To investigate prognostic 18F-FDG PET/CT parameters and develop a nomogram integrating inflammatory markers and clinicopathological characteristics for predicting progression-free survival (PFS) in stage I-IVa nasopharyngeal carcinoma (NPC). Stage I-IVa NPC patients who underwent pretreatment 18F-FDG PET/CT were retrospectively collected. The 18F-FDG PET and clinicopathologic parameters were analyzed. The correlation among PET parameters was evaluated with Spearman’s rho test. ROC curve was used to evaluate the predictive performance and calculate the optimal cut-off values for grouping. The survival analyses were performed by Kaplan-Meier analysis and log-rank test. Prognostic factors were identified using Cox regression, and a nomogram was constructed and validated. Eighty‑six patients were enrolled (63 [73.26

To compare different methods for myocardium quantification and exploratively evaluate the prognostic relationship between PET-measured viable myocardium and clinical outcomes in coronary artery disease (CAD) patients with ischemic cardiomyopathy (ICM). 183 CAD patients who underwent one-day 13NH3 and 18F-FDG PET/CT myocardial viability assessment were retrospectively enrolled. Using Corridor4DM software, different types of myocardium (viable, normal, scar) were quantified via visual analysis, semi-quantitative scoring, and software automatic quantification. As an exploratory secondary analysis, patients were grouped and method-dependent grouping differences were analyzed. The correlation between viable myocardium, treatment decisions, and prognosis was retrospectively evaluated. Software identified the most normal myocardium and the least viable myocardium, while semi-quantitative scoring was the opposite. High inter-method consistency (all ICC>0.75) was observed, in which visual and software analyses showed optimal agreement, contrasting with scoring analysis. No significant differences were found among when viable myocardium<20

Immunotherapy, represented by immune checkpoint inhibitors (ICIs), has revolutionized cancer treatment paradigms yet has simultaneously posed significant challenges due to various immune-related adverse events. Among these, ICI-associated myocarditis-a rare but potentially fatal complication that severely impacts long-term patient prognosis-makes early diagnosis and risk stratification crucial. However, its highly heterogeneous and insidiously progressive clinical presentation challenges timely and accurate detection by conventional diagnostic methods, highlighting an urgent clinical need for more effective approaches. Positron emission tomography (PET) molecular imaging, by targeting specific pathophysiological processes, holds great potential for the noninvasive diagnosis and monitoring of this disease. Ongoing advances in novel probes and imaging technologies may further improve the capability of PET to characterize key mechanisms of ICI-associated myocarditis, providing a unique imaging window for early and precise intervention. Based on current clinical evidence and research findings, this article elaborates on the application value of PET molecular imaging in the clinical management of ICI-associated myocarditis and summarizes recent research progress, aiming to inform future clinical practice and research.

Background and objectiveObesity is a heterogeneous metabolic condition that may influence tumor biology and therapeutic outcomes. However, factors associated with the response to postoperative radioactive iodine (131I) therapy in obese patients with papillary thyroid carcinoma (PTC) remain insufficiently understood. This study aimed to identify clinical and metabolic factors associated with treatment response in this population.MethodsThis retrospective observational study included obese patients with PTC who underwent postoperative 131I therapy between January 2020 and December 2023. Clinical, biochemical, imaging, treatment, and follow-up data were collected from electronic medical records. Treatment response at the most recent follow-up was classified as excellent response (ER) or non-excellent response (NER) according to the 2025 American Thyroid Association (ATA) guidelines. Logistic regression analysis was performed to identify factors associated with treatment response, and receiver operating characteristic (ROC) analysis was used to evaluate predictive performance.ResultsA total of 219 obese patients with PTC were included, with a median follow-up of 31.00 months. At the last follow-up, 91 patients (41.6%) achieved ER. In multivariable analysis, higher high-density lipoprotein (HDL) levels were independently associated with an increased likelihood of ER (OR = 22.891, 95% CI: 2.644-198.206, P = 0.004), whereas higher pre-ablation stimulated thyroglobulin (sTg) levels were independently associated with a lower likelihood of ER (OR = 0.793, 95% CI: 0.719-0.876, P < 0.001). Triglycerides (TG) also showed a weaker association with treatment response (OR = 0.662, 95% CI: 0.442-0.991, P = 0.045). Among the individual indicators, sTg showed the best discriminatory performance (AUC = 0.767), followed by HDL (AUC = 0.672) and TG (AUC = 0.624). A combined model incorporating HDL and sTg improved predictive performance (AUC = 0.822).ConclusionIn obese patients with PTC who underwent postoperative 131I therapy, pre-ablation sTg and HDL were independently associated with treatment response, whereas TG showed a weaker association. The combination of HDL and sTg provided better discriminatory performance than either marker alone. These findings suggest that combining metabolic indicators with conventional tumor-related markers may improve individualized evaluation of treatment response in obese patients with PTC.

The incidence of thyroid cancer has been rising in recent years. While tumorigenesis has traditionally been attributed to the accumulation of genetic mutations in oncogenes and tumor suppressor genes, increasing attention has been directed toward the role of epigenetic regulation in cancer development. Since the 1980s, however, it has been acknowledged that the role of another key regulatory system in carcinogenesis: epigenetics, shedding light on the regulation of gene expression without altering the DNA sequence.This review synthesizes current literature on epigenetic alterations in follicular cell-derived thyroid cancers, focusing on DNA methylation, histone modifications, chromatin remodeling, and RNA regulation. Evidence indicates that dysregulation of these epigenetic processes is prevalent in thyroid cancer, influencing tumor initiation, progression, and resistance to therapy. Several epigenetic inhibitors are under development, some demonstrating synergy with existing chemotherapies and immunotherapies. Understanding these mechanisms may facilitate the development of novel, more effective strategies for early detection and treatment.

Renal dynamic scintigraphy is a crucial diagnostic tool for assessing renal function, yet unexpected findings can provide additional insights into extrarenal conditions. We report 2 rare cases of extrarenal 99m Tc-DTPA uptake associated with adrenal tumors: one adrenal cortical carcinoma and one pheochromocytoma. In both cases, significant tracer accumulation in the adrenal region was observed, highlighting an uncommon but noteworthy diagnostic consideration. These cases emphasize the importance of including adrenal tumors in the differential diagnosis when encountering abnormal 99m Tc-DTPA uptake patterns, offering valuable clinical insights for interpreting atypical imaging findings and broadening diagnostic perspectives.

Sphingosine-1-phosphate (S1P) and its receptors (S1PRs) are pivotal regulators of immune cell trafficking, vascular integrity, and various physiological processes, playing key roles in the pathogenesis of neuroinflammatory and immune-related disorders. Among these, multiple sclerosis (MS) is the most common chronic inflammatory condition affecting the central nervous system (CNS), marked by autoimmune-induced neurodegeneration, inflammation, and ongoing demyelination. FTY720, known as fingolimod or Gilenya, is an immunomodulatory medication that was approved in 2010 as the first oral therapy for relapsing-remitting MS. Upon phosphorylation, FTY720 mimics S1P and binds selectively to all S1PR subtypes, except S1PR2, underscoring the therapeutic possibilities of focusing on the S1P-S1PR signaling axis for neuroinflammatory conditions. This success emphasizes the relevance of S1P-mediated pathways in both disease mechanisms and treatment strategies. Emerging precision medicine approaches emphasize the importance of noninvasive imaging to elucidate molecular mechanisms in vivo. Positron emission tomography (PET) imaging-utilizing suitable radioactive tracers to probe biological targets and processes in vivo-offers a transformative approach to quantifying receptor expression, thereby delineating crucial insights into disease diagnosis, therapy monitoring, and therapeutic drug development. As such, S1PR-specific PET imaging provides a promising approach to explore the pivotal role of S1PRs in MS and other immune-mediated diseases. This review offers a comprehensive overview of the development and clinical applications of S1PR-targeted PET radiopharmaceuticals, illustrating their potential to transform therapeutic strategies. Further, recent advances in radiopharmaceutical design have yielded S1PR-targeted PET probes with high specificity, improved metabolic stability, and enhanced blood-brain barrier penetration, addressing key challenges in imaging neuroinflammation. Additionally, it critically discusses future directions for S1PR-targeted PET imaging in advancing our understanding of disease mechanisms, improving patient outcomes, and contributing to the broader vision of precision medicine.

PURPOSE:To evaluate the efficacy of a novel recombinant human thyroid-stimulating hormone (ZGrhTSH) as an alternative to thyroid hormone withdrawal (THW) in dynamic assessment of DTC patients. METHODS:This phase 3, open-label, multicenter trial, conducted across 27 sites in China, employed a self-controlled design to enroll patients. Eligible patients had previously undergone total or near-total thyroidectomy, with or without RAI therapy. During both the ZGrhTSH-stimulated phase and the THW phase, Dx-WBS and serum Tg measurements were performed on all participants. The study focused on the concordance of Dx-WBS results, stimulated Tg levels, and their combination in patients across the two phases. Additionally, the safety and immunogenicity profiles of ZGrhTSH were assessed as well. RESULTS:In the assessment of radioiodine uptake and stimulated Tg levels, ZGrhTSH demonstrated efficacy comparable to that of THW. The concordance rate for scans between the two phases was 88.2% (95% CI: 83.7-92.7%). When setting stimulated Tg levels with a cutoff of 1 ng/mL, the concordance rate was 90.4% (95% CI: 86.1-94.6%), and the concordance of scans combined with stimulated Tg was 93.6% (95% CI: 90.1-97.1%). Adverse events associated with ZGrhTSH were reported in 22 patients (10.9%), all of which were mild and transient, graded as 1 or 2. CONCLUSION:ZGrhTSH showed non-inferior performance in detecting radioiodine uptake and serum Tg, and could be an effective and safe alternative for the dynamic evaluation of DTC patients. TRIAL REGISTRATION:ClinicalTrials.gov, NCT04971473. Registered July 7, 2021.

Figure S1: Thyroglobulin concentrations changes for individual patients with negative thyroglobulin antibody from baseline to the end of cycle 2.

PURPOSE:To evaluate the diagnostic performance of the PET Assisted Reporting System (PARS) in nasopharyngeal carcinoma (NPC) patients without distant metastasis, and to investigate the prognostic significance of the metabolic parameters. PATIENTS AND METHODS:Eighty-three NPC patients who underwent pretreatment 18 F-FDG PET/CT were retrospectively collected. First, the sensitivity, specificity, and accuracy of PARS for diagnosing malignant lesions were calculated, using histopathology as the gold standard. Next, metabolic parameters of the primary tumor were derived using both PARS and manual segmentation. The differences and consistency between the 2 methods were analyzed. Finally, the prognostic value of PET metabolic parameters was evaluated. Prognostic analysis of progression-free survival (PFS) and overall survival (OS) was conducted. RESULTS:PARS demonstrated high patient-based accuracy (97.2%), sensitivity (88.9%), and specificity (97.4%), and 96.7%, 84.0%, and 96.9% based on lesions. Manual segmentation yielded higher metabolic tumor volume (MTV) and total lesion glycolysis (TLG) than PARS. Metabolic parameters from both methods were highly correlated and consistent. ROC analysis showed metabolic parameters exhibited differences in prognostic prediction, but generally performed well in predicting 3-year PFS and OS overall. MTV and age were independent prognostic factors; Cox proportional-hazards models incorporating them showed significant predictive improvements when combined. Kaplan-Meier analysis confirmed better prognosis in the low-risk group based on combined indicators (χ² = 42.25, P < 0.001; χ² = 20.44, P < 0.001). CONCLUSIONS:Preliminary validation of PARS in NPC patients without distant metastasis shows high diagnostic sensitivity and accuracy for lesion identification and classification, and metabolic parameters correlate well with manual. MTV reflects prognosis, and its combination with age enhances prognostic prediction and risk stratification.

BackgroundThis study investigates the therapeutic potential and mechanisms of Apigenin (AGN) in treating triple-negative breast cancer (TNBC). Although AGN is recognized for its anti-tumor properties, its specific mechanisms in TNBC remain unclear.MethodsTo identify key genes associated with AGN’s effects on breast cancer, we utilized network pharmacology, conducting Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. We developed a macrophage membrane-coated nanomicelle system (m@peg-AGN) to enhance drug delivery and facilitate immune evasion.ResultsOur analyses identified 21 overlapping genes between AGN and breast cancer, including CDH1, TP53, and CCND1, critical in cancer progression. The m@peg-AGN system demonstrated superior immune evasion and effective tumor targeting, resulting in good tumor suppression without detected toxicity in major organs.ConclusionsThis study demonstrated the targeted tumor genes to TNBC for AGN, then innovatively integrates network pharmacology with biomimetic nanotechnology, developing a novel m@peg-AGN delivery system for TNBC treatment. This system enhanced the AGN’s water solubility and increased the accumulation to the tumor site. This compound has exhibited good anti-tumor effects in vivo, thereby could advance the treatment for TNBC.

Triple-negative breast cancer (TNBC) presents considerable treatment difficulties because of its highly aggressive behavior and the absence of targeted therapeutic options. This study aimed to develop a tumor microenvironment-responsive nanoplatform combining the enhancer of zeste homologue 2 (EZH2) inhibition and targeted radionuclide therapy (TRT) to enhance antitumor efficacy and remodel immunosuppressive signaling in TNBC. A cancer cell membrane (CCm)-camouflaged nanoplatform (CCm-HSA-Taz) was engineered to encapsulate the EZH2 inhibitor Tazemetostat (Taz), enabling tumor-targeted delivery. The nanoplatform was coadministered with [177Lu]Lu-based TRT to evaluate synergistic effects. Physicochemical characterization assessed the nanoplatform stability. In vivo efficacy was tested in TNBC-bearing murine models with tumor progression monitored via imaging and histopathology. The CCm-HSA-Taz nanoplatform exhibited favorable physicochemical properties and excellent stability. In vivo radioimmunoassay studies indicated that the immune response in the CCm-HSA-Taz combined with the [177Lu]Lu radiotherapy was stronger than that observed in the CCm alone or in the [177Lu]Lu radiotherapy alone. Additionally, the combination group exhibited an observed increase in the apoptotic cell population, and antitumor immunity was enhanced at the conclusion of the 19-day observation period. Furthermore, all results were corroborated through pathological and imaging examinations. We developed a tumor microenvironment-adaptive nanoplatform delivering Taz to disrupt immunosuppression and enhance radiotherapy sensitivity in TNBC, without significant side effects in animal models. Nuclear medicine imaging revealed reduced tumor glucose metabolism and improved immune cell cytotoxicity. Utilizing components approved by the FDA suggests the potential for this strategy to be translated into clinical settings.

BACKGROUND:The incidence of differentiated thyroid cancer (DTC) has been increasing, highlighting the need for reliable predictors of treatment response. This study aimed to assess the prognostic value of stimulated thyroglobulin (sTg) levels before and after the first 131I treatment in DTC patients without distant metastases. METHODS:Sixty patients were classified into excellent response (ER) and non-excellent response (NER) groups based on a comprehensive evaluation of imaging findings, sTg, suppressed Tg and other parameters. Clinical and pathological variables were analyzed using univariate and multivariate logistic regression. Receiver operating characteristic (ROC) curve analysis was used to determine optimal cut-off values for pre-131I sTg levels and for the rate of sTg decline after the first 131I therapy. RESULTS:Both pre-131I sTg level (OR: 3.010, 95% CI: 1.004-9.029, p = 0.049) and the rate of sTg decline (OR: 0.756, 95% CI: 0.590-0.968, p = 0.026) were identified as independent predictors of clinical outcomes. The optimal threshold for pre-131I sTg was 14.55 μg/L (sensitivity: 95.0%, specificity: 67.5%, AUC: 0.804), and for the rate of sTg decline, 44.75% (sensitivity: 70.0%, specificity: 97.5%, AUC: 0.889). A prognostic nomogram was developed incorporating sex, age, pre- and post-131I sTg levels, T and N stages, tumor size, and thyroiditis. CONCLUSION:Lower pre-131I sTg levels and/or a greater rate of sTg decline after the first 131I treatment are associated with more favorable clinical outcomes. The proposed nomogram may assist clinicians in optimizing treatment decisions and stratifying follow-up strategies for patients with DTC.

A 61-year-old male presented with hematemesis and melena. Biopsy and immunohistochemistry confirmed mucosa-associated lymphoid tissue (MALT) lymphoma in the posterior wall of the gastric antrum, prompting further evaluation with 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT). In addition to elevated uptake in the gastric antrum, 18F-FDG PET/CT showed diffuse uptake in multiple bone marrow, initially suspected to indicate bone marrow involvement by lymphoma. Further examination identified it as primary myelofibrosis (PMF). Following concurrent therapies, 18F-FDG PET/CT demonstrated negative uptake in gastric antrum, indicating complete remission of the lymphoma, while the elevated bone marrow uptake suggested progression of PMF. The coexistence of MALT lymphoma and PMF is very rare. This case highlights the image characteristics and potential diagnostic and therapeutic monitoring value of 18F-FDG PET/CT in patients with concurrent MALT lymphoma and PMF.

177Lu- prostate specific membrane antigen (PSMA) radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China. Based on domestic clinical practice and experimental data and referred to international experience and viewpoints, the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.