Umehara T, Nakayama Y, Matsuno H
… +4 more, Omoto S, Sengoku R, Murakami H, Iguchi Y
Clin Nucl Med
· 2026 Jun · PMID 42339662
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PURPOSE: Asymmetric nigrostriatal dopaminergic degeneration in Parkinson disease (PD) is linked to motor and nonmotor manifestations and may reflect Lewy body propagation patterns, particularly in brain-first pathology....PURPOSE: Asymmetric nigrostriatal dopaminergic degeneration in Parkinson disease (PD) is linked to motor and nonmotor manifestations and may reflect Lewy body propagation patterns, particularly in brain-first pathology. The clinical determinants of nigrostriatal dopaminergic asymmetry, however, remain unclear. METHODS: We studied 121 drug-naive patients with PD to examine associations between the striatal asymmetry index (AI) and clinical features, including olfactory function, constipation, and cardiac sympathetic dysfunction measured by 123I-metaiodobenzylguanidine (MIBG) scintigraphy. RESULTS: Patients with pronounced striatal asymmetry (AI >20%) exhibited lower prevalences of hypertension and smoking, a higher frequency of tremor-dominant phenotype, and predominantly right-sided motor symptoms compared with those with symmetric dopaminergic degeneration (AI ≤20%). They also had higher cardiac 123I-MIBG uptake and less severe orthostatic blood pressure decline. Unexpectedly, olfactory dysfunction severity was not associated with striatal AI. Multivariable regression analysis revealed that cardiac sympathetic dysfunction independently and robustly correlates with symmetric degeneration of nigrostriatal dopaminergic neurons (β=0.287, t=3.032, P=0.003). Hierarchical clustering grouped cardiac sympathetic dysfunction and striatal AI in the same lowest-level cluster (linkage dissimilarity = 0.66), indicating a close association. Patients exhibiting markedly reduced cardiac 123I-MIBG uptake demonstrated more symmetric dopaminergic degeneration compared with those with normal uptake (striatal AI: 10.8±10.2% vs. 23.5±15.8%; P=0.003). CONCLUSIONS: Cardiac sympathetic Lewy body burden appears to play a central role in shaping nigrostriatal dopaminergic asymmetry in early PD. Cardiac sympathetic denervation may act as a phenotypic modifier, influencing the spatial pattern of neurodegeneration and contributing to clinical heterogeneity.
Clin Nucl Med
· 2026 Jun · PMID 42335324
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Malignant laryngeal lesions are most commonly primary tumors, predominantly squamous cell carcinoma. Metastatic involvement of the larynx is extremely rare. Among metastatic tumors, renal cell carcinoma, melanoma, lung c...Malignant laryngeal lesions are most commonly primary tumors, predominantly squamous cell carcinoma. Metastatic involvement of the larynx is extremely rare. Among metastatic tumors, renal cell carcinoma, melanoma, lung cancer, and breast cancer represent the most frequent primary sources, whereas metastasis from prostate adenocarcinoma is exceptionally uncommon. Here, we present a case of vocal cord metastasis from prostate adenocarcinoma that was initially detected on 68Ga-PSMA PET/CT and remained clinically silent for a prolonged period.
Clin Nucl Med
· 2026 Jun · PMID 42335300
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A 10-year-old boy with clinically suspected left adrenal pheochromocytoma was enrolled in a clinical trial. He underwent 18F-MFBG PET/CT for further evaluation, which revealed intense tracer accumulation in the left adre...A 10-year-old boy with clinically suspected left adrenal pheochromocytoma was enrolled in a clinical trial. He underwent 18F-MFBG PET/CT for further evaluation, which revealed intense tracer accumulation in the left adrenal lesion, supporting the diagnosis of pheochromocytoma. Notably, pronounced 18F-MFBG uptake was also observed in multiple brown adipose tissue regions, including the cervical, supraclavicular, paraspinal, anterior mediastinum, and perirenal areas. The diagnosis was subsequently confirmed by histopathologic examination after adrenalectomy.
Clin Nucl Med
· 2026 Jun · PMID 42333429
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A 52-year-old man with a prior history of resected G2 pancreatic neuroendocrine tumor presented with a newly identified abdominal mass during 17-month follow-up. Contrast-enhanced MRI depicted a heterogeneously hyper-enh...A 52-year-old man with a prior history of resected G2 pancreatic neuroendocrine tumor presented with a newly identified abdominal mass during 17-month follow-up. Contrast-enhanced MRI depicted a heterogeneously hyper-enhancing jejunal mesenteric lesion, highly suggestive of metastatic disease. ¹⁸F-AlF-NOTA-Octreotide PET/CT revealed mild tracer accumulation within the lesion, which was initially interpreted as NET metastasis. Surgical pathology ultimately confirmed mesenteric fibromatosis. This case emphasizes an important diagnostic trap, as benign fibromatosis can mimic NET metastasis on both anatomic and SSTR-targeted PET imaging, alerting clinicians to avoid misdiagnosis and unnecessary treatment.
Nemati R, Juweid ME, Jafari E
… +5 more, Jokar N, Peer-Firozjaei M, Rekabpour SJ, Mottaghy FM, Assadi M
Clin Nucl Med
· 2026 Jun · PMID 42333414
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BACKGROUND: Progressive meningiomas present a significant therapeutic challenge; there are few therapeutic options in this scenario. Peptide receptor radionuclide therapy (PRRT) targeting somatostatin receptors (SSTRs) i...BACKGROUND: Progressive meningiomas present a significant therapeutic challenge; there are few therapeutic options in this scenario. Peptide receptor radionuclide therapy (PRRT) targeting somatostatin receptors (SSTRs) is a promising strategy. This study, for the first time, evaluates the efficacy and safety of a combination or sequential use of alpha- emitting [225Ac]Ac-DOTATATE and beta-emitting [177Lu]Lu-DOTATATE PRRT for patients with advanced, refractory meningiomas. PATIENTS AND METHODS: In this pilot study, 7 patients with inoperable or refractory meningiomas and high SSTR expression on [68Ga]Ga-DOTATATE PET/CT were included. Patients received a median of 4 PRRT cycles, combining [225Ac]Ac-DOTATATE and [177Lu]Lu-DOTATATE. One patient received only 225Ac-DOTATATE. The primary endpoint was progression-free survival (PFS) at 6 months following treatment using Response Assessment in Neuro-Oncology (RANO) criteria. Secondary endpoints included overall survival (OS), clinical response, imaging response, and toxicity. Imaging response was further assessed through semiquantitative analysis of pretreatment and posttreatment MRI and PET images. Single-lesion dosimetry was performed for 1 patient. RESULTS: Our study achieved a PFS-6 rate of 85.7% (95% CI: 42.1%-99.6%). Of the 7 patients, 1 achieved complete clinical remission, 2 had partial remission, and 3 had stable disease. A median OS of 14 months (95% CI: 8-18 mo). At the lesion level (n = 25), responses were heterogeneous; SUVmax revealed partial response in 4 lesions, stable disease in 19, and progressive disease in 2. The therapy was well-tolerated, with only mild, grade 1 hematological toxicities observed. Single-lesion dosimetry calculated a tumor absorbed dose of 3.36 Gy/MBq for [225Ac]Ac-DOTATATE and 2.37 Gy/GBq for [177Lu]Lu-DOTATATE. CONCLUSIONS: Combined PRRT with 225Ac/177Lu-DOTATATE appears feasible and potentially beneficial option in advanced meningiomas. However, given the small sample size, treatment heterogeneity, and lack of controlled comparison, the findings should be interpreted with caution. Larger prospective studies are warranted.
Mandal S, P RE, Parida GK
… +2 more, Nayak MK, Agrawal K
Clin Nucl Med
· 2026 Jun · PMID 42333406
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Pituitary abscess is a rare, life-threatening condition of the sella, accounting for less than 1% of all pituitary lesions. We present the first case documenting 68Ga FAPI uptake in a pituitary abscess, in conjunction wi...Pituitary abscess is a rare, life-threatening condition of the sella, accounting for less than 1% of all pituitary lesions. We present the first case documenting 68Ga FAPI uptake in a pituitary abscess, in conjunction with 18F FDG PET/CT. While both tracers localized the lesion, 68Ga FAPI PET/CT demonstrated intense avidity against a negligible physiological background in the brain, thereby enhancing the contrast and detectability of this often-minuscule lesion. This superior tumor-to-background contrast highlights the potential of 68Ga FAPI PET/CT for the high-contrast visualization of infectious/inflammatory sellar lesions.
Clin Nucl Med
· 2026 Jun · PMID 42329724
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An 85-year-old woman with a history of left breast cancer underwent 18F-FDG PET/CT for oncologic surveillance. Imaging demonstrated an incidental 7.5-cm intensely FDG-avid mass (SUVmax: 13.0) in the left lower abdominal...An 85-year-old woman with a history of left breast cancer underwent 18F-FDG PET/CT for oncologic surveillance. Imaging demonstrated an incidental 7.5-cm intensely FDG-avid mass (SUVmax: 13.0) in the left lower abdominal wall, suspicious for metastatic disease. Incisional biopsy revealed fibrosis with multiple suture granulomas and foreign-body giant cell reaction, without malignancy. The patient had undergone transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction more than 10 years earlier, with subsequent ventral hernia mesh repairs. This case illustrates an important FDG-PET/CT pitfall of suture granuloma at remote reconstructive donor sites, which can mimic malignancy, persisting even decades after surgery.
Samadi MH, Aryana K, Soltani E
… +2 more, Khorasanchi AR, Barashki S
Clin Nucl Med
· 2026 Jun · PMID 42329090
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We present the case of a 52-year-old woman with a history of poorly differentiated gastric adenocarcinoma who developed early satiety after gastrectomy and chemotherapy. Her CT and FDG PET/CT did not clearly show recurre...We present the case of a 52-year-old woman with a history of poorly differentiated gastric adenocarcinoma who developed early satiety after gastrectomy and chemotherapy. Her CT and FDG PET/CT did not clearly show recurrence, but the 99mTc-FAPI SPECT/CT scan detected all peritoneal and omental metastatic deposits with excellent clarity. Because FAPI targets activated stromal tissue, it is especially effective in poorly differentiated and mucinous tumors with limited FDG uptake. In this patient, FAPI revealed small peritoneal lesions missed by other imaging, highlighting its important role in detecting recurrence and guiding management.
Mohamed OAE, ElSayes KM, Morton K
… +2 more, Shaaban AM, Salem AE
Clin Nucl Med
· 2026 Jun · PMID 42307418
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A 70-year-old woman with a past medical history of breast cancer is undergoing surveillance. She also had a history of repeated blood transfusions for refractory anemia caused by treated marrow metastatic disease. Labora...A 70-year-old woman with a past medical history of breast cancer is undergoing surveillance. She also had a history of repeated blood transfusions for refractory anemia caused by treated marrow metastatic disease. Laboratory tests showed elevated AST (50 U/L) and ALT (115 U/L). 99mTc MDP bone scintigraphy revealed intense diffuse splenic uptake. No splenic calcifications or infarcts were found on contrast-enhanced CT. MRI demonstrated signal dropout on in-phase sequences and marked T2 hypointensity of the spleen and liver, without focal splenic lesions, suggesting transfusion-related secondary hemosiderosis. Iron overload should be considered when diffuse splenic uptake is observed on bone scintigraphy.
Baloglu MC, Şahin R, Tosunoglu Z
… +9 more, Ozturk AE, Şahin ÖF, Beyhan E, Erol Fenercioglu Ö, Alcin G, Ergul N, Cermik TF, Usul Afsar Ç, Arslan E
Clin Nucl Med
· 2026 Jun · PMID 42305081
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AIM: To prospectively evaluate the diagnostic performance of 68Ga-DOTA-Bombesin PET/CT compared with 18F-FDG PET/CT in breast cancer (BC), emphasizing its utility across molecular subtypes and nodal staging. PATIENTS AND...AIM: To prospectively evaluate the diagnostic performance of 68Ga-DOTA-Bombesin PET/CT compared with 18F-FDG PET/CT in breast cancer (BC), emphasizing its utility across molecular subtypes and nodal staging. PATIENTS AND METHODS: Twenty-four patients with biopsy-proven BC who underwent both 68Ga-DOTA-Bombesin and 18F-FDG PET/CT were included. Imaging findings were analyzed on a per-lesion and per-patient basis for primary tumor detection, axillary lymph-node involvement, and distant metastases. Quantitative parameters (SUVmax, MTV, and tumor-to-background ratios) were compared across histopathologic and receptor subgroups, with histopathology as the reference standard. RESULTS: 68Ga-DOTA-Bombesin visualized 92.3% of primary tumors, achieving comparable sensitivity to 18F-FDG (84.6%) but higher specificity in nodal staging (100% vs. 53.8%). Bombesin uptake correlated strongly with estrogen receptor positivity and a lower Ki-67 index (P<0.05). In a limited number of patients with distant metastases (n=4), FDG appeared to detect hepatic and pulmonary lesions, whereas Bombesin identified additional osseous and peritoneal lesions. Physiological uptake was lower in the liver and bone marrow but higher in the blood pool for Bombesin. Emerging antagonist data indicate further improvements in tumor-to-background ratios and potential theranostic applications. CONCLUSIONS: 68Ga-DOTA-Bombesin PET/CT provides a receptor-specific imaging approach in BC, showing complementary strengths to 18F-FDG, particularly in hormone-receptor-positive and low-proliferation tumors. Its superior nodal specificity and theranostic potential support further evaluation of GRPR-targeted imaging and therapy in personalized BC management.
Clin Nucl Med
· 2026 Jun · PMID 42302736
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A 70-year-old man with prostate cancer underwent contrast-enhanced CT for lesion characterization, which revealed two newly detected hepatic lesions suspicious for metastasis. The prostate-specific antigen level remained...A 70-year-old man with prostate cancer underwent contrast-enhanced CT for lesion characterization, which revealed two newly detected hepatic lesions suspicious for metastasis. The prostate-specific antigen level remained below the threshold for biochemical recurrence, whereas C-reactive protein was elevated. 18F-FDG PET/CT was performed for metabolic characterization and whole-body evaluation, demonstrating heterogeneous increased uptake in both lesions. On the basis of the CT findings and FDG hypermetabolism, liver-confined metastatic disease was suspected, and surgical resection was performed. Histopathology unexpectedly revealed a hepatic inflammatory pseudotumor.
Hwang SH, Ahn WK, Cho H
… +4 more, Lee HW, Han JW, Hahn SM, Kang WJ
Clin Nucl Med
· 2026 Jun · PMID 42302721
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BACKGROUND: Pediatric non-Hodgkin lymphoma (NHL) is the third most common childhood malignancy, but reliable prognostication remains challenging. This study aimed to evaluate the prognostic value of baseline 18F-FDG PET/...BACKGROUND: Pediatric non-Hodgkin lymphoma (NHL) is the third most common childhood malignancy, but reliable prognostication remains challenging. This study aimed to evaluate the prognostic value of baseline 18F-FDG PET/CT parameters reflecting disease spread, the largest interlesion distance (Dmax), and total metabolic tumor volume (TMTV), in pediatric patients with NHL. PATIENTS AND METHODS: We retrospectively enrolled 98 pediatric patients with NHL (74 males, 24 females; median age, 10.4 y; range, 0.3-17.9 y) who underwent FDG PET/CT for staging between January 2008 and November 2024. TMTVs were defined using a 41% maximum standardized uptake value threshold. Distances between all lesion pairs were calculated to determine Dmax. Prognostic significance of FDG PET/CT parameters and clinical factors for survival outcomes was evaluated using univariate analysis. RESULTS: Based on surrogate TMTV (sTMTV) and sDmax, patients were stratified into no (n = 61), 1-risk (n = 17), and 2-risk factor groups (n = 20). In the univariate analysis, advanced stage (≥IV), bone marrow involvement, elevated serum lactate dehydrogenase (LDH) level (>500 IU/L), sTMTV, sDmax, and the PET-based risk group were significant prognostic factors for event-free survival (P < 0.05). For overall survival, significant factors included LDH level, sTMTV, sDmax, and the PET-based risk group (P < 0.05). The PET-based risk stratification was also reflected in survival outcomes. CONCLUSIONS: sTMTV and sDmax derived from FDG PET/CT are significant prognostic biomarkers in pediatric NHL. Their combination enables effective stratification of pediatric patients with NHL into distinct risk groups and may inform future risk-adapted management strategies, potentially improving survival in this population.
Clin Nucl Med
· 2026 Jun · PMID 42302403
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OBJECTIVES: To evaluate and compare the therapeutic response, progression-free survival (PFS), overall survival (OS), and clinical toxicity of targeted alpha therapy (TAT) [225Ac]Ac-DOTATATE and salvage [177Lu]Lu-DOTATAT...OBJECTIVES: To evaluate and compare the therapeutic response, progression-free survival (PFS), overall survival (OS), and clinical toxicity of targeted alpha therapy (TAT) [225Ac]Ac-DOTATATE and salvage [177Lu]Lu-DOTATATE peptide receptor radionuclide therapy (PRRT) in metastatic neuroendocrine tumor (NET) patients who showed an objective response or disease stabilization following an initial course of [177Lu]Lu-DOTATATE PRRT and eventually developed progressive disease after a time interval of more than 6 months. PATIENTS AND METHODS: This was a single-institution, retrospective observational analysis conducted at a tertiary care institute. The medical records of metastatic NET patients who had been previously treated with an initial course of PRRT (I-PRRT) with 4-6 cycles of [177Lu]Lu-DOTATATE and showed an objective response or stable disease (SD) on the Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1) criteria after I-PRRT, but eventually developed progressive disease (PD) after a time gap of more than 6 months, and subsequently received [225Ac]Ac-DOTATATE or salvage [177Lu]Lu-DOTATATE were analyzed. These patients with matched baseline characteristics (site of primary disease, WHO grading of tumors, Ki-67 index, disease burden, [18F]F-FDG avidity, and previously treatments) were divided into the 2 treatment arms based on the treatment received by them, which in turn depended upon availability of therapeutic radionuclide, patient choice, and financial constraints as follows: Arm A: [225Ac]Ac-DOTATATE and Arm B: salvage [177Lu]Lu-DOTATATE. The treatment response was evaluated under 3 categories for all patients: (a) symptomatic, (b) biochemical, and (c) functional and anatomic imaging response. RESULTS: A total of 40 patients with metastatic NET (20 in each arm) were included and analyzed in the study. On the symptomatic response, 3 (15%) patients demonstrated a complete response (CR), and 7 (35%) patients demonstrated partial response (PR) in arm A, compared with no CR and PR of 4 (20%) patients in arm B. Biochemical response assessed by using serum CgA showed partial improvement in 10 (50%) patients in arm A versus 5 (25%) patients in arm B. On anatomic imaging, the disease control rate (DCR) was found to be 80% in arm A and 60% in arm B. The objective response rate (ORR) calculated based upon RECIST 1.1 criteria was 35% in arm A and 10% in arm B. The median progression-free survival was 10 months (95% CI, 6.0-24.0) in arm A and 12 months (95% CI, 4.0-33.0) in arm B, while the median overall survival was 16 months (95% CI, 10-16) in arm A and was not reached in arm B; neither difference reached statistical significance. Toxicities in both arms were predominantly mild and manageable, with no grade 3 or higher adverse events in either arm. CONCLUSIONS: This observational study shows that [225Ac]Ac-DOTATATE and salvage PRRT with [177Lu]Lu-DOTATATE are both efficacious and well-tolerated treatments for progressive metastatic NETs without high-grade toxicity. The numerically superior clinical, biochemical, and imaging response rates observed with TAT indicate that alpha-emitting radionuclides may partly overcome resistance to prior beta-emitter therapy. Prospective, larger multicenter randomized trials are needed to validate these findings, refine patient selection, and determine the appropriate treatment of alpha- or salvage beta-emitting radionuclide therapies in progressive NETs.
Clin Nucl Med
· 2026 Jun · PMID 42302400
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A 71-year-old woman receiving paclitaxel, carboplatin, and pembrolizumab for breast carcinoma developed severe diarrhea, followed by hypovolemic shock with generalized edema, raising suspicion of immune checkpoint inhibi...A 71-year-old woman receiving paclitaxel, carboplatin, and pembrolizumab for breast carcinoma developed severe diarrhea, followed by hypovolemic shock with generalized edema, raising suspicion of immune checkpoint inhibitor-related capillary leak syndrome. Dynamic scintigraphy was performed using intravenous technetium-99m-labeled human serum albumin combined with induced transient venous stasis. Baseline 3D CZT SPECT imaging showed symmetrical vascular activity. Cuff inflation induced a progressive unilateral increase in tracer uptake consistent with albumin extravasation, followed by incomplete washout. Volumetric leak imaging enabled precise localization of capillary leakage. This case illustrates the potential of 3D CZT-ring cameras for dynamic functional assessment of vascular permeability.
Clin Nucl Med
· 2026 Jun · PMID 42302393
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A 76-year-old man with mildly elevated prostate-specific antigen (PSA, 5.44ng/mL) and a PI-RADS 5 lesion on multiparametric MRI underwent dual-tracer PET/CT. 68Ga-PSMA PET/CT revealed focal intense uptake in one prostati...A 76-year-old man with mildly elevated prostate-specific antigen (PSA, 5.44ng/mL) and a PI-RADS 5 lesion on multiparametric MRI underwent dual-tracer PET/CT. 68Ga-PSMA PET/CT revealed focal intense uptake in one prostatic lobe, while 18F-FDG PET/CT demonstrated avid uptake in the contralateral lobe. Histopathology confirmed synchronous high-grade prostatic adenocarcinoma (Gleason 9) and sarcomatoid carcinoma with osteosarcomatous differentiation. This discordant dual-tracer pattern highlights the complementary role of PSMA and FDG PET/CT in detecting molecularly divergent synchronous prostatic malignancies.
Baehr M, Schellinger PD, Borggrefe J
… +1 more, Surov A
Clin Nucl Med
· 2026 Jun · PMID 42302392
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Immunoreactive encephalitis is a very rare side effect of immunotherapy, which can lead to severe morbidity. Following azetolizumab, it typically occurs within 0-12 months, with a median of 15 days. In this case, immunor...Immunoreactive encephalitis is a very rare side effect of immunotherapy, which can lead to severe morbidity. Following azetolizumab, it typically occurs within 0-12 months, with a median of 15 days. In this case, immunoreactive encephalitis occurred 3.5 months after treatment with azetolizumab ended and 15.5 months after it began. Tumefactive demyelinating lesions represent a focal cerebral lesion with inflammatory demyelination. They are usually associated with multiple sclerosis, but can also occur drug-induced or in the context of autoantibody-mediated diseases. In MRI, tumefactive demyelinating lesions mimic cerebral metastases. 18F-FDG PET/CT can enhance the diagnostic precision of both immunoreactive encephalitis and tumefactive demyelinating lesions.
Kitano Y, Miyake KK, Kawashima M
… +2 more, Shimizu Y, Nakamoto Y
Clin Nucl Med
· 2026 Jun · PMID 42302389
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We report the first documented case of focal nodular hyperplasia (FNH) demonstrating intense uptake on 18F-fluoroestradiol (18F-FES) PET/CT. A 46-year-old premenopausal woman with newly diagnosed ER-positive invasive lob...We report the first documented case of focal nodular hyperplasia (FNH) demonstrating intense uptake on 18F-fluoroestradiol (18F-FES) PET/CT. A 46-year-old premenopausal woman with newly diagnosed ER-positive invasive lobular breast cancer underwent whole-body 18F-FES PET/CT, which incidentally revealed a 3-cm hepatic mass with uptake comparable to physiological liver activity. Multimodality imaging (MRI, dynamic CT, and Sonazoid ultrasonography) showed characteristic features of FNH, which remained stable for 4 years. This case demonstrates that FNH can exhibit marked FES uptake. Awareness of this benign cause of FES avidity is important to avoid misinterpreting hepatic FES-avid lesions as metastasis.
Nakashima M, Iguchi T, Sugimoto S
… +3 more, Higaki F, Toyooka S, Takao H
Clin Nucl Med
· 2026 Jun · PMID 42302385
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BACKGROUND: Chronic lung allograft dysfunction (CLAD) is a major cause of late morbidity after lung transplantation, and spirometry lacks the ability to detect regional lung changes. Thus, in this study, we investigated...BACKGROUND: Chronic lung allograft dysfunction (CLAD) is a major cause of late morbidity after lung transplantation, and spirometry lacks the ability to detect regional lung changes. Thus, in this study, we investigated whether quantitative perfusion single-photon emission CT/CT parameters can distinguish CLAD from non-CLAD lungs and how they relate to pulmonary function. PATIENTS AND METHODS: This retrospective study included 80 lung transplant recipients who underwent SPECT/CT. Standardized uptake value (SUV)mean, total lung uptake (TLU), and percentage injected dose (%ID) were calculated, and group differences, receiver operating characteristic performance, and correlations with forced expiratory volume in 1 second, forced vital capacity, and total lung capacity were analyzed. RESULTS: No significant difference was observed for SUVmean (P = 0.250), whereas TLU and %ID were significantly lower in CLAD (P < 0.0001). Area under the curve values were 0.56 (SUVmean), 0.76 (TLU), and 0.78 (%ID). %ID showed the best accuracy (cutoff: 0.83; sensitivity: 65.0%; specificity: 83.8%). CONCLUSIONS: Volume-based metrics, especially %ID, serve as useful noninvasive indicators for the assessment of CLAD.
Bregenzer CM, Trepp R, Dammann F
… +3 more, Kaderli RM, Chouchane A, Seifert R
Clin Nucl Med
· 2026 Jun · PMID 42302384
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An 80-year-old man with hypercalcemia and hyperparathyroidism was suspected of having a parathyroid adenoma, which was localized on [18F]F-choline-PET/CT. Still, after surgical removal of the suspected adenoma with an in...An 80-year-old man with hypercalcemia and hyperparathyroidism was suspected of having a parathyroid adenoma, which was localized on [18F]F-choline-PET/CT. Still, after surgical removal of the suspected adenoma with an intraoperative parathyroid hormone decrease of >50%, severe hypercalcemia recurred quickly. A repeated [18F]F-choline-PET/CT raised suspicion of a single contralateral parathyroid adenoma or multiglandular disease. Given the inconclusive findings, a histological reassessment of the suspected parathyroid adenoma showed the presence of a singular vessel invasion, which alerted the diagnosis to parathyroid carcinoma. An additionally performed [18F]FDG-PET/CT revealed a liver lesion and MRI confirmed multiple liver metastases, which could not be seen on [18F]F-choline-PET/CT.