Efficacy and safety of rechallenge therapy with [177Lu]Lu-PSMA in metastatic castration-resistant prostate cancer: a systematic review and meta-analysis.

Background: Lutetium-177 PSMA radioligand therapy ([¹⁷⁷Lu]Lu-PSMA-RLT) is an effective treatment option for patients with metastatic castration-resistant prostate cancer (mCRPC). Prospective studies reported favourable efficacy and safety outcomes of up to 6 cycles of [¹⁷⁷Lu]Lu-PSMA. This study aimed to evaluate the efficacy and safety of [¹⁷⁷Lu]Lu-PSMA rechallenge therapy in patients with mCRPC who progressed after an initial course of [¹⁷⁷Lu]Lu-PSMA-RLT.

New semiquantitative parameters in digital [F]FDG PET/CT improve diagnostic accuracy in suspected infective endocarditis.

Background: The purpose of this study was to identify semiquantitative parameters of [F]FDG PET/CT using a digital PET scanner, which may increase diagnostic accuracy and readers' confidence in the diagnosis of infective endocarditis (IE).

Results: Images of 82 patients undergoing [F]FDG PET/CT for suspected IE were visually and semiquantitatively analyzed. Standardized uptake values (SUV) of suspected foci, also normalized to liver, mediastinum and surrounding activity were calculated.

Combination prostate-specific membrane antigen-targeted radiopharmaceutical therapy in metastatic prostate cancer.

Radiopharmaceutical therapy is emerging rapidly as an effective and safe pillar in cancer management. The regulatory approvals for Lu-PSMA-617 radiopharmaceutical therapy in both the pre- and post-chemotherapy metastatic castration resistant prostate cancer clinical space have paved the way for the implementation of this life-prolonging therapy in clinical practice. However, the emergence of resistance to radiopharmaceutical therapy is inevitable, and therefore, combination therapies will be needed to synergize treatment efficacy without untoward collective toxicity.

Radioactivity levels in the saliva of patients undergoing targeted radioligand therapy with [Lu]Lu-PSMA-I&T and [Lu]Lu-DOTA-TOC.

Objectives: The number of patients receiving radioligand therapy (RLT) has risen sharply in recent years. This raises concerns about possible risks to dental healthcare workers due to their exposure to the patients and their saliva. We therefore set about to measure the salivary radioactivity in patients undergoing Lu-RLT.

Ectopic Right Kidney Imaged With Dynamic 82Rb PET/CT.

Ectopic kidney in the thoracic region are infrequent in clinical practice. A 64-year-old man underwent a Rubidium (82Rb) positron emission tomography/computed tomography (PET-CT) scan for the evaluation of myocardial ischemia due to a diagnosed 2-vessel coronary artery disease. While no myocardial perfusion abnormalities were detected, the scan showed the presence of a diaphragmatic high stand on the right side, with evidence of an ectopic kidney.

Characterization of Effective Half-Life for Instant Single-Time-Point Dosimetry Using Machine Learning.

Single-time-point (STP) image-based dosimetry offers a more convenient approach for clinical practice in radiopharmaceutical therapy (RPT) compared with conventional multiple-time-point image-based dosimetry. Despite numerous advancements, current STP methods are limited by the need for strict and late timing in data acquisition, posing challenges in routine clinical settings. This study introduces a new concept of instant STP (iSTP) dosimetry, achieved by predicting the effective half-life ( ) of organs using machine learning applied on pretherapy patient data (PET and clinical values).

Automatic bone marrow segmentation for precise [Lu]Lu-PSMA-617 dosimetry.

Background: Bone marrow (BM) is the dominant dose-limiting organ in [Lu]Lu-PSMA-617 therapy for patients with metastasized castration resistant prostate cancer, where BM dosimetry is challenging due to segmentation.

Purpose: We aim to develop an automatic image-based segmentation method on peri-therapeutic sequential [Lu]Lu-PSMA-617 images for personalized BM dosimetry.

Methods: Quantitative SPECT/CT imaging at 2, 20, 40 and 60 (n = 14)/200 (n = 16) h post [Lu]Lu-PSMA-617 injection were analyzed for 10 patients with 30 treatment cycles.

Advancements in lung cancer: a comprehensive perspective on diagnosis, staging, therapy and follow-up from the SAKK Working Group on Imaging in Diagnosis and Therapy Monitoring.

In 2015, around 4400 individuals received a diagnosis of lung cancer, and Switzerland recorded approximately 3200 deaths related to lung cancer. Advances in detection, such as lung cancer screening and improved treatments, have led to increased identification of early-stage lung cancer and higher chances of long-term survival. This progress has introduced new considerations in imaging, emphasising non-invasive diagnosis and characterisation techniques like radiomics.

Evaluation of long axial field-of-view (LAFOV) PET/CT for post-treatment dosimetry in Yttrium-90 radioembolization of liver tumors: a comparative study with conventional SPECT imaging.

Purpose: Long axial field-of-view (LAFOV) positron emission tomography/computed tomography (PET/CT) scanners enable high sensitivity and wide anatomical coverage. Therefore, they seem ideal to perform post-selective internal radiation therapy (SIRT) Y scans, which are needed, to confirm that the dose is delivered to the tumors and that healthy organs are spared. However, it is unclear to what extent the use of LAFOV PET is feasible and which dosimetry approaches results in accurate measurements.

Long-axial field-of-view PET/CT improves radiomics feature reliability.

Purpose: To assess the influence of long-axial field-of-view (LAFOV) PET/CT systems on radiomics feature reliability, to assess the suitability for short-duration or low-activity acquisitions for textural feature analysis and to investigate the influence of acceptance angle.

Methods: 34 patients were analysed: twelve patients underwent oncological 2-[18F]-FDG PET/CT, fourteen [18F]PSMA-1007 and eight [68Ga]Ga-DOTATOC. Data were obtained using a 106 cm LAFOV system for 10 min.

The impact of different reconstruction parameters on quantitative Tc-DPD SPECT/CT values in the assessment of cardiac transthyretin amyloidosis.

Aim: To assess in a phantom and in a clinical study the influence of different reconstruction parameters on quantitative SPECT/CT values in the assessment of cardiac transthyretin amyloidosis (ATTR-CA).

Method: A hybrid SPECT/CT camera with a proprietary software for SPECT/CT-based quantification of myocardial uptake of Tc-DPD was used. Images were reconstructed with 6 different protocols, differing in iterations, subset and Gaussian filter.

Tailoring Fibroblast-Activation Protein Targeting for Theranostics: A Comparative Preclinical Evaluation of the Ga- and Lu-Labeled Monomeric and Dimeric Fibroblast-Activation Protein Inhibitors DOTA.SA.FAPi and DOTAGA.(SA.FAPi).

Background: FAP radiopharmaceuticals show promise for cancer diagnosis; however, their limited tumor residency hinders treatment. This study compared two FAPi derivatives, DOTA.SA.

PSMA-PET follow-up to assess response in patients not receiving PSMA therapy: Is there value beyond localization of disease?

Prostate Specific Membrane Antigen Positron Emission Tomography (PSMA-PET) is routinely used for the staging of patients with prostate cancer, but data on response assessment are sparse and primarily stem from metastatic castration-resistant prostate cancer (mCRPC) patients treated with PSMA radioligand therapy. Still, follow-up PSMA-PET is employed in earlier disease stages in case of clinical suspicion of disease persistence, recurrence or progression to decide if localized or systemic treatment is indicated. Therefore, the prognostic value of PSMA-PET derived tumor volumes in earlier disease stages (i.

Prostate-specific Membrane Antigen: Diagnostics.

Since its clinical introduction in May 2011, prostate-specific membrane antigen (PSMA)-PET/computed tomography has quickly gained worldwide recognition as a significant breakthrough in prostate cancer diagnostics. In the meantime, several new PSMA radioligands for PET imaging have been introduced into routine clinical practice. This article aims to introduce the most commonly used tracers and their key areas of application.

Prostate Cancer Theranostics With Lu-PSMA.

This review paper highlights the transformative role of PSMA-targeted diagnostics and therapy in prostate cancer management, particularly focusing on Lu-PSMA-617, approved by the FDA and EMA for metastatic castration-resistant prostate cancer (mCRPC) patients post-chemotherapy and ARPI treatment. Originating from the VISION trial's success, this paper navigates the current radioligand therapy (RLT) indications, emphasizing practical patient selection, planning, and treatment execution. It critically examines Lu-PSMA's comparative effectiveness against cabazitaxel and Ra-223, addressing decision-making dilemmas for mCRPC treatments.

The clinical acceptability of short versus long duration acquisitions for head and neck cancer using long-axial field-of-view PET/CT: a retrospective evaluation.

Purpose: To evaluate the utility of long duration (10 min) acquisitions compared to standard 4 min scans in the evaluation of head and neck cancer (HNC) using a long-axial field-of-view (LAFOV) system in 2-[18F]FDG PET/CT.

Methods: HNC patients undergoing LAFOV PET/CT were included retrospectively according to a predefined sample size calculation. For each acquisition, FDG avid lymph nodes (LN) which were highly probable or equivocal for malignancy were identified by two board certified nuclear medicine physicians in consensus.

Early response monitoring during [Lu]Lu-PSMA I&T therapy with quantitated SPECT/CT predicts overall survival of mCRPC patients: subgroup analysis of a Swiss-wide prospective registry study.

Purpose: To assess early tumor response with quantitated SPECT/CT and to correlate it with clinical outcome in metastatic castration-resistant prostate cancer (mCRPC) patients treated with Lutetium-PSMA I&T therapy.

Methods: Single-center, observational study, part of the prospective Swiss national cancer registry study investigating the safety and efficacy of [Lu]Lu-PSMA I&T (EKNZ: 2021-01271) in mCRPC patients treated with at least two cycles of [Lu]Lu-PSMA I&T 6-weekly. After the first and second cycle quantitated SPECT/CT (Symbia Intevo, Siemens) was acquired 48 h after injection (three fields of view from head to thigh, 5 s/frame) and reconstructed using xQuant® (48i, 1 s, 10-mm Gauss).

Lu-177-PSMA dosimetry for kidneys and tumors based on SPECT images at two imaging time points.

Background: Personalized dosimetry for Lu-177-PSMA treatment requires multiple-time-point SPECT/CT scans to calculate time-integrated activity (TIA). This study evaluates two-time-point (TTP) methods for TIA calculation for kidneys and tumors.

Methods: A total of 18 patients treated with 3.

Long-axial field-of-view PET/CT for the assessment of inflammation in calcified coronary artery plaques with [ Ga]Ga-DOTA-TOC.

Purpose: Inflamed, prone-to-rupture coronary plaques are an important cause of myocardial infarction and their early identification is crucial. Atherosclerotic plaques are characterized by overexpression of the type-2 somatostatin receptor (SST) in activated macrophages. SST ligand imaging (e.

[Lu]Lu-PSMA-617 Therapy in a Patient with Chronic Kidney Disease.

We report the dosimetric evaluation of prostate-specific membrane antigen-based radioligand therapy (RLT) for metastatic prostate cancer in a patient with autosomal-dominant polycystic kidney disease. The patient received hemodialysis during each of 6 RLT cycles while staying as an inpatient. We used voxel dosimetry and blood sampling for the dose calculation.

The diagnostic accuracy of radiolabeled PSMA-ligand PET for tumour staging in newly diagnosed prostate cancer patients compared to histopathology: a systematic review and meta-analysis.

Purpose: The current clinical recommendations posit the deployment of specific approved radiolabeled prostate-specific membrane antigen-ligand positron emission tomography (PSMA PET) for detecting metastatic prostate cancer during primary staging. Nevertheless, the precise efficacy of such ligands in localizing intraprostatic tumours (index tumour) and T-staging is not well established. Consequently, the objective of this inquiry is to ascertain the diagnostic accuracy of PSMA-PET in the tumour staging of newly diagnosed prostate cancer by means of a meta-analysis that integrates studies utilizing histological confirmation as the reference standard.

Amyloid Transthyretin Cardiomyopathy in Elderly Patients With Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation.

Background The prevalence of calcific aortic stenosis and amyloid transthyretin cardiomyopathy (ATTR-CM) increase with age, and they often coexist. The objective was to determine the prevalence of ATTR-CM in patients with severe aortic stenosis and evaluate differences in presentations and outcomes of patients with concomitant ATTR-CM undergoing transcatheter aortic valve implantation. Methods and Results Prospective screening for ATTR-CM with Technetium-3,3-diphosphono-1,2-propanodicarboxylic acid bone scintigraphy was performed in 315 patients referred with severe aortic stenosis between August 2019 and August 2021.