OBJECTIVE:To evaluate [18F]fluorodeprenyl-D2 ([18F]F-DED) positron-emission tomography (PET) imaging as a biomarker of disease activity in autoimmune encephalitis (AIE) associated with glutamic acid decarboxylase 65 (GAD65) antibodies. METHODS:[18F]F-DED PET was performed in 25 GAD65-AIE patients and 8 controls using dynamic (0-60 min) and static (30-60 min) acquisitions. Global astrogliosis was assessed by volumes of distribution (VT; 1-tissue-compartment model with carotid input) and standardized uptake values (SUV). Regional cerebellar and mesiotemporal (MT) uptake was normalized to global uptake (SUVr). PET measures were correlated with clinical phenotypes, MRI findings, and serum biomarkers (neurofilament light chain [sNfL], GAD65-Ab titers, and glial fibrillary acidic protein [sGFAP]). RESULTS:Clinical phenotypes included limbic encephalitis/temporal lobe epilepsy (LE/TLE; n = 17), stiff-person syndrome (n = 4), and cerebellar ataxia (CA; n = 4), with overlap in nine patients. Global [18F]F-DED uptake was higher in patients than controls. VT analysis showed increased cortical and MT uptake, while SUVr analysis demonstrated elevated MT uptake across the cohort. LE/TLE patients exhibited increased MT uptake, and CA patients showed higher cerebellar uptake. [18F]F-DED uptake did not correlate with sNfL or GAD65-Ab titers, but sGFAP showed associations with cerebellar and white-matter uptake. Regional uptake correlated with clinical severity in LE/TLE (MT lobe) and CA (cerebellar white matter). INTERPRETATION:[18F]F-DED PET reveals region-specific astrogliosis corresponding to clinical manifestations and disease severity in GAD65-AIE, supporting its potential as a monitoring tool for disease activity.

3068 Background: The role of adjuvant radioiodine therapy (RIT) in differentiated thyroid carcinoma (DTC) remains controversial due to a lack of long-term data from randomized controlled trials. Consequently, international guidelines diverge; while some advocate broad application, others prioritize a restrictive, risk-adapted approach. The CLERAD-PROBE trial aims to bridge this gap by comparing both strategies regarding blood dose — as an established surrogate for secondary malignancy risk — and oncological outcomes. Methods: CLERAD-PROBE is a prospective, randomized, bicentric study (NCT01704586) in adult DTC patients, excluding those with unifocal papillary microcarcinomas ≤ 10 mm limited to the thyroid. Following thyroidectomy, patients in Arm 1 underwent I-124 PET for staging and dosimetry. Adjuvant RIT was administered if one or multiple of the following risk factors were present: incomplete surgical resection, tumor size >4cm or extrathyroidal extent, lymph node metastases and age ≥ 45 years, distant metastases, and/or iodine-avid lesions on I-124 PET. In Arm 2, adjuvant RIT was generally performed. Follow-up was performed every 4–6 months using thyroglobulin measurements and cervical ultrasound. The primary endpoint was the mean blood dose after complete remission or 18 months. Secondary endpoints included progression- and recurrence-free survival at 3 and 10 years. Results: The primary endpoint was evaluable in 315 patients, enrolled from May 2015 to May 2021 (148 in Arm 1, 167 in Arm 2). Study arms were matched with regards to histology, age, and tumor/nodal stage, though Arm 1 had significantly fewer men (22% vs. 34%, p = 0.02). I-124 PET identified lymph node metastases in 49 patients and distant metastases in 13 patients. RIT was performed in 68 of 148 (46%) patients in Arm 1. Of these, 13 patients with low-risk carcinoma underwent RIT because of new metastases found on I-124 PET. The mean absorbed blood doses (252 mGy vs 447 mGy, range: 4 - 3217 mGy vs. 48 - 2520 mGy; p < 0.001) and administered I-131-activities (2.3 GBq vs. 4.9 GBq; range: 0 – 18.6 GBq vs. 1.0 – 26.2 GBq; p < 0.001) were lower in Arm 1. Conclusions: I-124 PET identifies persistent, iodine-avid disease in patients who would not routinely receive adjuvant RIT pursuant to ATA Guidelines, while enabling individualized selection in the others to minimize secondary malignancy risk. The impact on long term oncological outcomes has yet to be determined. Three years follow-up analyses evaluating recurrence rates and overall oncological safety are currently in progress and will be presented at the congress. Clinical trial information: NCT01704586 .

High expression of prostate-specific membrane antigen (PSMA) is not limited to prostate cancer but can be found in other tumor entities, such as hepatocellular carcinoma (HCC), and could possibly be used for theranostic purposes. Our aim was to investigate the diagnostic potential of the hepatobiliary excreted radiotracer [18F]PSMA-1007 on initial staging of HCC. Methods: This prospective clinical study (NCT05547919) included 10 participants (9 men, 1 woman) with treatment-naïve, histopathologically proven PSMA-positive HCC. All participants underwent [18F]PSMA-1007 PET with unenhanced low-dose CT. All scans were analyzed visually and quantitatively. We assessed the SUVmax of the primary tumor and the SUVmean of nonaffected liver parenchyma and calculated tumor-to-background ratios (i.e., SUVmax HCC/SUVmean liver) for each patient. In addition, we assessed possible eligibility for PSMA-directed radiopharmaceutical therapy according to the PROMISE criteria. The presence of local lymph nodes and distant metastases was noted for [18F]PSMA-1007 PET/CT and compared with the results of contrast-enhanced CT of the trunk and MRI of the upper abdomen. Possible prognostic implications of PSMA expression on immunohistochemistry and on [18F]PSMA-1007 PET/CT were compared with progression-free survival (defined as clinical progression, radiographic progression, or death from any cause) using Cox regression. Results: [18F]PSMA-1007 PET showed high uptake in 7 of 10 patients (PROMISE score 2, n = 4; PROMISE score 3, n = 3); mediocre or missing uptake was found in 3 participants (PROMISE score 0, n = 1; PROMISE score 1, n = 2). The median tumor-to-background ratio was 2.7 (interquartile range, 2.65). [18F]PSMA-1007 PET did not reveal new distant metastatic lesions compared with contrast-enhanced CT. In 1 patient, local lymph node metastases were considered PSMA-negative despite high uptake in the primary tumor. Whether assessed ex vivo or in vivo, PSMA expression did not correlate with progression-free survival. Conclusion: [18F]PSMA-1007 can be used depict untreated HCC and shows high uptake relative to background, indicative of excellent image contrast. High tracer accumulation in 70% of the participants suggests a possible use for PSMA-directed radiopharmaceutical therapy in an end-stage setting. However, PSMA expression was not prognostic for outcome, possibly because of the small sample size.

This study assessed the impact of structured reporting (SR) compared with conventional free-text reporting (FTR) on report quality for PSMA PET/CT for diagnosis and staging of prostate cancer (PC) using a dedicated template. Fifty consecutive patients were included. Original clinical FTRs were compared with SRs retrospectively generated for the same examinations using template-based online software featuring clickable decision trees. Two readers specialised in urology and radioligand therapy independently assessed reports with regard to completeness, ease of information extraction, linguistic and overall report quality. FTR achieved higher scores for overall report quality compared with SR (mean 5.46 versus 4.71; p < 0.0001) and was associated with fewer missing key features (present in 36

Purpose:Kidney transplantation is the treatment of choice for end-stage kidney disease, but predicting short-term and long-term outcomes remains challenging. Noninvasive, widely available tools for early risk stratification are lacking. This study evaluated whether the tubular extraction rate (TER) of Tc-99m-MAG3 measured by renal scintigraphy can predict transplant outcomes.Methods:In this prospective observational study, 488 kidney transplant recipients (2012-2022) underwent standardized Tc-99m-MAG3 scintigraphy on postoperative day 6 to quantify TER. Patients were stratified into quartiles. Primary short-term endpoints were delayed graft function (DGF) and length of hospital stay; the primary long-term endpoint was a composite of graft loss or death. Associations were assessed using multivariable logistic regression, generalized linear models, and Cox regression.Results:Lower TER was significantly associated with older donor and recipient age, longer ischemia times, and higher DGF risk [adjusted OR 9.45 (95% CI: 4.31-20.72), lowest vs. highest quartile]. Low TER was linked to more dialysis sessions and longer hospitalization. During a median follow-up of 8.4 years, low TER was independently associated with increased risk of biopsy-proven rejection (HR: 4.23; 95% CI: 1.05-17.13), graft failure or death (HR: 3.87; 95% CI: 1.67-8.97). eGFR values over time were consistently higher in patients with higher TER values.Conclusions:The tubular extraction rate derived from MAG3 scintigraphy is a strong and independent predictor of both short-term and long-term outcomes after kidney transplantation. As a noninvasive and widely available diagnostic tool, it may facilitate early identification of high-risk transplant recipients and support personalized post-transplant care strategies.

This article reports the results of the second iteration of the autoPET challenge on automated lesion segmentation in whole-body PET/CT, held in conjunction with the 26th International Conference on Medical Image Computing and Computer Assisted Intervention in 2023. In contrast to the first autoPET challenge, which served as a proof of concept, this study investigates whether machine learning-based segmentation models trained on data from a single source can maintain performance across clinically relevant variations in PET/CT data, reflecting the demands of real-world deployment. Methods: A comprehensive biomedical segmentation challenge on PET/CT domain generalization was designed and conducted. Participants were tasked to train machine learning models on annotated whole-body 18F-FDG data (n = 1,014). These models were then evaluated on a test set of 200 samples from 5 clinically relevant domains, including variations in institutions, pathologies, and populations and a different tracer. Performance was measured in terms of average dice similarity coefficient, average false-positive volume, and average false-negative volume. The best-performing teams were awarded in 3 categories. Furthermore, a detailed analysis was conducted after the challenge, examining results across domains and unique instances, along with a ranking analysis. Results: Generalization from a single-source domain remains a significant challenge. Seventeen international teams successfully participated in the challenge. The best-performing team reached an average dice similarity coefficient of 0.5038, a mean false-positive volume of 87.8388 mL, and a mean false-negative volume of 8.4154 mL on the test set. nnU-Net was the most commonly used framework, with most participants using a 3-dimensional U-Net. Despite competitive in-domain results, out-of-domain performance deteriorated substantially, particularly on pediatric and prostate-specific membrane antigen data. Detailed error analysis revealed frequent false-positives due to physiologic uptake and decreased sensitivity in detecting small or low-uptake lesions. A majority-vote ensemble offered minimal performance gains, whereas an oracle ensemble indicates hypothetical gains. Ranking analysis showed no single team consistently outperformed all others across ranking schemes. Conclusion: The second autoPET challenge provides a comprehensive evaluation of the current state of automated PET/CT tumor segmentation, highlighting both progress and persistent challenges of single-source domain generalization and the need for diverse public datasets to enhance algorithm robustness.

Diagnosis of Giant Cell Arteritis (GCA) and Polymyalgia rheumatica (PMR) may be challenging as many patients present with non-specific symptoms. Superficial cranial arteries are predilection sites of inflammatory affection. Ultrasound is typically the diagnostic tool of first choice supplementary to clinical and laboratory examination. Inflammation of temporal arteries can be detected sonographically with high reliability. However, due to the vessel’s course and location, occipital arteries evade sonographic detectability. The aim of our study was to evaluate the infestation pattern of superficial cranial arteries in GCA and PMR patients with special focus on the occipital arteries. 90 treatment-naïve patients with clinically and/or histologically proven GCA and/or PMR (51 GCA, 20 PMR, 10 GCA-PMR) were included in the study. All patients underwent contrast-enhanced, fat-suppressed, high-resolution black blood 2D T1-weighted spin echo imaging at 3T MRI. Images were read by three different readers independently. Temporal and occipital arteries were assessed regarding vasculitic affection. Circumferential mural hyperenhancement and thickening of the vessel wall ≥ 600 μm was considered positive for vasculitis. 9/90 (10

The extreme low-count regime for clinical 225Ac-SPECT imaging poses a challenge to energy-window based scatter correction (EWSC) methods. Moreover, SPECT imaging suffers from partial volume effects (PVE), which can degrade quantification and lead to an underestimation of the absorbed dose estimations, especially in small structures such as lesions. The aim of this study was to investigate the impact of scatter correction and partial volume correction (PVC) techniques on post-therapeutic imaging of the three imageable photopeaks of 225Ac. A phantom with three 3D-printed spheres (191, 100, 48 ml) was imaged to compare transmission-dependent scatter correction (TDSC) to EWSC (440, 218 keV)/no scatter correction (no SC) (78 keV), as well as the impact of iterative Yang (IY)- and Richardson-Lucy (RL)-based PVC techniques, in terms of contrast-to-noise ratios (CNR) and recovery coefficients (RC). These scatter correction and PVC methods were also compared for a patient cohort, with two SPECT/CTs acquired 24 and 48 h after [225Ac]Ac-PSMA-I T therapy, to evaluate their impact on kidney and lesion dosimetry. In the phantom study, TDSC outperformed EWSC/no SC across all energy windows in terms of CNR, and in terms of RC for 218 and 78 keV energy windows under clinically relevant conditions. Application of PVC techniques resulted in a clear increase in RC and CNR across all energy windows. In the patient study, RBE-weighted kidney absorbed doses increased on average across all kidneys by 9 ± 4

Background/Objectives: Red bone marrow irradiation is a major concern for patients with advanced prostate cancer undergoing [177Lu]Lu-PSMA therapy. However, low uptake in the red bone marrow and the presence of bone lesions complicate image-based red bone marrow dosimetry. This study aimed to investigate the general feasibility of image-based red bone marrow activity estimation for [177Lu]Lu-PSMA treatment and to develop a fully automated workflow for clinical implementation. Methods: In the first part of the study, 175 virtual patient phantoms with realistic 177Lu activity distributions were generated based on 639 pre-therapeutic [18F]F-PSMA-1007 PET/CT scans. The SIMIND Monte Carlo tool was used to simulate the 177Lu SPECT acquisitions (24 h post-injection (p.i.)), which were used to assess the uncertainty of red bone marrow activity estimation. In the second part, red bone marrow self- and cross-absorbed doses were estimated for four therapy cycles of 20 patients. Results: The simulation study shows a significant overestimation of activity in skeletal sites with bone lesions, with median recovery coefficients (RCs) across all phantoms yielding a median of 225% (range: 106–1015%). In contrast, the median RCs were markedly lower in skeletal sites neighboring or distant to lesion-carrying sites (105% [72–163%] and 107% [77–130%], respectively). The median total absorbed dose to the red bone marrow was 20.8 mGy/GBq (range: 5.6–297.9 mGy/GBq). Median blood levels decreased with an increasing median cumulative total absorbed dose. Conclusions: Reliable estimation of activity concentration in skeletal sites without bone lesion infiltration has been shown to be feasible. Based on this finding, an automated workflow for routine image-based red bone marrow dosimetry was developed.

Objective:Somatostatin receptor analogues are well-established in the treatment of metastatic gastro-enteropancreatic neuroendocrine tumours (GEP-NETs), especially for symptom control in patients with the carcinoid syndrome, and to control tumour growth. However, they need to be discontinued before peptide receptor radionuclide therapy (PRRT) as they may saturate the somatostatin receptor 2 (SSTR2) and prevent binding of the radioactive ligand. Design:We evaluated the effects of the novel somatostatin analogue paltusotine on 18F-SiTATE radioligand uptake and on GEP-NET cell viability in comparison to octreotide. Methods:Paltusotine and octreotide were evaluated in varying concentrations in an 18F-SiTATE uptake assay using stable hSSTR2 over-expressing BON-1 cells, and in a cell viability assay utilising different NET cell lines and human patient-derived GEP-NET primary cultures (n = 13). Results:Low, clinically-relevant concentrations of paltusotine (7.3-25.4 nM) demonstrated no influence on cellular radioligand uptake compared to the control. In contrast, octreotide reduced radioligand uptake at low, clinically-relevant concentrations (7.3-25.4 nM) and led to a further significant reduction of radioligand uptake at higher concentrations (73-508 nM). Both paltusotine and octreotide showed overall little or no significant anti-tumour effects in vitro in NET cell lines. However, in contrast to octreotide, paltusotine led to a slight decrease in cell viability of patient-derived GEP-NET primary cultures. Conclusions:Treatment with paltusotine did not significantly reduce radioligand binding of 18F-SiTATE in vitro, indicating no influence on SSTR2 targeting. This might enable a continuation of somatostatin receptor analogue therapy with paltusotine during PRRT, potentially improving symptom control in GEP-NET patients with the carcinoid syndrome.

BACKGROUND:Markedly expressed on hematopoietic stem cells, C-X-C motif chemokine receptor 4 (CXCR4)-directed radioligand therapy (RLT) has been used in relapsed/refractory (r/r) MM to prepare for hematopoietic stem cell transplantation (HSCT). We aimed to determine the myeloablative efficacy of CXCR4 RLT in MM patients and assessed the safety profile of this treatment. METHODS:Thirty-eight patients with r/r MM were treated with 40 cycles of CXCR4-targeting [ 90 Y]Y-PentixaTher or [ 177 Lu]Lu-PentixaTher. Myeloablative dynamics were closely monitored by examining hematologic parameters before the application of RLT (day 1), on day 2, and on the start day of conditioning chemotherapy (CON, median day 10). Laboratory parameters evaluating organ toxicity were collected and categorized following the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Cairo-Bishop classification was also applied to identify patients experiencing laboratory tumor lysis syndrome (TLS) caused by RLT. After CON, we determined the rate of patients receiving hematopoietic stem cell transplantation (HSCT) followed by successful neutrophile engraftment. RESULTS:Forty cycles of CXCR4-directed RLT were applied. Myeloablative effects resulted in an 81.8% decline in leukocytes and a 69.4% decrease in neutrophil levels till the day of CON ( P <0.0001, respectively), followed by platelets (63.1%; P <0.0001) and hemoglobin (9%; P =0.002). We observed 58 AE Events (1/58 [1.7%], ≥ grade 3). CON could be applied successfully after 39/40 (97.5%) cycles. After CON, in 39/39 (100%) of the cycles, HSCT was conducted, and successful neutrophil engraftment was reached after 37/39 (94.9%) of these cycles. CONCLUSIONS:CXCR4-directed RLT exerted relevant myeloablative effects. When performing HSCT after applying additional CON, successful neutrophile engraftment was reached in the vast majority of the cases.

Peptide receptor radionuclide therapy (PRRT) with [177Lu]Lu-DOTA-TATE is an established treatment for advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs). While overall renal safety is high, the kidneys remain an organ at risk. This study aimed to determine whether clinical parameters can predict the risk of PRRT-associated renal function decline. This retrospective single-center study included 178 patients with well-differentiated GEP-NETs (Grade 1 or 2) who completed four cycles of [177Lu]Lu-DOTA-TATE between 2012 and 2023. Mean baseline eGFR was 81.1 ± 16.3 mL/min/1.73 m² and remained stable at follow-up (81.1 ± 17.8 mL/min/1.73 m², p = 0.989). A KDIGO-defined renal function decline (eGFR follow-up to baseline ratio < 0.8) was observed in 15 patients (8.9

AT1R (angiotensin II type 1 receptors) are central to the renin-angiotensin system and are involved in regulating blood pressure and renal physiology. This study introduces [18F]DR29, a fluorine-18-labeled radiotracer for positron emission tomography imaging, to enable noninvasive visualization of AT1R expression. Its potential applications in understanding AT1R-associated renal processes are explored in healthy and hypertensive rat models. Radiolabeling was established, and biodistribution studies were conducted on healthy Wistar rats with and without the AT1R antagonist candesartan and transporter inhibitors. Dynamic positron emission tomography imaging assessed tracer specificity, and feasibility for renal AT1R quantification was explored using a hypertensive rat model. [18F]DR29 was radiolabeled with a yield of 36±6%. High kidney uptake was observed, significantly reduced by candesartan (kidney-to-blood ratio, 0.43±0.01 versus 4.54±1.59 in vehicle, where vehicle refers to saline without any treatment). Transporter inhibition protocols targeting organic anion transporting polypeptides (liver) and organic anion transporters (kidneys) successfully reduced radiotracer clearance, increasing the specific accumulation of [18F]DR29 in the kidneys and improving renal imaging contrast. Positron emission tomography imaging revealed rapid kidney uptake and stable retention over 2 hours. In hypertensive rats, kidney uptake was higher, aligning with AT1R expression levels. These results support [18F]DR29 as a promising tool for the noninvasive evaluation of renal AT1R expression in healthy and diseased states. The findings lay the groundwork for clinical translation, offering potential applications in diagnosing and managing kidney-related diseases, including hypertension and other conditions involving AT1R dysregulation.

We aimed to evaluate the safety and efficacy to explore predictors of prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) with [¹⁷⁷Lu]Lu-PSMA I T in metastatic castration-resistant prostate cancer (mCRPC) patients aged ≥ 75 and explored baseline predictors of overall survival (OS). 56 men (median age 78, range 75–95) were treated with RLT. Adverse events were graded according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Baseline Gleason score, blood parameters (PSA, LDH), and sites of metastases (bone, lymph nodes, liver, lung) were recorded. Quantitative PET parameters such as SUVmean (mean standardized uptake value), SUVpeak (peak standardized uptake value), SUVmax (maximum standardized uptake value), PSMA-TV (PSMApositive tumor volume), TL-PSMA (total lesion PSMA) were measured. PET response was assessed by RECIP 1.0 (response evaluation criteria in PSMA imaging); biochemical response by PCWG3 (prostate cancer working group 3). Associations with OS were analyzed via uni- and multivariable Cox regression and Kaplan–Meier curves. No CTCAE grade III–V toxicities occurred. Grade I/II hematologic events included anemia (23.2

Ziel/Aim: Xerostomia is a frequent side effect of [177Lu]Lu-PSMA-617 radiopharmaceutical therapy (RPT) in patients with metastatic castration-resistant prostate cancer (mCRPC), posing a major threat for quality of life. This project aims to assess xerostomia trends during the first two cycles of PSMA-RPT using the "Functional Assessment of Cancer Therapy-Radionuclide Therapy" (FACT-RNT) patient-reported outcome questionnaire, and to determine the absorbed doses in the salivary glands.

Integrated biomarkers that predict survival in patients with gastroenteropancreatic neuroendocrine tumors (GEP-NET) receiving peptide receptor radionuclide therapy (PRRT) are still limited. This study aims to identify predictors of progression-free survival (PFS) in patients with GEP-NET undergoing two cycles of PRRT. Methods: This single-center retrospective study included 178 patients with GEP-NET (G1 and G2) who received at least two consecutive cycles of PRRT with [177Lu]Lu-DOTA-TATE and underwent somatostatin receptor (SSTR)-PET/CT before and after therapy. At baseline, Krenning score (KS) > 2, clinical, pathological and laboratory parameters were collected and correlated to PFS. Survival predictors were analyzed using univariate and multivariate models. For goodness-of-fit analysis, the Akaike information criterion and Harrell concordance index were determined. To determine the impact on the regression model the Wald-Test was performed. Results: In univariate analysis, KS 3 (vs. KS 4; HR, 2.02; 95% CI, 1.27-3.22; p = 0.012), Ki-67 > 5 % (HR, 2.00; 95% CI, 1.31-3.04; p = 0.008), CgA > 200 ng/mL (HR, 1.77; 95% CI, 1.14-2.76; p = 0.027) and NSE > 35 ng/mL (HR, 2.37; 95% CI, 1.44-3.89; p < 0.008) were significantly associated with shorter PFS, with CgA providing the highest C-index (0.6). In multivariate analysis , KS 3 (vs. KS 4; HR, 1.94; 95% CI, 1.17-3.21; p = 0.01), CgA > 200 ng/mL (HR, 1.76; CI, 1.08-2.87; p = 0.024), NSE > 35 ng/mL (HR, 1.98; 95% CI, 1.17-3.36; p = 0.011), and Ki-67 > 5 % (HR, 1.89; 95% CI, 1.18-3.02; p = 0.008) were significantly associated with reduced PFS. Including KS into multivariate analysis significantly improved the Cox regression model performance, as shown by a reduction in Akaike Information Criterion (592/596) and an increase in concordance index (0.66/0.65). The Wald test for individual variables supported the significance of both Ki-67 (7.1) and KS (6.7) as independent predictors of PFS. Conclusions: NSE, CgA, KS and Ki-67 emerged as independent predictors of PFS in GEP-NET patients scheduled for two cycles of PRRT, thereby emphasizing the importance of integrated diagnostics including in- and ex-vivo biomarkers to identify high-risk individuals prone to disease progression.

Ziel/Aim: Identifikation von Parametern, die bei Durchführung einer kombinierten perkutanen Strahlentherapie (EBRT) mit SSTR-gerichteter Peptidrezeptor-Radionuklidtherapie (PRRT) prognostisch für das Gesamtüberleben (OS) bzw. Progressionsfreie Überleben (PFS) sind.