Nuclear Medicine

RECIP 1.0: standardized PSMA PET/CT response criteria with survival prognostic value

RECIP 1.0 defines PSMA PET/CT response using changes in PSMA-positive total tumor volume plus appearance of new lesions. It categorizes advanced prostate cancer into complete, partial, stable, or progressive disease, addressing bone-only and early metastatic changes. RECIP-defined responses correlate strongly with overall and progression-free survival, supporting use as imaging endpoints in trials and practice. A visual RECIP approach shows excellent concordance with quantitative segmentation, but manual tumor segmentation remains labor-intensive. 1

PSMA radioligand therapy advances beyond 177Lu-PSMA-617 toward alphas, combinations, and personalization

177Lu-PSMA-617 improves overall and progression-free survival versus standard care in metastatic castration-resistant prostate cancer, establishing PSMA RLT as a major treatment pillar. Alpha emitters like 225Ac and isotopes such as terbium-161 aim to overcome resistance and better address micrometastatic disease. Combination regimens with PARP inhibitors, immune checkpoint blockade, and androgen receptor pathway inhibitors show early signs of added efficacy. Advances in imaging, dosimetry, and molecular diagnostics support more refined patient selection and adaptive dosing schemes. 2

Interpretable XGBoost model enhances CAD diagnosis from multiparametric PET MPI

An XGBoost model integrated 10 PET-derived parameters, including CAC, MBF, MFR, TPD, LV function, and clinical variables from cardiac PET/CT. In 1,278 angiography-validated patients, the model achieved AUC 0.83 for obstructive CAD, exceeding experienced physicians at 0.80. It outperformed individual biomarkers such as ischemic TPD and MFR, with statistically significant AUC differences. Diagnostic performance remained consistent across sex, body mass index, and age strata. 3

18F-Florbetazine shows specific cardiac amyloid binding with favorable early human kinetics

In vitro autoradiography demonstrated specific, high-affinity binding of 18F-Florbetazine to AL and ATTR cardiac amyloid deposits. In rats, the tracer exhibited rapid myocardial and renal uptake followed by efficient clearance from normal tissues. Healthy volunteers showed minimal myocardial and renal background by 40 minutes post-injection, supporting delayed imaging protocols. A patient with biopsy-proven AL amyloidosis had intense delayed myocardial and renal uptake concordant with known organ involvement. 4