Elevated FDG uptake in non-tumorous lung regions does not predict immune checkpoint inhibitor-related pneumonitis in lung cancer patients.

Background: Predictors for checkpoint inhibitor-related pneumonitis (cinrPneumonitis) are desperately needed. This study aimed to investigate the pretreatment standardized uptake value (SUV) on [F]FDG-PET/CT of non-tumorous lung tissue as a predictive imaging marker for the development of cinrPneumonitis in 239 patients with lung cancer.

Methods: All patients with lung cancer receiving [F]Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) prior to immune checkpoint inhibitor (ICI) therapy were included and retrospectively analyzed.

Prognostic Value of Automated Bone Scan Index (aBSI) in Patients with mCRPC Undergoing Three vs. Six Cycles of Ra Therapy.

: In patients with metastatic castration-resistant prostate cancer (mCRPC) and osseous metastases only, Radium therapy represents a valuable therapeutic option. Bone scintigraphy (BS) is typically performed to assess metastasis load, with the BS-derived automated bone scan index (aBSI) used for response assessment. This study aimed to evaluate the prognostic value of aBSI in patients receiving three or six cycles of Ra therapy.

Randomized Phase 2 Trial of an Extended and Flexible Dosing Schedule of Lu-PSMA Molecular Radiotherapy in Patients with Metastatic Castration-Resistant Prostate Cancer (FLEX-MRT): Study Protocol.

[Lu]Lu-PSMA-617 radiopharmaceutical therapy has been approved for the treatment of men with metastatic castration-resistant prostate cancer (mCRPC) using a fixed dosing schedule of once every 6 wk for up to a total of 6 doses. We hypothesized that patients may benefit from a flexible and extended dosing schedule, up to 12 doses with potential "treatment holiday" periods. The objective of this study is to determine the 2-y survival rate of patients with mCRPC treated with an extended and flexible dosing schedule of [Lu]Lu-PSMA-617 therapy in comparison to patients treated with the standard fixed dosing schedule of a maximum of 6 treatment cycles once every 6 wk.

[Options in nuclear medicine for advanced prostate cancer in practice].

Over the last few years diagnostic and therapeutic advances have contributed to the significant relevance of prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) and PSMA radioligand therapy in patients with advanced prostate cancer (PCa). The PSMA-PET/CT has a higher accuracy for the detection of PCa metastases than the combination of CT and bone scintigraphy. Based on the theranostic approach, PSMA radioligand therapy can be performed in the castration-resistant stage in patients with sufficient PSMA expression of the tumor lesions in PSMA PET/CT and progression of PCa after chemotherapy and therapy with abiraterone or an androgen receptor signalling pathway inhibitor.

Association of integrated biomarkers and progression-free survival prediction in patients with gastroenteropancreatic neuroendocrine tumors undergoing [177Lu]Lu-DOTA-TATE therapy.

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. 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.

Changes of Prostate-Specific Membrane Antigen-Radioligand Uptake on PET with Systemic Therapy in Patients with Metastatic Renal Cell Carcinoma.

: Early treatment assessment in metastatic renal cell carcinoma (mRCC) remains challenging due to the limited accuracy of current imaging methods. Given prostate-specific membrane antigen (PSMA) overexpression in mRCC, PSMA PET is a promising approach. Despite numerous studies on PSMA imaging in mRCC, data on PSMA uptake changes during systemic therapy are scarce.

Cost-Effectiveness of [Lu]Lu-DOTATATE for the Treatment of Newly Diagnosed Advanced Gastroenteropancreatic Neuroendocrine Tumors: An Analysis Based on Results of the NETTER-2 Trial.

The recently published results of the NETTER-2 trial suggest the use of [Lu]Lu-DOTATATE as a new standard of care in first-line therapy of patients with grade 2 or 3, well-differentiated, advanced gastroenteropancreatic neuroendocrine tumors. The NETTER-2 trial found superior median progression-free survival (22.8 mo vs.

Impact of hyperglycemia and antidiabetic medication on pancreatic uptake on [Ga]Ga-DOTATOC PET/CT.

Introduction: Positron-emission-tomography-(PET)/computed-tomography-(CT) using somatostatin-receptor-(SSTR)-binding radioligands is well established in the imaging of neuroendocrine tumors (NETs). SSTRs are expressed in NETs and endocrine and exocrine tissues, e.g.

Comparison of the Hematotoxicity of PRRT with Lutathera and Locally Manufactured Lu-HA-DOTATATE in Patients with Neuroendocrine Tumors and the Impact of Different Application Intervals.

Background/objectives: Peptide Receptor Radionuclide Therapy (PRRT) is approved for patients with inoperable, progressive and/or metastatic well-differentiated NETs. Before the approval of Lutathera, locally manufactured Lu-HA-DOTATATE was used on a regular basis in clinical routine. The aim of this study was (1) to compare the hematotoxicity of locally manufactured Lu-HA-DOTATATE with Lutathera in GEP-NET patients and (2) to compare the recommended treatment interval of 8 weeks between each cycle to a prolonged scheme of up to 11 weeks for both Lu-HA-DOTATATE and Lutathera.

[Tc]Tc-antigranulocyte scintigraphy for prediction of bone marrow reserve prior to radioligand therapy in patients with metastatic castration resistant prostate cancer.

Purpose: Radioligand therapy (RLT) targeting PSMA (prostate-specific membrane antigen) has transformed the treatment of metastatic castration-resistant prostate cancer (mCRPC). However, bone marrow depletion remains a common side effect, particularly in patients with extensive bone metastases or prior myelotoxic therapies. This study evaluated [Tc]Tc-antigranulocyte scintigraphy to assess bone marrow reserve to guide myelotoxic treatment decisions.

Updated Prostate Cancer Risk Groups by Prostate-specific Membrane Antigen Positron Emission Tomography Prostate Cancer Molecular Imaging Standardized Evaluation (PPP2): Results from an International Multicentre Registry Study.

Background And Objective: We established prognostic nomograms incorporating prostate-specific membrane antigen (PSMA) positron emission tomography (PET) parameters standardised by Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE; PPP1). Here, we develop an updated PPP2 risk score from a large international multicentre registry study.

Methods: We included 6128 prostate cancer patients who underwent PSMA-PET at 20 hospitals in Europe, USA, and Australia between 2013 and 2022.

Evidence-Based Clinical Protocols to Monitor Efficacy of [Lu]Lu-PSMA Radiopharmaceutical Therapy in Metastatic Castration-Resistant Prostate Cancer Using Real-World Data.

Our objectives were to assess the prognostic value of posttherapy [Lu]Lu-PSMA (LuPSMA) SPECT/CT by visual evaluation using RECIP 1.0 during LuPSMA therapy and develop an evidence-based clinical protocol to monitor the efficacy of LuPSMA. Patients with metastatic castration-resistant prostate cancer who received at least 2 LuPSMA cycles between April 2019 and November 2023 were retrospectively included in this study.

Ga-FAPI and F-FAPI PET/CT for detection of nodal metastases prior radical cystectomy in high-risk urothelial carcinoma patients.

Introduction: To determine the best therapeutic strategy for muscle-invasive bladder cancer (BC), the accuracy of lymph node staging is of paramount importance. However, diagnostic performance of conventional computed tomography in BC prior to radical cystectomy (RC) remains unsatisfactory. There is an increased interest in evaluating F-FAPI PET/CT for hybrid imaging due to their logistical advantages compared to [Ga]Ga-based FAPI tracers in clinical routine.

PET- and CT-Based Imaging Criteria for Response Assessment of Gastroenteropancreatic Neuroendocrine Tumors Under Radiopharmaceutical Therapy.

Despite well-documented limitations, current guidelines recommend the use of size-based RECIST 1.1 for response assessment of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) under radiopharmaceutical therapy (RPT). We hypothesize that functional criteria are superior to RECIST 1.

Early changes of PSMA PET expression after initiation of androgen receptor signaling inhibitors in CRPC: an international multicenter retrospective study.

Background: An increase of PSMA expression under androgen receptor signaling inhibitors (ARSi) measured on PSMA PET was reported: However, results were inconsistently reproduced clinically and the frequency and timing of the PSMA expression modulation by ARSi remains unknown.

Methods: In this multicenter retrospective study, we aimed at assessing in patients with CRPC the influence of ARSi early after initiation (≤ 30 days) on PSMA expression at the whole-body (WB) level by using WB PSMA PET quantitative parameters. (m)CRPC patients from 5 international sites who underwent a PSMA PET prior to (PET1) and early (< 30 days) after (PET2) ARSi initiation were included.

RECIP 1.0 + PSA for response assessment in mCRPC patients treated with Ac / Lu PSMA combination therapy.

Background: Targeted alpha therapy (TAT) with Ac has shown promising results in metastatic castration-resistant prostate cancer (mCRPC) patients pre-treated with [Lu]Lu-PSMA radioligand therapy (RLT). A combination treatment regimen adding Lu to decreased Ac activities may improve toxicity profile while maintaining sufficient anti-tumor effect. We therefore evaluated clinical and image-based response parameters in patients treated with Ac-/Lu-PSMA combination therapies (ALCT).

Lenticulostriatal Ischemia Shows Relevant SSTR Expression on PET/CT Imaging Using the Novel SSTR-Targeting Peptide 18 F-SiTATE.

A 64-year-old woman with meningioma presented with left-sided lenticulostriatal ischemia following craniotomy and debulking of a sphenoid wing meningioma. For subsequent radiotherapy planning, an SSTR-targeted PET/CT using the novel ligand 18 F-SiTATE was performed 2.5 months thereafter.

PSMA-PET/CT response after metastasis-directed radiotherapy of bone oligometastases in prostate cancer.

Objective: Bone metastases are very common in advanced prostate cancer and can sensitively be detected utilizing PSMA-PET/CT. Therefore, our goal was to evaluate the suitability of PSMA-PET/CT-guided metastasis-directed external beam radiotherapy (MDT) as treatment option for patients with biochemical recurrence and oligometastatic bone lesions.

Materials & Methods: We retrospectively examined 32 prostate cancer patients with biochemical recurrence and PSMA-positive oligometastatic disease limited to the bone (n = 1-3).

Implementation of PET/CT in radiation oncology-a patterns-of-care analysis of the German Society of Nuclear Medicine and the German Society of Radiation Oncology.

Background: The use of positron-emission tomography (PET)/computed tomography (CT) in radiation therapy (RT) has increased. Radiation oncologists (RadOncs) have access to PET/CT with a variety of tracers for different tumor entities and use it for target volume definition. The German Society of Nuclear Medicine (DGN) and the German Society of Radiation Oncology (DEGRO) aimed to identify current patterns of care in order to improve interdisciplinary collaboration.

Impact of the Reference Multiple-Time-Point Dosimetry Protocol on the Validity of Single-Time-Point Dosimetry for [Lu]Lu-PSMA-I&T Therapy.

Internal dosimetry supports safe and effective patient management during radionuclide therapy. Yet, it is associated with high clinical workload, costs, and patient burden, as patient scans at multiple time points (MTPs) must be acquired. Dosimetry based on imaging at a single time point (STP) has continuously gained popularity.

[Ga]Ga-FAPI-46 PET/CT for penile cancer - a feasibility study.

Purpose: Penile cancer is a rare entity and has a good prognosis in localized stage. Delayed surgical treatment of lymphatic disease is associated with poor overall survival but conventional imaging cannot detect occult lymph node metastasis sufficiently. Imaging cancer related fibroblasts has shown promising results as non-invasive staging tool in various tumor entities but has not yet been evaluated in penile cancer.