Advancing Positron Emission Tomography Image Quantification: Artificial Intelligence-Driven Methods, Clinical Challenges, and Emerging Opportunities in Long-Axial Field-of-View Positron Emission Tomography/Computed Tomography Imaging.

Positron emission tomography/computed tomography (PET/CT) imaging plays a pivotal role in oncology, aiding tumor metabolism assessment, disease staging, and therapy response evaluation. Traditionally, semi-quantitative metrics such as SUVmax have been extensively used, though these methods face limitations in reproducibility and predictive capability. Recent advancements in artificial intelligence (AI), particularly deep learning, have revolutionized PET imaging, significantly enhancing image quantification accuracy, and biomarker extraction capabilities, thereby enabling more precise clinical decision-making.

Artificial Intelligence-Guided PET Image Reconstruction and Multi-Tracer Imaging: Novel Methods, Challenges, and Opportunities.

This article reviews recent advancements in PET/computed tomography imaging, emphasizing the transformative impact of total-body and long-axial field-of-view scanners, which offer increased sensitivity, larger coverage, and faster, lower-dose imaging. It highlights the growing role of artificial intelligence (AI) in enhancing image reconstruction, resolution, and multi-tracer applications, enabling rapid processing and improved quantification. AI-driven techniques, such as super-resolution, positron range correction, and motion compensation, are improving lesion detectability and image quality.

Physician-in-the-Loop Active Learning in Radiology Artificial Intelligence Workflows: Opportunities, Challenges, and Future Directions.

Artificial intelligence (AI) is being explored for a growing range of applications in radiology, including image reconstruction, image segmentation, synthetic image generation, disease classification, worklist triage, and examination scheduling. However, training accurate AI models typically requires substantial amounts of expert-labeled data, which can be time-consuming and expensive to obtain. Active learning offers a potential strategy for mitigating the impacts of such labeling requirements.

Long Axial Field-of-view PET: A New Era of Quantitative PET Imaging for Theranostic Applications in Clinic.

Long axial field-of-view PET (LAFOV) PET offers a dramatic increase not only in the area simultaneously scanned at any given time and bed position but also in sensitivity compared to conventional PET, enabling, among other benefits, streamlined whole-body dynamic and multiparametric imaging, delayed acquisitions, and accurate tracer quantification with reduced injected dose. These capabilities allow more precise and complete evaluation of tumor distribution, kinetics, and heterogeneity-essential for personalizing radiopharmaceutical therapy (RPT) for optimal safety and efficacy. Current one-protocol-fits-all RPT schemes, based on fixed activity and fixed scheduling, do not account for patient-specific biology.

Is Long-Axial-Field-of-View PET/CT Cost-Effective? An International Health-Economic Analysis.

Our aim is to assess the cost-effectiveness of long-axial-field-of-view (LAFOV) versus short-axial FOV (SAFOV) PET/CT systems using international data. Our model compares equipment and operational costs for a PET/CT center and investigates the effect of camera choice (SAFOV vs. LAFOV) and operational models.

Role of RGS17 in cisplatin-induced cochlear inflammation and ototoxicity via caspase-3 activation.

Cisplatin is a chemotherapy drug used to treat different solid tumors, including ovarian, bladder, lung, and head and neck cancers. One of its significant side effects is ototoxicity, especially when high doses are required. Cisplatin-induced ototoxicity is associated with increased cochlear cell death resulting from DNA damage, caspase activation, oxidative stress, inflammation, and glutamate excitotoxicity.

The impact of long axial field of view (LAFOV) PET on oncologic imaging.

The development of long axial field of view (LAFOV) positron emission tomography coupled with computed tomography (PET/CT) scanners might be considered the biggest step forward in PET imaging since it became a mainstream clinical modality. Despite increased capital and maintenance costs and data storage requirements, the improvement in image quality, significantly faster acquisition times and lower radiopharmaceutical administered activities, allow a high quality and more efficient clinical service. This step change in technology overcomes some of the limitations of standard short axial field of view scanners.

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.

Total-Body PET/CT: Challenges and Opportunities.

Long-axial field-of-view (LAFOV) systems have changed the field of molecular imaging. Since their introduction, many PET centers have installed these next-generation digital systems to provide more detailed imaging and acquire PET images in a single bed position. Indeed, vertex to thigh imaging for oncological indications can be obtained in most of the population with the currently available LAFOV systems.

Theranostic digital twins: Concept, framework and roadmap towards personalized radiopharmaceutical therapies.

Radiopharmaceutical therapy (RPT) is a rapidly developing field of nuclear medicine, with several RPTs already well established in the treatment of several different types of cancers. However, the current approaches to RPTs often follow a somewhat inflexible "one size fits all" paradigm, where patients are administered the same amount of radioactivity per cycle regardless of their individual characteristics and features. This approach fails to consider inter-patient variations in radiopharmacokinetics, radiation biology, and immunological factors, which can significantly impact treatment outcomes.

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.

Successful treatment of immune checkpoint inhibitor-related periaortitis.

We report a 64-year-old patient with melanoma receiving ipilimumab and nivolumab therapy who presented with a periaortic soft tissue mass around the abdominal aorta on restaging fluorodeoxyglucose positron emission tomography/computed tomography imaging. Clinical, laboratory, and radiologic findings resulted in a diagnosis of immune checkpoint inhibitor-related periaortitis. Periaortitis is a rare disease presenting with fibro-inflammatory tissue around the aorta and may lead to serious complications.

Detection of individual brain tau deposition in Alzheimer's disease based on latent feature-enhanced generative adversarial network.

Objective: The conventional methods for interpreting tau PET imaging in Alzheimer's disease (AD), including visual assessment and semi-quantitative analysis of fixed hallmark regions, are insensitive to detect individual small lesions because of the spatiotemporal neuropathology's heterogeneity. In this study, we proposed a latent feature-enhanced generative adversarial network model for the automatic extraction of individual brain tau deposition regions.

Methods: The latent feature-enhanced generative adversarial network we propose can learn the distribution characteristics of tau PET images of cognitively normal individuals and output the abnormal distribution regions of patients.

FDG imaging with long-axial field-of-view PET/CT in patients with high blood glucose-a matched pair analysis.

Purpose: High blood glucose (hBG) in patients undergoing [F]FDG PET/CT scans often results in rescheduling the examination, which may lead to clinical delay for the patient and decrease productivity for the department. The aim of this study was to evaluate whether long-axial field-of-view (LAFOV) PET/CT can minimize the effect of altered bio-distribution in hBG patients and is able to provide diagnostic image quality in hBG situations.

Materials And Methods: Oncologic patients with elevated blood glucose (≥ 8.

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.

Single time point quantitation of cerebral glucose metabolism by FDG-PET without arterial sampling.

Background: Until recently, quantitation of the net influx of 2-[F]fluorodeoxyglucose (FDG) to brain (K) and the cerebrometabolic rate for glucose (CMR) required serial arterial blood sampling in conjunction with dynamic positron emission tomography (PET) recordings. Recent technical innovations enable the identification of an image-derived input function (IDIF) from vascular structures, but are frequently still encumbered by the need for interrupted sequences or prolonged recordings that are seldom available outside of a research setting. In this study, we tested simplified methods for quantitation of FDG-K by linear graphic analysis relative to the descending aorta IDIF in oncology patients examined using a Biograph Vision 600 PET/CT with continuous bed motion (Aarhus) or using a recently installed Biograph Vision Quadra long-axial field-of-view (FOV) scanner (Bern).

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.

Effects of natural products on cisplatin ototoxicity and chemotherapeutic efficacy.

Introduction: Cisplatin is a very effective chemotherapeutic agent against a variety of solid tumors. Unfortunately, cisplatin causes permanent sensorineural hearing loss in at least two-thirds of patients treated. There are no FDA approved drugs to prevent this serious side effect.

New thresholds in semi-quantitative [F]FDG PET/CT are needed to assess large vessel vasculitis with long-axial field-of-view scanners.

Aim: [F]FDG PET/CT proved accurate in the diagnostic work-up of large vessel vasculitis (LVV). While a visual interpretation is currently considered adequate, several attempts have been made to integrate it with a semiquantitative evaluation. In this regard, there is the need to validate current or new thresholds for the semiquantitative parameters on long-axial field of view (LAFOV) scanners.

[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.

Investigating the influence of long-axial versus short-axial field of view PET/CT on stage migration in lymphoma and non-small cell lung cancer.

Objectives: The objective of this study was to evaluate the influence of a long-axial field-of-view (LAFOV) on stage migration using a large single-centre retrospective cohort in lymphoma and non-small cell lung cancer (NSCLC).

Methods: A retrospective study is performed for patients undergoing PET/computed tomography (CT) on either a short-axial field-of-view (SAFOV) or LAFOV PET/CT system for the staging of known or suspected NSCLC or for therapeutic response in lymphoma. The primary endpoint was the Deauville therapy response score for patients with lymphoma for the two systems.

Literature review: Imaging in prostate cancer.

Imaging plays an increasingly important role in the detection and characterization of prostate cancer (PC). This review summarizes the key conventional and advanced imaging modalities including multiparametric magnetic resonance imaging (MRI) and positron emission tomography (PET) imaging and tries to instruct clinicians in finding the best image modality depending on the patient`s PC-stage. We aim to give an overview of the different image modalities and their benefits and weaknesses in imaging PC.

Targeting CXCL1 chemokine signaling for treating cisplatin ototoxicity.

Cisplatin is chemotherapy used for solid tumor treatment like lung, bladder, head and neck, ovarian and testicular cancers. However, cisplatin-induced ototoxicity limits the utility of this agent in cancer patients, especially when dose escalations are needed. Ototoxicity is associated with cochlear cell death through DNA damage, the generation of reactive oxygen species (ROS) and the consequent activation of caspase, glutamate excitotoxicity, inflammation, apoptosis and/or necrosis.