The standard 2-day dual-tracer PET protocol provides more information but is time consuming. Thus, this study aimed to validate the feasibility of 1-day 68Ga-DOTATATE and 18F-FDG dual-low-activity PET/MR imaging in patient with neuroendocrine neoplasms (NENs). Fourteen NENs patients who underwent 1-day 68Ga-DOTATATE and 18F-FDG dual-low-activity PET/MR, and another 14 patients matched with the same primary tumor sites and tumor grades who underwent 2-day 68Ga-DOTATATE and 18F-FDG PET/MR were retrospectively enrolled. Imaging analysis was performed, including lesion detection rate and diagnostic confidence. Additionally, the diagnostic confidence was also assessed based on 68Ga-DOTATATE PET, 18F-FDG PET and PET/MR, respectively. The 1-day protocol detected 39 out of 40 lesions in 14 patients, while the 2-day protocol detected 65 out of 66 lesions in 14 patients. No significant differences were observed in lesion detection (all P > 0.05). There was no significant difference in diagnostic confidence between the 1-day protocol and the 2-day protocol for 68Ga-DOTATATE PET (median [IQR]: 3[2–3] vs. 3[2–3]), 18F-FDG PET (1[1–2] vs. 1[1–1]), and PET/MR (4[3–5] vs. 5[4–5]) in all lesions (all P > 0.05). The 1-day 68Ga-DOTATATE and 18F-FDG dual-low-activity PET/MR imaging protocol in patients with NENs is feasible and provides equivalent lesion detection and diagnostic confidence compared to the 2-day protocol.

Elevated Stabilin-2 (STAB2) expression in macrophages within atherosclerotic plaques offers a promising molecular target for imaging vascular inflammation. The S2P peptide specifically binds STAB2. This study aims to evaluate the feasibility of using the STAB2-targeted 18F-labeled tracer (18F-S2P) for positron emission tomography (PET) imaging to identify atherosclerotic plaques. Stab2 expression was validated via single-cell RNA sequencing of Ldlr−/− mouse samples. Biodistribution and micro-PET/CT imaging were performed in high-fat diet-fed Ldlr−/− mice (3–12 weeks) and chow-fed controls, with comparisons to 18F-FDG and 18F-Pentixafor. Plaque burden and macrophage infiltration were evaluated using Oil Red O, H E, and immunofluorescence staining. Immunohistochemical staining was used to detect STAB2 expression in human atherosclerotic specimens. ScRNA-seq analysis identified Stab2 as a macrophage-specific marker in atherosclerosis plaque. In vivo micro-PET/CT quantification revealed disease duration-dependent uptake (1.41 ± 0.31 ID

To characterize the systemic and organ-specific pharmacokinetics (PK) of a novel bis-boron tracer, [18F]BBPA, using total-body PET imaging in comparison with conventional blood sampling. Ten healthy volunteers underwent 60-minute dynamic total-body [18F]BBPA PET, followed by three static scans (up to 240 min p.i.), alongside 11 venous blood sampling. Regions of interest were drawn on PET in their right atrium, superior vena cava (SVC), and inferior vena cava (IVC) to obtain image-derived blood time-activity curves (TACs), as well as in major organs to obtain tissue TACs. PK parameters of [18F]BBPA were assessed using both blood samples and image-derived blood TACs. Additionally, tissue TACs were analyzed for organ-specific PK and fitted with an tissue-compartment models for kinetic rates of [18F]BBPA. [18F]BBPA exhibited rapid clearance (6.58 ± 0.57 L/h, a short elimination half-life (186.48 ± 30.29 min), and a volume of distribution of 29.22 ± 3.52 L. Image-derived PK results were comparable to those obtained from blood sampling, with the relative differences < 13 www.chinadrugtrials.org.cn (CTR20233997).

OBJECTIVES:This systematic review describes the spectrum, distribution, and etiologies of non‑target [68Ga]Ga‑DOTANOC‑avid lesions proven by histopathology or follow‑up to be unrelated to normal biodistribution or the primary SSTR‑expressing disease. METHODS:PubMed, Web of Science, and Scopus databases were utilized to conduct a systematic search and were updated until May 31, 2025. Three authors independently screened the titles and abstracts of the retrieved articles and selected the articles on the basis of the inclusion and exclusion criteria. RESULTS:Seventy-six eligible studies encompassing 542 patients reported 799 non-target [68Ga]Ga-DOTANOC-avid findings. Nononcologic causes accounted for the majority (59.6%), with malignant oncologic and benign tumorous etiologies accounting for 30.2% and 10.3%, respectively. The abdomen was the most common anatomical site (38%), followed by the thorax (21.6%), head/neck (18.1%), and musculoskeletal system (13.1%), whereas pelvic involvement was least common (9%). CONCLUSIONS:Abdominal non-target [68Ga]Ga-DOTANOC-avid findings represent a major interpretive challenge in [68Ga]Ga-DOTANOC PET/CT, as these findings often overlap with NET-predominant regions. Recognition of these patterns can increase diagnostic accuracy and support broader clinical integration of [68Ga]Ga-DOTANOC beyond its conventional utility.

Abstract Background 177Lu-PSMA-617 is a radioligand therapy targeting cells expressing prostate-specific membrane antigen (PSMA). The pharmacokinetics, dosimetry, and safety of 177Lu-PSMA-617 in participants with metastatic castration-resistant prostate cancer are described previously. In this study, we describe the blood pharmacokinetics behavior, biodistribution, and dosimetry of 177Lu-PSMA-617 to support its clinical use in Chinese participants. Results Nine participants were infused with 177Lu-PSMA-617 (range: 6985.6–8036.0 MBq). The geometric (Geo)-mean blood terminal half-life was 52.6 h, corresponding to an effective half-life of approximately 40 h. The Geo-mean maximum blood concentration of 11.3 ng/mL was achieved at a median time of 0.217 h post administration. The Geo-mean volume of distribution and clearance were 123 L and 1.62 L/h, respectively. The lacrimal glands received the highest absorbed dose of 3.1 mGy/MBq (Geo-coefficient of variation, 93.7%), followed by the thyroid, kidneys, and salivary glands. The Geo-mean whole-body effective dose was 890 mSv (Geo-coefficient of variation, 112.4%). Conclusions The blood pharmacokinetics and organ dosimetry of 177Lu-PSMA-617 in Chinese participants with progressive metastatic castration-resistant prostate cancer were consistent with those previously reported. The cumulative absorbed dose, corresponding to six cycles of treatment, was consistent with published literature. This analysis was conducted as part of a phase II study registered as NCT05670106 at ClinicalTrials.gov on November 7, 2022.

Although perioperative immunotherapy has shown promising results in locally advanced gastric adenocarcinoma (LAGA), the predictive biomarkers remain unclear. Our study aimed to investigate the predictive value of [18F]FDG PET/CT characteristics at baseline for the efficacy of neoadjuvant immunotherapy plus concurrent chemoradiotherapy in the post hoc analysis of the Neo-PLANET phase II trial. A total of 29 patients with LAGA receiving neoadjuvant immunotherapy plus concurrent chemoradiotherapy from the Neo-PLANET phase II trial (Zhongshan Hospital Fudan University, NCT03631615, 2018-08-13) were included in our study. Semiautomated techniques were used to analyze pre-operative [18F]FDG PET/CT images to determine primary tumor, nodal metabolic and spleen parameter scores [including max and mean adjusted for lean body mass standardized uptake values (SUV), metabolic tumour volume (MTV) and total lesional glycolysis (TLG)]. Kaplan–Meier method and log-rank test to evaluate the associations between PET/CT parameters and disease-free survival (DFS) and overall survival (OS). Pathological complete response (pCR) and major pathological response (mPR) were not related to DFS and OS in patients receiving neoadjuvant immunotherapy plus concurrent chemoradiotherapy. Interestingly, a higher SUVmean of the spleen (S-SUVmean) is positively associated with longer DFS (HR = 0.19, 95

To investigate the association of amygdalar activity with disease activity, inflammatory markers, cerebrovascular events, and structural vascular injury in patients with Takayasu arteritis (TAK). A total of 303 TAK patients underwent 18F-fluorodexoyglucose positron emission tomography/computed tomography (¹⁸F-PET/CT). Amygdalar, bone marrow, and vessel wall SUV were quantified. Clinical, laboratory, and imaging data were collected. The median follow-up duration was 27 months, during which adverse events were recorded. No significant association was found between amygdalar SUV and cerebrovascular events in the overall cohort. However, among treatment-naïve patients, those with cerebrovascular events had significantly lower amygdalar SUVmax (9.3±2.0 v.s. 10.3±2.0, p=0.011) and SUVmean (6.6±1.2 v.s. 7.4±1.5, p=0.003) than event-free patients. The low SUV group had a higher proportion of cerebrovascular events (24.3

BackgroundFibroblast activation protein inhibitor (FAPI) positron emission tomography/computed tomography (PET/CT) has emerged as a promising molecular imaging modality with favorable lesion-to-background contrast across several malignancies. In radioiodine-refractory thyroid carcinoma (RAIR-TC) and thyroglobulin-elevated negative iodine scintigraphy (TENIS) syndrome, conventional radioiodine imaging and fluorodeoxyglucose (FDG) PET/CT may be limited in selected clinical scenarios. This systematic review evaluated the diagnostic utility, comparative performance, and potential clinical impact of FAPI PET/CT in this patient population.MethodsPubMed, Embase, and Scopus were searched from inception to 6 August 2025 according to PRISMA 2020 guidelines. Eligible studies included original clinical studies and case reports evaluating FAPI PET/CT in RAIR-TC or TENIS syndrome. Non-original, non-human, in vitro, conference abstract, and non-English publications were excluded. Two reviewers independently performed study selection, data extraction, and quality assessment. QUADAS-2 was applied to eligible cohort studies.ResultsEight studies comprising 167 patients were included: three prospective studies, one retrospective study, and four case reports. FAPI PET/CT showed promising complementary diagnostic value in selected clinical scenarios, particularly for lesions with low FDG conspicuity or high physiologic FDG background. In one prospective cohort of 24 patients, [68Ga]Ga-DOTA-FAPI-04 PET/CT detected disease in 87.5% of patients. In the largest retrospective cohort (n = 117), [68Ga]Ga-DOTA.SA.FAPi showed higher detection than FDG PET/CT for selected metastatic sites, including lymph nodes, liver, and brain. However, comparative performance varied across tracers, lesion sites, and study designs; one prospective [18F]FAPI-74 study reported lower lesion detection than FDG PET/CT.ConclusionFAPI PET/CT demonstrates promising but preliminary diagnostic utility in RAIR-TC and TENIS syndrome. Current evidence supports a complementary role in selected patients, but remains insufficient to establish routine diagnostic superiority over FDG PET/CT. Larger prospective multicenter studies with standardized protocols and robust reference validation are required.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251123809.

Abstract Topic Esophageal Cancer: New Diagnostic Modalities (Including PET, PET-CT, New Tracers) Background Fibroblast activation protein (FAP)-positive cancer-associated fibroblasts, predominant in the tumor microenvironment, play an important role in tumor progression and therapeutic efficacy. 68Ga-labeled FAP inhibitor (FAPI), an emerging PET tracer, provided localization and quantification for FAP-positive ESCC tumors and was superior to 18F-FDG for the precise staging of ESCC. However, the value of 68Ga-FAPI PET-CT in the assessment of neoadjuvant treatment response is still unclear. This study was to investigate whether dual-tracer 68Ga-FAPI-04 and 18F-FDG PET-CT metabolic parameters could predict pathological response after neoadjuvant immunochemotherapy (nICT) in patients with locally advanced esophageal squamous cell carcinoma (ESCC). Methods This prospective study enrolled 19 patients with locally advanced ESCC who underwent baseline dual-tracer PET-CT before nICT. The participants underwent surgery after 2 cycles of nICT. PET parameters including maximum, mean, and peak SUVs, metabolic tumor volume (MTV), total lesion glycolysis/FAP expression (TLG/TLF), and tumor-to-background ratios (TBRs) were measured for both tracers, and the ratio indices were calculated by dividing FAPI-derived parameters by corresponding FDG-derived values. Major pathological response (MPR) was defined as ≤10% residual viable tumor cells in the primary tumor bed. Patients were classified into good and poor responders groups based on their pathological results. We compared these indices between the good and poor pathological response groups and analyzed their predictive performance for tumor pathological response. Univariate and multivariate logistic regression analyses were performed to identify predictors of MPR. Model performance was evaluated using ROC and decision curve analyses. Results Nine patients were classified as good responders, and 10 were poor responders. The baseline characteristics of these two groups were comparable. A significant difference was observed in the FAPI-SUVmean and FDG-TBR, with the good responders having higher values compared to the poor (P < 0.05). To identify potential predictive factors, we calculated ratios between the FAPI and FDG PET/CT parameters (e.g. MTV ratio = FAPI-MTV/FDG-MTV). The univariate analysis revealed that MTV ratio, TLF/TLG ratio, TBR ratio, and SUVmean ratio were significantly associated with pathological response (all OR > 1, p < 0.05). Multivariate analysis indicated the combined model incorporating MTV ratio and TBR ratio achieved the highest predictive performance (AUC = 0.822), superior to either parameter alone. Higher ratio values, indicating stromal predominance relative to tumor metabolism, predicted poorer response to nICT. Conclusion Dual-tracer FAPI/FDG ratio indices represent novel imaging biomarkers for predicting pathological response to nICT in ESCC, offering a noninvasive tool to identify patients unlikely to benefit from nICT.

Lutetium-177(177Lu)-prostate specific membrane antigen(PSMA)-617 is a small-molecule radioligand therapy(RLT)drug targeting PSMA.By selectively delivering the β-radiation emitted by 177Lu to PSMA-positive prostate cancer cells,it induces tumor cell death.The agent has been approved in multiple nations and regions for the treatment of PSMA-positive metastatic castration-resistant prostate cancer,thereby expanding therapeutic options for this patient population.This review outlines the development,pharmacological properties,and current clinical applications of 177Lu-PSMA-617,aiming to provide a theoretical basis for the clinical practice of RLT in prostate cancer treatment.

Abstract Background This systematic review and meta-analysis evaluates the safety and efficacy of emerging prostate-specific membrane antigen (PSMA) radioligand therapy (RLT) agents used beyond [¹⁷⁷Lu]Lu-PSMA in metastatic castration-resistant prostate cancer (mCRPC). Methods Systematic searches of PubMed, Web of Science, and Scopus were performed from inception until November 3, 2025. Studies reporting objective response rate (ORR), disease control rate (DCR), and/or toxicity outcomes were included. Meta-analytic pooling, assessment of publication bias, heterogeneity analyses, and subgroup evaluations were conducted using Stata software. Results A total of 33 studies published between 2017 and 2025 met inclusion criteria, encompassing 3625 therapy cycles administered to 1525 patients. The pooled DCR was 86% (95% CI: 82–90%), and the pooled ORR was 57% (95% CI: 50–63%). [²²⁵Ac]Ac-PSMA monotherapy, evaluated in 17 studies, achieved pooled DCR and ORR values of 88% and 62%. Eight studies assessing [¹⁷⁷Lu]Lu/[²²⁵Ac]Ac-PSMA tandem therapy reported pooled DCR and ORR values of 84% and 51%. Five studies on [¹⁶¹Tb]Tb-PSMA demonstrated pooled DCR and ORR values of 81% and 46%. [¹³¹I]PSMA therapy, reported in three studies, resulted in a pooled DCR of 75% and pooled ORR of 48%. Adverse events were documented in 32 studies, with a pooled incidence of 26%. Most events were low-grade and reversible. Xerostomia and anemia were the most frequently reported toxicities, with xerostomia particularly associated with [²²⁵Ac]Ac-PSMA–containing regimens. Conclusion These findings underscore the promising therapeutic potential of emerging PSMA RLT agents beyond [¹⁷⁷Lu]Lu-PSMA, with favorable biochemical responses and manageable safety profiles. Future large-scale prospective studies are essential to define optimal therapeutic roles and expand treatment opportunities for patients with mCRPC.

Acute medical conditions represent a significant and heterogeneous clinical burden, often requiring rapid and accurate diagnosis to guide timely management. Positron emission tomography/computed tomography (PET/CT), which integrates functional PET imaging with CT's anatomical detail, has expanded beyond its traditional oncologic applications and is being increasingly explored in acute or emergency settings. PET/CT, particularly with but not limited to 18F-fluorodeoxyglucose, represents a promising adjunct, offering unique pathophysiological insights that can complement conventional imaging, supporting diagnostic decision-making and patient management in select non-oncologic contexts. This review examines the evolving role of PET/CT in acute clinical scenarios, highlighting its ability to detect early metabolic or inflammatory changes that may precede structural abnormalities on conventional imaging modalities such as CT or MRI. It also highlights how further evidence is, nonetheless, still required to better define optimal clinical integration.

To investigate organ-specific glucose metabolism and inter-organ metabolic network alterations under fasting (FAST) and oral glucose and intravenous insulin loading (G/I) status in patients with ischemic cardiomyopathy (ICM) using total-body PET/CT. This is a self-control, single-center prospective study conducted as part of a series investigating the imaging characteristics of ICM patients. All patients underwent two-day protocol FAST and G/I total-body 18F-FDG PET/CT scans. In the present analysis, SUVmean were measured across 24 predefined ROIs (14 peripheral organs, 10 sub-brain regions), and compared in the FAST and G/I status. Metabolic network connectivity was assessed using mutual information-based analysis, with stratification by DM status and subgroup analyses by age and smoking status. Thirty-three patients (17 DM, 16 non-DM) were enrolled in this study, with a mean left ventricular ejection fraction (LVEF) of 39.39

A 70-year-old man with prostate cancer underwent contrast-enhanced CT for lesion characterization, which revealed two newly detected hepatic lesions suspicious for metastasis. The prostate-specific antigen level remained below the threshold for biochemical recurrence, whereas C-reactive protein was elevated. 18 F-FDG PET/CT was performed for metabolic characterization and whole-body evaluation, demonstrating heterogeneous increased uptake in both lesions. On the basis of the CT findings and FDG hypermetabolism, liver-confined metastatic disease was suspected, and surgical resection was performed. Histopathology unexpectedly revealed a hepatic inflammatory pseudotumor.

This systematic review and meta-analysis evaluated the safety and efficacy of somatostatin receptor (SSTR) peptide receptor radionuclide therapy (PRRT) in patients with metastatic or progressive medullary thyroid cancer (MTC). PubMed, Scopus, and Web of Science databases were systematically searched from inception to April 22, 2025, to identify relevant clinical studies. Methodological quality was assessed via the National Institutes of Health Quality Assessment Tool. Pooled estimates of the disease control rate (DCR), overall response rate (ORR), and adverse events (AEs) following SSTR PRRT administration were calculated for both the imaging and biochemical endpoints via Stata software version 17. The analysis revealed pooled DCRs of 52

A 55-year-old woman underwent CT for abdominal distension, which incidentally revealed coronary sinus dilatation. The echocardiography showed a mass in the coronary sinus. Coronary CTA showed a slightly low-density mass in the coronary sinus without enhancement. Subsequently, contrast-Enhanced 18 F-FDG PET/MR was performed to exclude underlying malignancy, which revealed low uptake (SUVmax 2.5) and mild segmental heterogeneous enhancement in the tumor. Then the patient underwent surgery, and histopathologic examination revealed epithelioid hemangioendothelioma.

A 70-year-old man with prostate cancer underwent contrast-enhanced CT for lesion characterization, which revealed two newly detected hepatic lesions suspicious for metastasis. The prostate-specific antigen level remained below the threshold for biochemical recurrence, whereas C-reactive protein was elevated. 18 F-FDG PET/CT was performed for metabolic characterization and whole-body evaluation, demonstrating heterogeneous increased uptake in both lesions. On the basis of the CT findings and FDG hypermetabolism, liver-confined metastatic disease was suspected, and surgical resection was performed. Histopathology unexpectedly revealed a hepatic inflammatory pseudotumor.