Garcia JR, Vallejos V, Niñerola A
… +1 more, Jover R
Rev Esp Med Nucl Imagen Mol (Engl Ed)
· 2026 May · PMID 42178026
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OBJECTIVE: To analyze the participation of Nuclear Medicine specialists in multidisciplinary committees (MCs) in Spain, assessing their level of involvement, perception of performance, main challenges, and areas for impr...OBJECTIVE: To analyze the participation of Nuclear Medicine specialists in multidisciplinary committees (MCs) in Spain, assessing their level of involvement, perception of performance, main challenges, and areas for improvement. METHOD: A descriptive, cross-sectional observational study was conducted using a structured survey designed by the Management and Quality Working Group (GTGyC) of the Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM). The questionnaire included closed and open-ended questions about professional profile, participation in MCs, their organization, available resources, perceived barriers, and satisfaction level. The survey was distributed through SEMNIM's institutional platform and via email to all members and registered services. Responses were collected between January and September 2025. RESULTS: A total of 86 responses were analyzed: 81 specialists (94.2%) and 5 residents (5.8%). Most worked in the public healthcare sector (93%) and had more than five years of experience (70.9%). 94.2% participate in oncology committees, and 32.6% in more than three committees. 97.7% attend at least one weekly session, dedicating between 10% and 30% of their working time to preparation. Overall satisfaction with MC performance was high (87.2% scored >7). However, relevant areas for improvement were identified, mainly in case management (59.4%), available infrastructure (51.3%), and interprofessional coordination (43%). 91.9% consider the representation of specialties adequate, and 74.4% confirmed the existence of standardized protocols. Likewise, 87.7% perceived a positive impact of their participation on diagnostic quality and clinical outcomes. CONCLUSION: Nuclear Medicine plays an essential role in MCs, contributing significantly to multidisciplinary decision-making. Nevertheless, organizational challenges and resource limitations persist and must be addressed to optimize efficiency and ensure quality care.
Lyu Q, Lin D, Li S
… +5 more, Zhang J, Chen W, Chen D, Pan X, Liu D
Rev Esp Med Nucl Imagen Mol (Engl Ed)
· 2026 May · PMID 42178025
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OBJECTIVE: To evaluate the predictive performance of radiomics models based on F-FDG PET/CT for determining programmed cell death ligand-1 status in treatment-naïve gastric cancer. METHODS: This retrospective study inclu...OBJECTIVE: To evaluate the predictive performance of radiomics models based on F-FDG PET/CT for determining programmed cell death ligand-1 status in treatment-naïve gastric cancer. METHODS: This retrospective study included 170 gastric cancer patients who underwent preoperative F-FDG PET/CT. Patients were randomly assigned to training (n = 119) and testing (n = 51) cohorts. PD-L1 positivity was defined as a combined positive score ≥5. Radiomic features were extracted from PET, CT, and fused PET/CT images and processed through a comprehensive pipeline with multiple methods employed for normalization, preprocessing, and feature selection. Each pipeline retained 20 radiomic features, which were subsequently evaluated with 10 different classifiers using feature subsets ranging from 1 to 20 to identify the optimal radiomics model. Model performance was assessed by AUC, accuracy, and related metrics, with 5-fold cross-validation on the training set. RESULTS: The integrated PET/CT model achieved the best performance on the test set (AUC 0.750; accuracy 0.745). The CT-based model yielded a test AUC of 0.678 and accuracy of 0.762, while the PET-based model showed a test AUC of 0.653 and accuracy of 0.706. All three radiomics models outperformed the conventional metabolic-parameter model (AUC 0.578; accuracy 0.544). The optimal predictive pipeline varied across the different imaging modalities. CONCLUSION: Integrated F-FDG PET/CT radiomics demonstrated superior potential for noninvasive prediction of PD-L1 expression in gastric adenocarcinoma compared with single-modality imaging or metabolic parameters, supporting its potential utility for guiding patient selection for immunotherapy, with further validation warranted.
Pradère C, Mucientes Rasilla J, Navarro Matilla B
… +6 more, Manuel Meneses Soares P, Velásquez Díaz K, Garrido Solesio I, Grajeda Gallardo A, Del Pilar Estrella Caballero M, Mitjavila Casanovas M
Rev Esp Med Nucl Imagen Mol (Engl Ed)
· 2026 May · PMID 42128173
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OBJECTIVE: To systematically evaluate the available evidence on the prognostic value of F-FDG PET/CT-based radiomics in Hodgkin lymphoma (HL), its methodological limitations, and potential clinical implications. MATERIAL...OBJECTIVE: To systematically evaluate the available evidence on the prognostic value of F-FDG PET/CT-based radiomics in Hodgkin lymphoma (HL), its methodological limitations, and potential clinical implications. MATERIALS AND METHODS: A systematic search was conducted in PubMed following PRISMA guidelines. Observational studies or radiomic analyses within clinical trials were included if they evaluated patients with HL and assessed the prognostic value of radiomic features extracted from PET/CT by analyzing their association with survival, treatment response, or treatment refractoriness. Reviews, meta-analyses, and studies without clinical outcomes were excluded. Study quality was assessed using the Radiomics Quality Score (RQS). Given the limited number of studies, a narrative synthesis was performed. RESULTS: Of the 53 initially identified references, 9 retrospective studies met the inclusion criteria. In 7 studies, radiomic or multimodal models showed greater prognostic performance for progression-free survival and overall survival than clinical or volumetric models, with AUC values ranging from 0.86 to 0.92. Textural features derived from GLRLM, GLSZM, and NGTDM were independent predictors of adverse outcomes, with high hazard ratios. Two studies demonstrated a high ability to identify primary refractory disease (AUC > 0.95). Integrating multiple lesions increased predictive accuracy compared with the analysis of a single target lesion. Substantial variability persisted in feature segmentation, extraction, and standardization. CONCLUSIONS: Baseline F-FDG PET/CT-based radiomics provides relevant complementary prognostic information in HL, particularly for predicting survival and treatment refractoriness. However, methodological heterogeneity, small sample sizes, and the lack of external validation currently limit its clinical implementation. For radiomics to be realistically incorporated into clinical practice, further studies are needed that are externally validated in large, multicenter cohorts, methodologically reproducible, and widely available for use and validation.
Jiménez Heffernan A, Orta Tomás N, Pubul Nuñez V
… +1 more, Ruano Pérez R
Rev Esp Med Nucl Imagen Mol (Engl Ed)
· 2026 May · PMID 42119847
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Cardiac amyloidosis (CA) is an infiltrative myocardiopathy caused by extracellular deposits of misfolded proteins, with evolution to heart failure (HF) and high mortality. The main forms are light-chain amyloidosis (AL-C...Cardiac amyloidosis (CA) is an infiltrative myocardiopathy caused by extracellular deposits of misfolded proteins, with evolution to heart failure (HF) and high mortality. The main forms are light-chain amyloidosis (AL-CA) and transthyretin amyloidosis (ATTR-CA), including the wild type and hereditary. Cardiac involvement constitutes the main prognostic factor. Scintigraphy has transformed the diagnosis by identifying ATTR-CA without biopsy by cardiac imaging with [Tc]Tc-diphosphonates, especially with SPECT/CT, which also allows quantifying the amyloid load and thus, introducing prognostic value. Amyloid PET imaging with the new pan-amyloid Radiopharmaceuticals has expanded the diagnostic possibilities, further favoring quantification, early diagnosis and prognostic evaluation and therapeutic response. In parallel, the development of modifying therapies (TTR stabilizers, gene silencers and anti-amyloid agents) has changed the prognosis of patients with CA. This Continuing Education article describes the advances in molecular imaging and its integration with disease-modifying therapies.
OBJECTIVE: To evaluate salivary gland function in patients with rheumatoid arthritis (RA) and to assess its association with disease activity and systemic inflammatory markers. METHODS: In this retrospective study, 90 pa...OBJECTIVE: To evaluate salivary gland function in patients with rheumatoid arthritis (RA) and to assess its association with disease activity and systemic inflammatory markers. METHODS: In this retrospective study, 90 patients with RA and 50 age- and sex-matched healthy controls underwent ⁹⁹ᵐTcO₄ dynamic planar salivary gland scintigraphy. No SPECT or CT acquisition was performed. Maximum accumulation rate (MAR) and maximum secretion rate (MSR) were calculated for the parotid and submandibular glands. Associations with DAS28-CRP, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), and anti-cyclic citrullinated peptide antibodies (anti-CCP) were assessed using Spearman correlation analysis. RESULTS: RA patients showed significantly lower MAR and MSR compared with healthy controls (both P < 0.001). Salivary gland function declined progressively with increasing disease activity. MAR and MSR were negatively correlated with CRP, ESR, RF, and anti-CCP levels. CONCLUSION: Salivary gland dysfunction is common in RA patients without Sjögren's syndrome and is associated with disease activity and systemic inflammation. Dynamic planar salivary gland scintigraphy provides a non-invasive quantitative method for evaluating glandular function in RA. Prospective studies are warranted to further define its clinical role.
Martínez Albero E, Vega Pérez D, García Donoso C
… +5 more, García Bracamonte B, Martínez Gómez LC, Tietze JK, Castellucci P, Saviatto Nardi A
Rev Esp Med Nucl Imagen Mol (Engl Ed)
· 2026 Mar · PMID 41912030
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Non-melanoma skin cancer (NMSC), which includes basal cell carcinoma and cutaneous squamous cell carcinoma, is the most common malignant neoplasm worldwide, with an increasing incidence in Europe and Spain. Although surg...Non-melanoma skin cancer (NMSC), which includes basal cell carcinoma and cutaneous squamous cell carcinoma, is the most common malignant neoplasm worldwide, with an increasing incidence in Europe and Spain. Although surgery remains the treatment of choice, there are patients in whom this option is not feasible or does not ensure a satisfactory functional and esthetic outcome. Rhenium-188 (Re-188) resin represents a minimally invasive, painless, and outpatient therapeutic alternative, allowing the delivery of high doses of localized beta radiation to lesions up to 3 mm in depth while preserving healthy surrounding tissue. Its physical and radiobiological principles are based on the emission of beta particles with limited penetration and on both direct effects on tumor DNA and indirect effects mediated by reactive oxygen species and the bystander effect. Published clinical series report complete response rates above 90-95%, with low recurrence and an acceptable safety profile, predominantly grade 1-2 toxicity. Esthetic results are generally good to excellent, with high patient satisfaction. Moreover, promising outcomes have been described in non-approved indications such as extramammary Paget's disease and keloid scars. In conclusion, Re-188 resin therapy constitutes an effective and safe option for selected patients with NMSC, particularly those who are not candidates for surgery or have lesions in anatomically complex locations. Its progressive implementation in specialized centers will help standardize protocols and expand the available clinical evidence.
Garcia JR, Pinilla L, Compte A
… +9 more, Garrido N, Mont-Castro LL, Ruiz S, Garcia Magro J, Santabárbara JM, Tovar D, Mourelo S, Soria M, Riera E
Rev Esp Med Nucl Imagen Mol (Engl Ed)
· 2026 Mar · PMID 41856314
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OBJECTIVE: To evaluate the impact of initial staging in prostate cancer patients using 18F-PSMA PET/MR and to analyze the prognostic value of pre-treatment PET/MRI imaging biomarkers. METHODS: Prospective study of 50 con...OBJECTIVE: To evaluate the impact of initial staging in prostate cancer patients using 18F-PSMA PET/MR and to analyze the prognostic value of pre-treatment PET/MRI imaging biomarkers. METHODS: Prospective study of 50 consecutive patients diagnosed with intermediate/high-risk prostate cancer. Simultaneous acquisition on PET/MR (SIGNA GE) 1 h after intravenous administration of 370 ± 10% MBq of 18F-PSMA-1007: - Prostate (20 min): PET emission + mpMRI sequences: DIXON, T1, T2, DWI, DCE. - Whole-body (30 min): PET emission + MR sequences: DIXON, T1, T2, DWI, STIR. Consensus between nuclear medicine physician and radiologist for T, nodal, and metastatic staging. Visual interpretation. Treatment selection by multidisciplinary tumor board. SUV and ADC values were calculated. Pearson correlation analysis was performed. Radiomic analysis included extraction of 93 features: first-order and texture-based. Significant differentiation was assessed using ANOVA between two prognostic groups: (1) TxN0M0 or TxN1M0; (2) TxN1M1a or M1b. RESULTS: PET/MRI enabled comprehensive staging in a single session, classifying 28% of patients as T3b and detecting extraprostatic disease in 44% (28% oligometastatic, 16% polymetastatic). PET/MRI concordance for extracapsular extension and seminal vesicle infiltration was high in T3b (85.7%) but markedly lower in T3a (25%). SUVmax/ADC correlation was inverse and significant (P < .05). Texture features showed superior discriminative ability compared to conventional parameters, achieving an AUC of 0.79 for differentiating advanced T stages. Following PET/MR, 66% of patients underwent radical prostatectomy (with targeted lymphadenectomy in N1), 18% received image-guided radiotherapy, and 16% systemic therapy, without performing surgery in cases with extracapsular extension or metastatic disease. CONCLUSION: PET/MRI with [18F]F-PSMA-1007 is a feasible and effective technique for initial staging of intermediate/high-risk prostate cancer, acting as a comprehensive "one-stop" diagnostic procedure. Its high sensitivity for nodal and bone disease, combined with integration of radiomic biomarkers, provides prognostic value and enables optimization of personalized therapeutic decisions.
Yalçınkaya M, Demir F, Karaçavuş S
… +1 more, Demir M
Rev Esp Med Nucl Imagen Mol (Engl Ed)
· 2026 Mar · PMID 41850431
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OBJECTIVE: This study aims to retrospectively evaluate the renal and hematologic toxicity profile of Lu-PSMA-RLT in patients with metastatic castration-resistant prostate cancer. METHODS: Renal function (GFR, BUN, and cr...OBJECTIVE: This study aims to retrospectively evaluate the renal and hematologic toxicity profile of Lu-PSMA-RLT in patients with metastatic castration-resistant prostate cancer. METHODS: Renal function (GFR, BUN, and creatinine) and hematological parameters (hemoglobin, leukocyte, platelet) before and after treatment were examined in 41 patients who received Lu-PSMA-RLT at our clinic, and changes along with toxicity grades were determined. Additionally, pre-treatment PSMA PET/CT findings and other demographic and clinical data were assessed. RESULTS: In terms of renal toxicity, G0-G1 level toxicity was observed in 97.6% of cases, while G2 toxicity was observed in only one patient. This patient already had a low GFR before treatment and experienced only a 2-unit decrease. Regarding hematological toxicity, the rates of G3-4 toxicity were as follows: leukocytes 7.3%, hemoglobin 9.8%, platelets 7.3%. CONCLUSION: No clinically significant nephrotoxicity was observed with Lu-PSMA-RLT. Hematologic toxicity is significant but manageable, and severe side effects are rare and within predictable limits.
Rev Esp Med Nucl Imagen Mol (Engl Ed)
· 2026 Feb · PMID 41720219
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OBJECTIVE: This study aimed to investigate the relationship between left ventricular phase analysis parameters and Peak Emptying Rate (PER) with ejection fraction (EF); to evaluate the role of PER in predicting early sys...OBJECTIVE: This study aimed to investigate the relationship between left ventricular phase analysis parameters and Peak Emptying Rate (PER) with ejection fraction (EF); to evaluate the role of PER in predicting early systolic dysfunction; and to examine how these parameters are affected by the severity of coronary artery disease (CAD) in patients with ischemia or infarction detected by gated myocardial perfusion scintigraphy (gMPS). MATERIALS AND METHODS: Data from 430 patients who underwent myocardial perfusion scintigraphy for confirmed or suspected CAD were retrospectively analyzed. Based on perfusion defect scores, patients were categorized into three groups: normal (142 patients, SSS ≤ 3), ischemia (140 patients, SSS ≥ 4, reversible defect), and infarction (148 patients, SSS ≥ 4, fixed defect). Systolic and diastolic functional parameters of the left ventricle (EF, EDV, ESV, PER, PFR, TPFR) and synchrony indices (phase standard deviation [SD], histogram bandwidth [HBW]) were measured and compared across groups. RESULTS: EF values (65, 60, and 43%) and PER values (3.15, 2.94, and 2.06 s¹) progressively decreased from the normal to the ischemia and infarction groups, with statistically significant differences among groups (p < 0.001). Synchrony indices (SD and HBW) increased markedly, especially in the infarction group (mean HBW: 60.86-75.01 - 149.31; p < 0.001). In both ischemia and infarction groups, significant correlations were observed between synchrony (HBW) and systolic (EF, PER) as well as diastolic (PFR, TPFR) parameters, with the strongest associations in the infarction group (p < 0.001). CONCLUSION: Progressive coronary artery disease is associated with worsening left ventricular systolic and diastolic function, along with impaired mechanical contraction synchrony. PER may serve as a valuable scintigraphic parameter for improving the diagnostic assessment of left ventricular systolic function.
Dos Santos SG, Fernandes AM, Ferreira G
… +2 more, Santos AP, Sampaio IL
Rev Esp Med Nucl Imagen Mol (Engl Ed)
· 2026 Feb · PMID 41720218
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PURPOSE: Evidence from randomized control trials supporting peptide receptor radionuclide therapy (PRRT) with [177Lu]Lu DOTATATE in patients with lung neuroendocrine tumors (NETs) is limited. Real world data is needed. M...PURPOSE: Evidence from randomized control trials supporting peptide receptor radionuclide therapy (PRRT) with [177Lu]Lu DOTATATE in patients with lung neuroendocrine tumors (NETs) is limited. Real world data is needed. METHODS: We conducted a retrospective cohort study of patients with metastatic or unresectable lung carcinoid tumors treated with [177Lu]Lu-DOTATATE at a single Tertiary Oncology Center. Radiographic response (objective response rate - ORR; disease control rate - DCR), progression-free survival (PFS), overall survival (OS) and treatment toxicity (CTCAE v4) were assessed. Exploratory univariate Cox regression analyses were performed to evaluate predictors of PFS and OS. RESULTS: Twenty-two patients were included. The ORR was 31.8%, with DCR of 63.6%. Median PFS was 19 months (95% CI, 10-28), and median OS was 46 months (95% CI, 38-53). No grade 3/4 toxicities were observed. Symptom improvement was reported in 35.7% of symptomatic patients. Prior treatment with somatostatin analogues was significantly associated with longer PFS (HR 0.18, 95% CI, 0.05-0.62, p = 0.007), while respiratory symptoms were associated with shorter PFS (HR 5.01, 95% CI, 1.44-17.87, p = 0.012). CONCLUSIONS: PRRT with [177Lu]Lu-DOTATATE appears to be safe and effective for patients with advanced lung carcinoids. These findings support PRRT as a valuable treatment option in selected patients, while highlighting the urgent need for prospective trials to establish its role in lung NETs.