging post-extravasation (2015-2025). Patient height, weight, serum creatinine, urea, uric acid, and renal dynamic curves were used as inputs to develop a Transformer deep learning model for calibrating curves and predicting GFR. Following injection extravasation during SPECT renal dynamic imaging, the proposed model achieved a high overall alignment with the ground truth curves (Median R²>0.93). However, performance variability was observed, with a small subset of outliers showing poor fit (minimum R²<0) due to complex noise artifacts. For the left kidney, the model achieved an R² of 0.9288, with 91.78% of predictions falling within a clinically acceptable tolerance of ±5 ml/min of the ground truth. Similarly, for the right kidney, the R² reached 0.9216, with an accuracy rate of 93.15% based on the same tolerance threshold. It is important to note that the ±5 ml/min criterion was used strictly as a statistical threshold to define 'clinical accuracy' and did not involve any modification of the predicted values. In conclusion, a Transformer model can accurately calibrate and predict bilateral renal curves and GFR values after injection extravasation in SPECT renal dynamic imaging, potentially enhancing clinical workflow efficiency and diagnostic accuracy.