Nuclear Medicine

FAP-2286 PET/CT enhances metastatic breast cancer detection and supports FAP-targeted therapy

In 20 patients with suspected recurrent or metastatic breast cancer, [68Ga]Ga-FAP-2286 PET/CT detected more lesions than [18F]FDG PET/CT (85.4% vs 70.5%). Detection gains were most pronounced for hepatic and bone metastases, while performance for primary tumors and nodal disease was similar between tracers. FAP-2286 showed higher SUVmax and TBR in bone metastases, potentially improving lesion conspicuity and quantitative assessment. In four patients, [177Lu]Lu-FAP-2286 therapy produced sustained tumor uptake with measurable absorbed doses and acceptable short-term safety over four months. 1

Two-day PSA change predicts response and survival after first 177Lu-PSMA-617 cycle

This retrospective study in 76 mCRPC patients evaluated PSA change two days after the first [177Lu]Lu-PSMA-617 cycle. Patients were grouped as early PSA decrease (< -10%), stable PSA (-10% to +10%), or increase (> +10%). Those with early PSA decrease or stable PSA were more likely to achieve partial biochemical response by PCWG3 criteria than those with PSA increase. Early PSA decrease or stability was also associated with longer mean overall survival compared with early PSA increase. Day-2 PSA offers a simple, rapid marker for early risk stratification during PSMA-radioligand therapy. 2

WBC SPECT/CT outperforms MRI for initial diabetic foot osteomyelitis diagnosis

In 47 patients with suspected diabetic foot osteomyelitis, 99mTc-WBC SPECT/CT and MRI were prospectively compared against bone biopsy. For initial diagnosis, WBC SPECT/CT achieved higher sensitivity and specificity than MRI (85% and 79% vs 73% and 43%). Positive and negative predictive values were also superior for WBC SPECT/CT, supporting its use as a primary diagnostic tool. Among 20 patients reimaged after antibiotics, WBC SPECT/CT and MRI showed identical performance, with 75% sensitivity and specificity each. These findings support WBC SPECT/CT for baseline evaluation and either modality for monitoring treatment response. 3

The Centamine scale standardizes dopaminergic PET/SPECT quantification in Parkinson’s disease

This study introduces the Centamine scale to harmonize dopaminergic imaging metrics across tracers and modalities. Level 1 defined Centamines using [123I]ioflupane SPECT data from 224 healthy subjects. Level 2 mapped [18F]AV133 PET onto the Centamine scale using head-to-head data from 68 participants. Regional correlations between tracers were moderate to strong (R2 0.51–0.83), with mapped Centamine values differing by only 1.5–3%. This framework could enable consistent dopaminergic imaging endpoints in multicenter Parkinson’s disease trials and longitudinal follow-up. 4