Hier finden Sie die aktuellsten Publikationen aus dem Gebiet der Nuklearmedizin in Österreich. Zusätzlich sind die Publikationen aus den Teilbereichen der PET, SPECT sowie nuklearmedizinischen Therapien unserer Kollegen in Österreich gesondert hervorgehoben.
Rezente Publikationen in Österreich
Development and External Validation of an Updated Nomogram Including Both MRI and Local PSMA PET/CT Information for the Prediction of Side-specific Extraprostatic Extension in Patients Treated with Radical Prostatectomy
Sweere V, Slot AB, Heetman JG, Hermsen R, Wever L, Lavalaye J, Vinken M, Bahler CD, Tann M, Kesch C, Telli T, Fendler WP, Chiu PK, Kit Wu SK, Zattoni F, Evangelista L, Ceci F, Miszczyk M, Rajwa P, Matsukawa A, Fazekas T, Barletta F, Briganti A, Gandaglia G, Van Basten JA, Van Melick HHE, Van den Bergh RCN, Marra G, Scheltema MJV and Soeterik TFW
Development and External Validation of an Updated Nomogram Including Both MRI and Local PSMA PET/CT Information for the Prediction of Side-specific Extraprostatic Extension in Patients Treated with Radical Prostatectomy
Sweere V, Slot AB, Heetman JG, Hermsen R, Wever L, Lavalaye J, Vinken M, Bahler CD, Tann M, Kesch C, Telli T, Fendler WP, Chiu PK, Kit Wu SK, Zattoni F, Evangelista L, Ceci F, Miszczyk M, Rajwa P, Matsukawa A, Fazekas T, Barletta F, Briganti A, Gandaglia G, Van Basten JA, Van Melick HHE, Van den Bergh RCN, Marra G, Scheltema MJV and Soeterik TFW
The predictive value of prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) for extraprostatic extension (EPE) in prostate cancer remains unclear.
PSMA PET/CT Kinetics During Systemic Therapy and Radiotherapy in Hormone-sensitive Prostate Cancer: A Systematic Review
Le Guévelou J, Bauckneht M, Soeterik TFW, Scheltema M, Bianchi L, Kesch C, Gandaglia G, Rajwa P, Nicoletti R, Zattoni F, Martini A, Fasulo V, Kasivisvanathan V, Preisser F, Sanchez LR, Ambrosini F, Falagario U, Fazekas T, Giesen A, Rovera G, Maggi M, Mercinelli C, Miszczyk M, Rivas JG, Windisch O, Stroomberg H, Rui B, Bourgi A, Tilki D, Marra G and
PSMA PET/CT Kinetics During Systemic Therapy and Radiotherapy in Hormone-sensitive Prostate Cancer: A Systematic Review
Le Guévelou J, Bauckneht M, Soeterik TFW, Scheltema M, Bianchi L, Kesch C, Gandaglia G, Rajwa P, Nicoletti R, Zattoni F, Martini A, Fasulo V, Kasivisvanathan V, Preisser F, Sanchez LR, Ambrosini F, Falagario U, Fazekas T, Giesen A, Rovera G, Maggi M, Mercinelli C, Miszczyk M, Rivas JG, Windisch O, Stroomberg H, Rui B, Bourgi A, Tilki D, Marra G and
Although prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) is commonly used for both initial staging and restaging at biochemical recurrence for patients diagnosed with prostate cancer (PCa), its role in the evaluation of treatment response is currently not validated.
Beyond radiotheranostics: how imaging modality defines theranostics
Pashkunova-Martic I, Pichler V and Helbich TH
Beyond radiotheranostics: how imaging modality defines theranostics
Pashkunova-Martic I, Pichler V and Helbich TH
Theranostics integrates diagnostic imaging and therapy within a single platform, enabling image-guided treatment delivery, real-time monitoring, and therapeutic optimization. The choice of imaging modality fundamentally shapes the design, functionality, and clinical maturity of theranostic systems. This review examines the theranostic concept through the lens of major imaging modalities employed in clinical and preclinical practice, including positron emission tomography (PET), single-photon emission computed tomography (SPECT), ultrasound (US), optical imaging (OI), magnetic resonance imaging (MRI), and computed tomography (CT). Beyond modality-specific approaches, the review highlights emerging multimodal theranostic strategies that integrate complementary imaging technologies to overcome individual limitations, enhance biological specificity, and improve treatment guidance. For each modality, we discuss the structural components of theranostic agents, their mechanisms of action, and the balance between diagnostic sensitivity and therapeutic efficacy. The review also highlights current and emerging clinical applications across major disease areas, while critically addressing limitations, such as spatial resolution, depth penetration, toxicity, and translational barriers. Overall, this article underscores that theranostics are expanding from modality-defined implementation toward integrated, multimodal strategies that are likely to shape the next generation of personalized and precision imaging-guided therapies. RELEVANCE STATEMENT : Imaging modality-driven theranostic design enables more precise, adaptive, and personalized image-guided therapies by aligning diagnostic sensitivity with therapeutic mechanisms, thereby improving treatment selection, response monitoring, and translational integration across clinical disciplines. KEY POINTS: Theranostics is determined by the underlying imaging modality rather than by a unified theranostic framework. Imaging modality dictates integration strategy. Nuclear medicine theranostics are clinically established, while MRI-, CT-, ultrasound-, and optical-based theranostics remain largely translational or function primarily as image-guided therapies. Multimodal theranostics address modality-specific limitations. Future progress depends on imaging-driven design and standardization.
Repeated metastasis-directed radiotherapy in patients with oligorecurrent prostate cancer: outcomes and risk stratification from a large multinational PSMA PET-guided cohort
van der Walle R, van Bergen TD, Miszczyk M, Peters M, Bilski M, Francolini G, Garlatti P, Mezeckis M, Kociolek J, Teunissen FR, Westhoff PG, Braat AJAT, van den Berg CAT, Shariat SF, Eppinga WSC, Aluwini S and Soeterik TFW
Repeated metastasis-directed radiotherapy in patients with oligorecurrent prostate cancer: outcomes and risk stratification from a large multinational PSMA PET-guided cohort
van der Walle R, van Bergen TD, Miszczyk M, Peters M, Bilski M, Francolini G, Garlatti P, Mezeckis M, Kociolek J, Teunissen FR, Westhoff PG, Braat AJAT, van den Berg CAT, Shariat SF, Eppinga WSC, Aluwini S and Soeterik TFW
Repeated metastasis-directed radiotherapy (MDRT) is increasingly used in patients with metachronous oligometastatic prostate cancer. However, the efficacy and optimal patient selection criteria remain insufficiently defined.
Segment-based comparison of multiparametric MRI, Gallium-68-PSMA-PET/CT and combined imaging with histopathology in prostate cancer
Schmidt CJ, Bernhardt M, Kristiansen G, Gaertner FC, Kreppel B, Essler M, Luetkens JA, Attenberger U, Anspach M, Ohlmann CH, Hauser S, Ellinger J, Ritter M and Krausewitz P
Segment-based comparison of multiparametric MRI, Gallium-68-PSMA-PET/CT and combined imaging with histopathology in prostate cancer
Schmidt CJ, Bernhardt M, Kristiansen G, Gaertner FC, Kreppel B, Essler M, Luetkens JA, Attenberger U, Anspach M, Ohlmann CH, Hauser S, Ellinger J, Ritter M and Krausewitz P
To compare the segment-based diagnostic performance of multiparametric magnetic resonance imaging (mpMRI), Gallium-68-prostate-specific membrane antigen-positron emission tomography/computed tomography (Ga-PSMA-PET/CT), for detecting histopathologically confirmed prostate cancer (PCa).
Gallium-68 and zirconium-89 complexes of DFO-analogs for molecular imaging applications using PET/CT
Maradan RAJ, Neuzilova B, Kronberger J, Feiner I, Guarrochena X, Kılçar AY, Ralis J, Petrik M and Mindt TL
Gallium-68 and zirconium-89 complexes of DFO-analogs for molecular imaging applications using PET/CT
Maradan RAJ, Neuzilova B, Kronberger J, Feiner I, Guarrochena X, Kılçar AY, Ralis J, Petrik M and Mindt TL
The β-emitters gallium-68 (Ga) and zirconium-89 (Zr) are among the most widely used metallic radionuclides in nuclear medicine for diagnostic imaging by Positron Emission Tomography (PET). Inspired by nature's bacterial siderophore desferrioxamine-B (DFO), a number of structurally related oligohydroxamate-based chelators have been studied for the complexation of both radiometals and for applications in nuclear medicine. We report here the solid phase (sp) synthesis of a new member of this family of acyclic chelators, DFO* 3, and its comparison with DFO 1 (control) and DFO-analogs DFO* 2, and oxoDFO* 4 in vitro and in vivo.
Molecular imaging in adult spondylodiscitis: current evidence, clinical applications, and future perspectives
Al-Ibraheem A, Estrada-Lobato E, Ruzzeh S, Brink A, Giammarile F, Al-Foqahaa M, Al-Jaddadi M, Hussain S, Amro A and Paez D
Molecular imaging in adult spondylodiscitis: current evidence, clinical applications, and future perspectives
Al-Ibraheem A, Estrada-Lobato E, Ruzzeh S, Brink A, Giammarile F, Al-Foqahaa M, Al-Jaddadi M, Hussain S, Amro A and Paez D
Adult spondylodiscitis is an infection of the intervertebral disc and adjacent vertebral bodies that may progress to paravertebral extension, epidural involvement, spinal instability, sepsis, and neurological compromise. Because clinical symptoms and laboratory markers are often nonspecific, imaging is central to diagnosis, assessment of disease extent, biopsy planning, and selective evaluation of treatment response. Magnetic resonance imaging (MRI) remains the first-line anatomical technique for early marrow, disc, epidural, and paraspinal disease, while computed tomography (CT) is valuable for osseous destruction, instability, and biopsy guidance. Molecular imaging complements these modalities by depicting biological activity rather than structure alone. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ([18F]FDG PET/CT) is the most established molecular technique, offering high diagnostic performance, whole-body evaluation for multifocal or metastatic infection, and support for management when MRI is contraindicated, equivocal, or difficult to interpret after surgery. Its main limitations are limited pathogen specificity, uptake in sterile inflammatory or reparative processes, heterogeneous interpretation criteria, and uncertain thresholds for treatment monitoring. Emerging approaches, including hybrid positron emission tomography/magnetic resonance imaging (PET/MRI), fibroblast activation protein inhibitor (FAPI) tracers, pathogen-targeted radiopharmaceuticals, quantitative PET biomarkers, and artificial intelligence (AI), remain investigational and require prospective validation of diagnostic and clinical utility. This review summarizes current evidence, clinical applications, limitations, and future directions for molecular imaging in spondylodiscitis.
Fibroblast activation protein-targeted PET uptake across various histopathological and molecular subtypes of breast cancer: a systematic review and meta-analysis
Sadeghpour S, Mirshahvalad SA, Askari E, Doostparast A, Raeisi N, Zendehdel Z, Sadeghi R, Pirich C and Beheshti M
Fibroblast activation protein-targeted PET uptake across various histopathological and molecular subtypes of breast cancer: a systematic review and meta-analysis
Sadeghpour S, Mirshahvalad SA, Askari E, Doostparast A, Raeisi N, Zendehdel Z, Sadeghi R, Pirich C and Beheshti M
To conduct a systematic review and meta-analysis on the uptake value of fibroblast activation protein (FAP)-targeted PET (FAPI PET) across different histopathological and molecular breast cancer subtypes. As a secondary objective, to perform head-to-head comparisons with [F]FDG PET.
Longitudinal PET RANO 1.0 and RANO 2.0 response assessment in vorasidenib-treated IDH-mutant gliomas: the VORAFET study
Lombardi G, Bosio A, Librizzi G, Anglani M, Ius T, Caccese M, Padovan M, Cavallin F, Maccari M, Volpin F, Pasqualetti F, Simeone R, Parisi A, Salvalaggio A, Bellu L, Denaro L, Lonardi S, Preusser M, Albert NL and Cecchin D
Longitudinal PET RANO 1.0 and RANO 2.0 response assessment in vorasidenib-treated IDH-mutant gliomas: the VORAFET study
Lombardi G, Bosio A, Librizzi G, Anglani M, Ius T, Caccese M, Padovan M, Cavallin F, Maccari M, Volpin F, Pasqualetti F, Simeone R, Parisi A, Salvalaggio A, Bellu L, Denaro L, Lonardi S, Preusser M, Albert NL and Cecchin D
Conventional MRI may not fully reflect the biological activity of vorasidenib. PET may detect treatment-related metabolic changes before structural changes become evident on MRI. We evaluated longitudinal PET and MRI changes in patients with IDH-mutant gliomas receiving vorasidenib.
Effectiveness, safety, and retreatment outcomes in GEP-NET patients undergoing Lu-based PRRT: a ten-year real-world experience
Trinkl L, Thöne P, Dierneder J and Rumpold H
Effectiveness, safety, and retreatment outcomes in GEP-NET patients undergoing Lu-based PRRT: a ten-year real-world experience
Trinkl L, Thöne P, Dierneder J and Rumpold H
Peptide receptor radionuclide therapy (PRRT) using Lu-labeled somatostatin analogues is an established and increasingly applied treatment for advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs). We report results focusing on effectiveness, short-term safety, and retreatment outcomes, based on ten years of clinical experience from an Austrian center of expertise, including patients referred for retreatment after prior therapy elsewhere.
Teilbereich PET
Development and External Validation of an Updated Nomogram Including Both MRI and Local PSMA PET/CT Information for the Prediction of Side-specific Extraprostatic Extension in Patients Treated with Radical Prostatectomy
Sweere V, Slot AB, Heetman JG, Hermsen R, Wever L, Lavalaye J, Vinken M, Bahler CD, Tann M, Kesch C, Telli T, Fendler WP, Chiu PK, Kit Wu SK, Zattoni F, Evangelista L, Ceci F, Miszczyk M, Rajwa P, Matsukawa A, Fazekas T, Barletta F, Briganti A, Gandaglia G, Van Basten JA, Van Melick HHE, Van den Bergh RCN, Marra G, Scheltema MJV and Soeterik TFW
Development and External Validation of an Updated Nomogram Including Both MRI and Local PSMA PET/CT Information for the Prediction of Side-specific Extraprostatic Extension in Patients Treated with Radical Prostatectomy
Sweere V, Slot AB, Heetman JG, Hermsen R, Wever L, Lavalaye J, Vinken M, Bahler CD, Tann M, Kesch C, Telli T, Fendler WP, Chiu PK, Kit Wu SK, Zattoni F, Evangelista L, Ceci F, Miszczyk M, Rajwa P, Matsukawa A, Fazekas T, Barletta F, Briganti A, Gandaglia G, Van Basten JA, Van Melick HHE, Van den Bergh RCN, Marra G, Scheltema MJV and Soeterik TFW
The predictive value of prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) for extraprostatic extension (EPE) in prostate cancer remains unclear.
PSMA PET/CT Kinetics During Systemic Therapy and Radiotherapy in Hormone-sensitive Prostate Cancer: A Systematic Review
Le Guévelou J, Bauckneht M, Soeterik TFW, Scheltema M, Bianchi L, Kesch C, Gandaglia G, Rajwa P, Nicoletti R, Zattoni F, Martini A, Fasulo V, Kasivisvanathan V, Preisser F, Sanchez LR, Ambrosini F, Falagario U, Fazekas T, Giesen A, Rovera G, Maggi M, Mercinelli C, Miszczyk M, Rivas JG, Windisch O, Stroomberg H, Rui B, Bourgi A, Tilki D, Marra G and
PSMA PET/CT Kinetics During Systemic Therapy and Radiotherapy in Hormone-sensitive Prostate Cancer: A Systematic Review
Le Guévelou J, Bauckneht M, Soeterik TFW, Scheltema M, Bianchi L, Kesch C, Gandaglia G, Rajwa P, Nicoletti R, Zattoni F, Martini A, Fasulo V, Kasivisvanathan V, Preisser F, Sanchez LR, Ambrosini F, Falagario U, Fazekas T, Giesen A, Rovera G, Maggi M, Mercinelli C, Miszczyk M, Rivas JG, Windisch O, Stroomberg H, Rui B, Bourgi A, Tilki D, Marra G and
Although prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) is commonly used for both initial staging and restaging at biochemical recurrence for patients diagnosed with prostate cancer (PCa), its role in the evaluation of treatment response is currently not validated.
Beyond radiotheranostics: how imaging modality defines theranostics
Pashkunova-Martic I, Pichler V and Helbich TH
Beyond radiotheranostics: how imaging modality defines theranostics
Pashkunova-Martic I, Pichler V and Helbich TH
Theranostics integrates diagnostic imaging and therapy within a single platform, enabling image-guided treatment delivery, real-time monitoring, and therapeutic optimization. The choice of imaging modality fundamentally shapes the design, functionality, and clinical maturity of theranostic systems. This review examines the theranostic concept through the lens of major imaging modalities employed in clinical and preclinical practice, including positron emission tomography (PET), single-photon emission computed tomography (SPECT), ultrasound (US), optical imaging (OI), magnetic resonance imaging (MRI), and computed tomography (CT). Beyond modality-specific approaches, the review highlights emerging multimodal theranostic strategies that integrate complementary imaging technologies to overcome individual limitations, enhance biological specificity, and improve treatment guidance. For each modality, we discuss the structural components of theranostic agents, their mechanisms of action, and the balance between diagnostic sensitivity and therapeutic efficacy. The review also highlights current and emerging clinical applications across major disease areas, while critically addressing limitations, such as spatial resolution, depth penetration, toxicity, and translational barriers. Overall, this article underscores that theranostics are expanding from modality-defined implementation toward integrated, multimodal strategies that are likely to shape the next generation of personalized and precision imaging-guided therapies. RELEVANCE STATEMENT : Imaging modality-driven theranostic design enables more precise, adaptive, and personalized image-guided therapies by aligning diagnostic sensitivity with therapeutic mechanisms, thereby improving treatment selection, response monitoring, and translational integration across clinical disciplines. KEY POINTS: Theranostics is determined by the underlying imaging modality rather than by a unified theranostic framework. Imaging modality dictates integration strategy. Nuclear medicine theranostics are clinically established, while MRI-, CT-, ultrasound-, and optical-based theranostics remain largely translational or function primarily as image-guided therapies. Multimodal theranostics address modality-specific limitations. Future progress depends on imaging-driven design and standardization.
Repeated metastasis-directed radiotherapy in patients with oligorecurrent prostate cancer: outcomes and risk stratification from a large multinational PSMA PET-guided cohort
van der Walle R, van Bergen TD, Miszczyk M, Peters M, Bilski M, Francolini G, Garlatti P, Mezeckis M, Kociolek J, Teunissen FR, Westhoff PG, Braat AJAT, van den Berg CAT, Shariat SF, Eppinga WSC, Aluwini S and Soeterik TFW
Repeated metastasis-directed radiotherapy in patients with oligorecurrent prostate cancer: outcomes and risk stratification from a large multinational PSMA PET-guided cohort
van der Walle R, van Bergen TD, Miszczyk M, Peters M, Bilski M, Francolini G, Garlatti P, Mezeckis M, Kociolek J, Teunissen FR, Westhoff PG, Braat AJAT, van den Berg CAT, Shariat SF, Eppinga WSC, Aluwini S and Soeterik TFW
Repeated metastasis-directed radiotherapy (MDRT) is increasingly used in patients with metachronous oligometastatic prostate cancer. However, the efficacy and optimal patient selection criteria remain insufficiently defined.
Segment-based comparison of multiparametric MRI, Gallium-68-PSMA-PET/CT and combined imaging with histopathology in prostate cancer
Schmidt CJ, Bernhardt M, Kristiansen G, Gaertner FC, Kreppel B, Essler M, Luetkens JA, Attenberger U, Anspach M, Ohlmann CH, Hauser S, Ellinger J, Ritter M and Krausewitz P
Segment-based comparison of multiparametric MRI, Gallium-68-PSMA-PET/CT and combined imaging with histopathology in prostate cancer
Schmidt CJ, Bernhardt M, Kristiansen G, Gaertner FC, Kreppel B, Essler M, Luetkens JA, Attenberger U, Anspach M, Ohlmann CH, Hauser S, Ellinger J, Ritter M and Krausewitz P
To compare the segment-based diagnostic performance of multiparametric magnetic resonance imaging (mpMRI), Gallium-68-prostate-specific membrane antigen-positron emission tomography/computed tomography (Ga-PSMA-PET/CT), for detecting histopathologically confirmed prostate cancer (PCa).
Gallium-68 and zirconium-89 complexes of DFO-analogs for molecular imaging applications using PET/CT
Maradan RAJ, Neuzilova B, Kronberger J, Feiner I, Guarrochena X, Kılçar AY, Ralis J, Petrik M and Mindt TL
Gallium-68 and zirconium-89 complexes of DFO-analogs for molecular imaging applications using PET/CT
Maradan RAJ, Neuzilova B, Kronberger J, Feiner I, Guarrochena X, Kılçar AY, Ralis J, Petrik M and Mindt TL
The β-emitters gallium-68 (Ga) and zirconium-89 (Zr) are among the most widely used metallic radionuclides in nuclear medicine for diagnostic imaging by Positron Emission Tomography (PET). Inspired by nature's bacterial siderophore desferrioxamine-B (DFO), a number of structurally related oligohydroxamate-based chelators have been studied for the complexation of both radiometals and for applications in nuclear medicine. We report here the solid phase (sp) synthesis of a new member of this family of acyclic chelators, DFO* 3, and its comparison with DFO 1 (control) and DFO-analogs DFO* 2, and oxoDFO* 4 in vitro and in vivo.
Molecular imaging in adult spondylodiscitis: current evidence, clinical applications, and future perspectives
Al-Ibraheem A, Estrada-Lobato E, Ruzzeh S, Brink A, Giammarile F, Al-Foqahaa M, Al-Jaddadi M, Hussain S, Amro A and Paez D
Molecular imaging in adult spondylodiscitis: current evidence, clinical applications, and future perspectives
Al-Ibraheem A, Estrada-Lobato E, Ruzzeh S, Brink A, Giammarile F, Al-Foqahaa M, Al-Jaddadi M, Hussain S, Amro A and Paez D
Adult spondylodiscitis is an infection of the intervertebral disc and adjacent vertebral bodies that may progress to paravertebral extension, epidural involvement, spinal instability, sepsis, and neurological compromise. Because clinical symptoms and laboratory markers are often nonspecific, imaging is central to diagnosis, assessment of disease extent, biopsy planning, and selective evaluation of treatment response. Magnetic resonance imaging (MRI) remains the first-line anatomical technique for early marrow, disc, epidural, and paraspinal disease, while computed tomography (CT) is valuable for osseous destruction, instability, and biopsy guidance. Molecular imaging complements these modalities by depicting biological activity rather than structure alone. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ([18F]FDG PET/CT) is the most established molecular technique, offering high diagnostic performance, whole-body evaluation for multifocal or metastatic infection, and support for management when MRI is contraindicated, equivocal, or difficult to interpret after surgery. Its main limitations are limited pathogen specificity, uptake in sterile inflammatory or reparative processes, heterogeneous interpretation criteria, and uncertain thresholds for treatment monitoring. Emerging approaches, including hybrid positron emission tomography/magnetic resonance imaging (PET/MRI), fibroblast activation protein inhibitor (FAPI) tracers, pathogen-targeted radiopharmaceuticals, quantitative PET biomarkers, and artificial intelligence (AI), remain investigational and require prospective validation of diagnostic and clinical utility. This review summarizes current evidence, clinical applications, limitations, and future directions for molecular imaging in spondylodiscitis.
Fibroblast activation protein-targeted PET uptake across various histopathological and molecular subtypes of breast cancer: a systematic review and meta-analysis
Sadeghpour S, Mirshahvalad SA, Askari E, Doostparast A, Raeisi N, Zendehdel Z, Sadeghi R, Pirich C and Beheshti M
Fibroblast activation protein-targeted PET uptake across various histopathological and molecular subtypes of breast cancer: a systematic review and meta-analysis
Sadeghpour S, Mirshahvalad SA, Askari E, Doostparast A, Raeisi N, Zendehdel Z, Sadeghi R, Pirich C and Beheshti M
To conduct a systematic review and meta-analysis on the uptake value of fibroblast activation protein (FAP)-targeted PET (FAPI PET) across different histopathological and molecular breast cancer subtypes. As a secondary objective, to perform head-to-head comparisons with [F]FDG PET.
Longitudinal PET RANO 1.0 and RANO 2.0 response assessment in vorasidenib-treated IDH-mutant gliomas: the VORAFET study
Lombardi G, Bosio A, Librizzi G, Anglani M, Ius T, Caccese M, Padovan M, Cavallin F, Maccari M, Volpin F, Pasqualetti F, Simeone R, Parisi A, Salvalaggio A, Bellu L, Denaro L, Lonardi S, Preusser M, Albert NL and Cecchin D
Longitudinal PET RANO 1.0 and RANO 2.0 response assessment in vorasidenib-treated IDH-mutant gliomas: the VORAFET study
Lombardi G, Bosio A, Librizzi G, Anglani M, Ius T, Caccese M, Padovan M, Cavallin F, Maccari M, Volpin F, Pasqualetti F, Simeone R, Parisi A, Salvalaggio A, Bellu L, Denaro L, Lonardi S, Preusser M, Albert NL and Cecchin D
Conventional MRI may not fully reflect the biological activity of vorasidenib. PET may detect treatment-related metabolic changes before structural changes become evident on MRI. We evaluated longitudinal PET and MRI changes in patients with IDH-mutant gliomas receiving vorasidenib.
Effectiveness, safety, and retreatment outcomes in GEP-NET patients undergoing Lu-based PRRT: a ten-year real-world experience
Trinkl L, Thöne P, Dierneder J and Rumpold H
Effectiveness, safety, and retreatment outcomes in GEP-NET patients undergoing Lu-based PRRT: a ten-year real-world experience
Trinkl L, Thöne P, Dierneder J and Rumpold H
Peptide receptor radionuclide therapy (PRRT) using Lu-labeled somatostatin analogues is an established and increasingly applied treatment for advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs). We report results focusing on effectiveness, short-term safety, and retreatment outcomes, based on ten years of clinical experience from an Austrian center of expertise, including patients referred for retreatment after prior therapy elsewhere.
Teilbereich SPECT
Sentinel Node Biopsy in the Neck Management of cN0 Sinonasal Squamous Cell Carcinoma: A Multicenter Pilot Trial on Safety and Feasibility
Doescher J, von Witzleben A, Eberhardt N, Sauter C, Mlynarcik C, Peiper A, Treutlein E, Schuler PJ, Sommer F, Laban S, Beer AJ, Zenk J and Hoffmann TK
Sentinel Node Biopsy in the Neck Management of cN0 Sinonasal Squamous Cell Carcinoma: A Multicenter Pilot Trial on Safety and Feasibility
Doescher J, von Witzleben A, Eberhardt N, Sauter C, Mlynarcik C, Peiper A, Treutlein E, Schuler PJ, Sommer F, Laban S, Beer AJ, Zenk J and Hoffmann TK
To date, there are no clear recommendations for the treatment of a clinically inconspicuous neck (cN0) in sinonasal squamous cell carcinoma. Elective neck dissection or neck irradiation appears too aggressive given the relatively low occult metastasis rates. However, the development of neck lymph node metastases is significantly associated with worse survival, therefore patients at relevant risk need to be identified. The aim of this trial was to evaluate feasibility and safety of sentinel node biopsy for sinonasal squamous cell carcinoma.
Prognostic Impact of Liver Metastases on [Lu]Lu-PSMA Therapy Outcomes in Metastatic Castration-Resistant Prostate Cancer
Shamshirgaran A, Samadi MH, Sahafi P, Aboutalebi F, Roustaei H, Shafiei S, Aryana K, Aghaee A, Barashki S, Harsini S and Askari E
Prognostic Impact of Liver Metastases on [Lu]Lu-PSMA Therapy Outcomes in Metastatic Castration-Resistant Prostate Cancer
Shamshirgaran A, Samadi MH, Sahafi P, Aboutalebi F, Roustaei H, Shafiei S, Aryana K, Aghaee A, Barashki S, Harsini S and Askari E
This study assessed the efficacy, safety, and laboratory changes of lutetium-177 [Lu]Lu-PSMA-617 in metastatic castration-resistant prostate cancer (mCRPC) patients with liver metastasis.
Beyond radiotheranostics: how imaging modality defines theranostics
Pashkunova-Martic I, Pichler V and Helbich TH
Beyond radiotheranostics: how imaging modality defines theranostics
Pashkunova-Martic I, Pichler V and Helbich TH
Theranostics integrates diagnostic imaging and therapy within a single platform, enabling image-guided treatment delivery, real-time monitoring, and therapeutic optimization. The choice of imaging modality fundamentally shapes the design, functionality, and clinical maturity of theranostic systems. This review examines the theranostic concept through the lens of major imaging modalities employed in clinical and preclinical practice, including positron emission tomography (PET), single-photon emission computed tomography (SPECT), ultrasound (US), optical imaging (OI), magnetic resonance imaging (MRI), and computed tomography (CT). Beyond modality-specific approaches, the review highlights emerging multimodal theranostic strategies that integrate complementary imaging technologies to overcome individual limitations, enhance biological specificity, and improve treatment guidance. For each modality, we discuss the structural components of theranostic agents, their mechanisms of action, and the balance between diagnostic sensitivity and therapeutic efficacy. The review also highlights current and emerging clinical applications across major disease areas, while critically addressing limitations, such as spatial resolution, depth penetration, toxicity, and translational barriers. Overall, this article underscores that theranostics are expanding from modality-defined implementation toward integrated, multimodal strategies that are likely to shape the next generation of personalized and precision imaging-guided therapies. RELEVANCE STATEMENT : Imaging modality-driven theranostic design enables more precise, adaptive, and personalized image-guided therapies by aligning diagnostic sensitivity with therapeutic mechanisms, thereby improving treatment selection, response monitoring, and translational integration across clinical disciplines. KEY POINTS: Theranostics is determined by the underlying imaging modality rather than by a unified theranostic framework. Imaging modality dictates integration strategy. Nuclear medicine theranostics are clinically established, while MRI-, CT-, ultrasound-, and optical-based theranostics remain largely translational or function primarily as image-guided therapies. Multimodal theranostics address modality-specific limitations. Future progress depends on imaging-driven design and standardization.
Outcome-driven dosimetry optimization for [Lu]Lu-PSMA-617 radiopharmaceutical therapy: proof of concept on single time point dosimetry optimization
Hu J, Seifert R, Gomes CV, Chen Y, Liu Y, Jutidamrongphan W, Amon M, Wang J, Xue S, Rominger A, Afshar-Ormieh A and Shi K
Outcome-driven dosimetry optimization for [Lu]Lu-PSMA-617 radiopharmaceutical therapy: proof of concept on single time point dosimetry optimization
Hu J, Seifert R, Gomes CV, Chen Y, Liu Y, Jutidamrongphan W, Amon M, Wang J, Xue S, Rominger A, Afshar-Ormieh A and Shi K
Internal dosimetry in radiopharmaceutical therapy (RPT) traditionally prioritizes methodological optimization driven by physical dose accuracy. However, even recommended multiple-time-point (MTP) dosimetry remains subject to uncertainties related to limited sampling schedules, pharmacokinetic, and curve-fitting modeling assumptions. In patients with metastatic castration-resistant prostate cancer (mCRPC) treated with [Lu]Lu-PSMA-617 RPT, we explored an outcome-driven dosimetry optimization strategy by comparing MTP and single-time-point (STP) dosimetry, and identifying optimal time-points (TPs) for Hänscheid approximation based on therapy outcomes.
Paediatric nephro-urology imaging: updates in renal scintigraphy and pitfalls
Hlongwa K, Brink A and More S
Paediatric nephro-urology imaging: updates in renal scintigraphy and pitfalls
Hlongwa K, Brink A and More S
Paediatric nephro-urology imaging plays a central role in the evaluation of congenital renal abnormalities, with renal scintigraphy remaining the reference standard for functional assessment of drainage, differential renal function, and cortical integrity. Despite advances in ultrasound and cross-sectional imaging, nuclear medicine techniques continue to provide unique quantitative and physiological information that directly influences clinical decision-making. Recent developments include improved standardisation of paediatric renography protocols, optimised use of Tc-labeled radiopharmaceuticals such as [Tc]Tc-MAG3, [Tc]Tc-EC and [Tc]Tc-DMSA, and increasing incorporation of hybrid SPECT/CT imaging for problem-solving in equivocal cases. Interpretation of diuretic renography has also evolved, with greater emphasis on integrated analysis rather than reliance on single quantitative indices. Paediatric renal scintigraphy, however, remains prone to interpretative pitfalls due to developmental renal physiology, technical variability, and overlapping imaging appearances between obstructive and non-obstructive systems. False-positive obstruction, misinterpretation of drainage patterns, and challenges in cortical defect characterisation remain significant issues. This review summarises current advances in paediatric renal scintigraphy, highlights optimised imaging protocols, and discusses common interpretative pitfalls with strategies to improve diagnostic accuracy in clinical practice.
Quantitative Tc-PYP SPECT/CT at 90 minutes improves diagnostic stratification in transthyretin cardiac amyloidosis
Nazerani-Zemann T, Stanzel S, Weitzer F, Kuenzer T, Stangl VM and Bucerius J
Quantitative Tc-PYP SPECT/CT at 90 minutes improves diagnostic stratification in transthyretin cardiac amyloidosis
Nazerani-Zemann T, Stanzel S, Weitzer F, Kuenzer T, Stangl VM and Bucerius J
Scintigraphy using Tc-labeled bone-seeking tracers is a cornerstone in the non-invasive diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CM). However, planar imaging alone, particularly in patients with Perugini score 1, often lacks diagnostic specificity. This study evaluates the incremental diagnostic value of quantitative SPECT/CT at 90 min post-injection (p.i.) when added to standard planar imaging at 60 and 180 min.
Early timepoint Tc-DPD whole body scintigraphy and quantitative SPECT/CT imaging for diagnosis of cardiac ATTR amyloidosis
Settelmeier S, Kessler L, Hammersen N, Papathanasiou M, Rischpler C, Carpinteiro A, Oubari S, Michel L, Vogel J, Wollenweber T, Ning J, Hacker M, Spielvogel CP, Varasteh Z, Fendler WP, Barbato F, Costa PF, Leyser S, Rassaf T, Herrmann K, Telli T and Kersting D
Early timepoint Tc-DPD whole body scintigraphy and quantitative SPECT/CT imaging for diagnosis of cardiac ATTR amyloidosis
Settelmeier S, Kessler L, Hammersen N, Papathanasiou M, Rischpler C, Carpinteiro A, Oubari S, Michel L, Vogel J, Wollenweber T, Ning J, Hacker M, Spielvogel CP, Varasteh Z, Fendler WP, Barbato F, Costa PF, Leyser S, Rassaf T, Herrmann K, Telli T and Kersting D
Cardiac transthyretin amyloidosis (ATTR-CM) is a progressive myocardial disease ultimately leading to heart failure. Standard diagnostic workup includes Tc-DPD scintigraphy performed after 2.5-3 h. The purpose of this study is to compare early (1 h after injection) to late imaging of Tc-DPD scintigraphy and SPECT for the detection of ATTR-CM. Early imaging could improve patient comfort and examination efficiency.
Radioembolization Practice in North America Versus Europe: Results from a Global Survey
Keane G, Lam MGEH, Braat AJAT, Bruijnen RCG, Kaufmann N, de Jong HWAM, Salem R and Smits MLJ
Radioembolization Practice in North America Versus Europe: Results from a Global Survey
Keane G, Lam MGEH, Braat AJAT, Bruijnen RCG, Kaufmann N, de Jong HWAM, Salem R and Smits MLJ
The Cardiovascular and Interventional Radiological Society of Europe (CIRSE) conducted an international survey on the real-life application of transarterial radioembolization (TARE). This sub-analysis of the complete survey evaluates intercontinental disparities in TARE practices.
Revisiting the F3 Peptide: In Vitro Investigations of C- and N-Terminally Modified Peptide Conjugates for Radiotracer Development
Anderla M, Grillmayr M, Huemer K and Mindt TL
Revisiting the F3 Peptide: In Vitro Investigations of C- and N-Terminally Modified Peptide Conjugates for Radiotracer Development
Anderla M, Grillmayr M, Huemer K and Mindt TL
: The F3 peptide, a tumor-homing peptide known to bind cell-surface nucleolin, is frequently employed as a targeting vector in cancer research. However, the impact of the modification site on its cellular binding properties has not been investigated yet. In this work, we aimed to design an improved F3-based radioconjugate by identifying the optimal conjugation site and establishing a protocol for its biological evaluation in vitro. To achieve this, we compared F3 peptide derivatives modified at their N- or C-termini with DOTA for complexation of indium-111 (In) for SPECT or Auger electron therapy or a fluorophore (FITC) for optical imaging. : N-and C-terminal DOTA-modified F3 peptides were radiolabeled with indium-111 and compared for their in vitro stability in different physiologically relevant media. Suitable nucleolin-positive cell lines for further in vitro studies were identified by confocal microscopy of a FITC-labeled F3 peptide derivative. The radioconjugates were then investigated on MDA-MB-231 (breast cancer) and PC-3 (prostate cancer) cells for nucleolin-specific cell binding and uptake, and several parameters of the in vitro assays were varied to establish a suitable protocol. : In general, in vitro assays with F3 peptide conjugates are challenging, as the outcome depends on a number of experimental parameters, leading, in some cases, to varying results. In particular, the presence of Ca and Mg had a decisive impact on the results, likely because the metal ions compete with the binding of F3 conjugates to nucleolin. The C-terminal modified, In-labeled F3 radioconjugate performed better than the N-terminal modified analog. While several parameters of the in vitro experiments were optimized, the overall cell uptake in vitro of radioactivity was still low (<2% of applied radioactivity). : A standardized in vitro protocol for evaluating F3 peptide conjugates on cancer cells was established, revealing that the C-terminus is the preferred site for modification. Because the cellular uptake of the radiotracer was shown to likely not be sufficient for radiotracer development, further studies on the optimization of the F3 peptide conjugates, including structural modifications, are required.
Preclinical comparison of [In]In-BPAMD and [Tc]Tc-DPD for SPECT/CT-based bone imaging
Felber V and Mindt TL
Preclinical comparison of [In]In-BPAMD and [Tc]Tc-DPD for SPECT/CT-based bone imaging
Felber V and Mindt TL
Our goal was to establish a preclinical model that simulates prostate cancer (PCa)-derived, but PSMA-negative (PSMA) bone metastasis, which can be visualized via single-photon emission computed tomography (SPECT) and to compare In- and Tc-labeled bone-seeking agents, ideally by using this animal model.
Teilbereich Nuklearmedizinische Therapie
Tumour-absorbed dose and efficacy of peptide receptor radionuclide therapy with [Y]Y-DOTATOC in patients with refractory meningioma: a single-centre experience
Schweiger L, Santo G, Kronthaler A, di Santo G, Iglseder S, Mangesius S, Mangesius J, Stock K and Virgolini I
Tumour-absorbed dose and efficacy of peptide receptor radionuclide therapy with [Y]Y-DOTATOC in patients with refractory meningioma: a single-centre experience
Schweiger L, Santo G, Kronthaler A, di Santo G, Iglseder S, Mangesius S, Mangesius J, Stock K and Virgolini I
The management of treatment-refractory meningioma in patients with previous surgical resection and radiation therapy remains challenging due to the lack of effective systemic treatment options. Therefore, novel therapeutic applications, such as peptide receptor radionuclide therapy (PRRT) targeting somatostatin receptors, may offer a promising therapeutic strategy. We aimed to assess the lesion-based tumour-absorbed dose and efficacy of PRRT with [Y]Y-DOTATOC in patients with treatment-refractory meningioma.
The Global Theranostics Access Gap: Real-World Disparities in PSMA PET/CT and Lu-PSMA Therapy Between Centers in Brazil and Europe
Cerci JJ, Fanti S, Herrmann K, Rodrigues DF, Leite PHF, Masukawa M, da Silva MM, Fendler WP, Goncalves E Silva A, Sanfelice EN, Ayelet W, Ghetti F, Bascioni A, Estrado Lobato EE and Paez D
The Global Theranostics Access Gap: Real-World Disparities in PSMA PET/CT and Lu-PSMA Therapy Between Centers in Brazil and Europe
Cerci JJ, Fanti S, Herrmann K, Rodrigues DF, Leite PHF, Masukawa M, da Silva MM, Fendler WP, Goncalves E Silva A, Sanfelice EN, Ayelet W, Ghetti F, Bascioni A, Estrado Lobato EE and Paez D
Real-world disparities in access to PSMA-targeted theranostics are poorly characterized. We compared waiting times for PSMA PET/CT and Lu-PSMA therapy between centers in Brazil and Europe. This retrospective multicenter study included 91 patients (50 from Brazil, 41 from Europe) treated with Lu-PSMA. Outcomes were days from request to PSMA PET/CT completion (diagnostic access) and days from request to first therapy dose (therapeutic access). Groups were compared using the Mann-Whitney test. Diagnostic access was similar between Brazil (median, 17.5 d; interquartile range [IQR], 9-34 d) and Europe (median, 19 d; IQR, 14-23 d; = 0.39). Therapeutic access was significantly delayed in Brazil (median, 59 d; IQR, 54.5-91) compared with Europe (median, 21 d; IQR, 17-31 d; < 0.01), representing a 2.8-fold longer wait. Despite comparable access to PSMA PET/CT, initiation of Lu-PSMA therapy is nearly 3 times slower in Brazil than in Europe. Closing the therapeutic access gap requires targeted investments in radiopharmaceutical supply chains and regulatory efficiency.
Real-world outcomes of [Lu]Lu-PSMA-I&T in [F]FDG-positive metastatic castration-resistant prostate cancer: factors related to response and survival
Santo G, di Santo G, Kronthaler A, Farsad M, Rossetti LM, Lehmann P, Scherbauer F, Cicone F and Virgolini IJ
Real-world outcomes of [Lu]Lu-PSMA-I&T in [F]FDG-positive metastatic castration-resistant prostate cancer: factors related to response and survival
Santo G, di Santo G, Kronthaler A, Farsad M, Rossetti LM, Lehmann P, Scherbauer F, Cicone F and Virgolini IJ
Little is known about predictors of response to radionuclide therapy with PSMA-ligands in patients with [F]FDG-positive metastatic castration-resistant prostate cancer (mCRPC). We assessed the correlation between baseline characteristics, including dual tracer PET parameters, and response to [Lu]Lu-PSMA-I&T in a cohort of patients with [F]FDG-positive mCRPC. Prognostic factors related to progression-free survival (PFS) and overall survival (OS) were also investigated.
Beta Atlas: Charting Global Production of Nonconventional β-Emitters for Targeted Radiopharmaceutical Therapy-Part 1
Tosato M, Kleynhans J, van de Voorde M, Favaretto C, Harriswangler C, Chaple I, Mastroianni S, Starovoitova V, Hoerres R, Burgoyne A, Korde A, Gestin JF, van der Meulen NP, Asti M, Köster U, Ramogida CF and Radchenko V
Beta Atlas: Charting Global Production of Nonconventional β-Emitters for Targeted Radiopharmaceutical Therapy-Part 1
Tosato M, Kleynhans J, van de Voorde M, Favaretto C, Harriswangler C, Chaple I, Mastroianni S, Starovoitova V, Hoerres R, Burgoyne A, Korde A, Gestin JF, van der Meulen NP, Asti M, Köster U, Ramogida CF and Radchenko V
β-minus particle (β)-emitting radionuclides have long been central to targeted radiopharmaceutical therapy. Interest in expanding their repertoire beyond conventional options has grown over time, as the need for radionuclides with different emission profiles and theranostic potential becomes increasingly clear. Nonetheless, their clinical translation remains limited by production constraints, inconsistent clinical evidence supporting their use. By reporting the state of the art in nonconventional β-radionuclide production, the current global landscape of production centers and reviewing current clinical evaluations, this β-atlas provides a critical overview of how these radionuclides may influence the future of targeted radiopharmaceutical therapy. This perspective is intended to support researchers, clinicians, and industry in recognizing both the opportunities and the constraints associated with integrating alternative β-emitters into clinical practice. Ultimately, this β-atlas aims to serve as a strategic resource to foster collaboration and guide investment toward more reliable and scalable supply chains of nonconventional β-emitters, thereby strengthening the foundation for future innovation in β-based therapy. This review focuses on β-emitters that have already progressed to clinical evaluation, including Cu, Sm, Tb, Ho, Re, and Re.
[Lu]Lu-DOTATATE Molecular Radiotherapy During Induction Chemotherapy for First-Line Stage 4 High-Risk Neuroblastoma in South African Children: Protocol for a Phase 1 Randomized Controlled Trial (LuDO-SA Trial)
van Heerden J, Kruger M, Reddy K, van Zyl A, Warwick J, Burger C, Moalosi T, van Reenen C, Davidson A, Hlongwa K, Violante D, Bruwer N, Naidu G, Rowe B, Louw L, van Wyk B, Vorster M, Mkhize T and Brink A
[Lu]Lu-DOTATATE Molecular Radiotherapy During Induction Chemotherapy for First-Line Stage 4 High-Risk Neuroblastoma in South African Children: Protocol for a Phase 1 Randomized Controlled Trial (LuDO-SA Trial)
van Heerden J, Kruger M, Reddy K, van Zyl A, Warwick J, Burger C, Moalosi T, van Reenen C, Davidson A, Hlongwa K, Violante D, Bruwer N, Naidu G, Rowe B, Louw L, van Wyk B, Vorster M, Mkhize T and Brink A
In South Africa, the metastatic response rate for stage 4 high-risk neuroblastoma (HR-NB) to induction chemotherapy is lower than that of similar regimens in well-resourced settings. Augmenting current induction chemotherapy regimens with molecular radiotherapy, without increasing toxicity, is an attractive systemic treatment in radioisotope-avid tumors, especially in a resource-limited setting where stem cell transplantation and immunotherapy are unavailable and costly. Clinical trials of [Lu]Lutetium DOTATATE ([Lu]Lu-DOTATATE) have primarily focused on refractory or relapsed HR-NB, with disappointing results. This study evaluates the feasibility and dose-limiting toxicity grading of adding a single dose of [Lu]Lu-DOTATATE to induction chemotherapy in achieving metastatic remission rates.
Effectiveness, safety, and retreatment outcomes in GEP-NET patients undergoing Lu-based PRRT: a ten-year real-world experience
Trinkl L, Thöne P, Dierneder J and Rumpold H
Effectiveness, safety, and retreatment outcomes in GEP-NET patients undergoing Lu-based PRRT: a ten-year real-world experience
Trinkl L, Thöne P, Dierneder J and Rumpold H
Peptide receptor radionuclide therapy (PRRT) using Lu-labeled somatostatin analogues is an established and increasingly applied treatment for advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs). We report results focusing on effectiveness, short-term safety, and retreatment outcomes, based on ten years of clinical experience from an Austrian center of expertise, including patients referred for retreatment after prior therapy elsewhere.
Peptide receptor radionuclide therapy in neuroendocrine tumours: advances, combination strategies, and future directions
Virgolini IJ, Di Santo G and Santo G
Peptide receptor radionuclide therapy in neuroendocrine tumours: advances, combination strategies, and future directions
Virgolini IJ, Di Santo G and Santo G
Peptide receptor radionuclide therapy (PRRT) has established itself as a pivotal component in the management of advanced, somatostatin receptor (SSTR)-positive neuroendocrine tumours (NETs). The NETTER-1 phase III trial demonstrated that [Lu]Lu-DOTATATE significantly prolongs progression-free survival (PFS) and improves quality of life in patients with midgut NETs refractory to somatostatin analogues, leading to regulatory approval by both EMA (2017) and FDA (2018). The recent NETTER-2 phase III trial further extended these findings by supporting the first-line use of PRRT in Grade 2 and 3 gastroentero-pancreatic (GEP)-NETs (Ki-67 ≥ 10 ≤ 55%). Beyond standard β-emitting therapy, several developments are reshaping the field: the clinical adoption of SSTR antagonists such as radiolabelled JR-11 and LM3, targeted α-particle-emitting therapies (Ac, Pb, Bi) for resistant disease, and rational combination strategies with chemotherapy, DNA-repair inhibitors, and immunotherapy. Parallel innovation in radiopharmaceutical chemistry has yielded new peptide ligands, including cholecystokinin-2 receptor (CCK2R)-targeted compounds such as DOTA-MGS5, which show promise for rare NETs such as medullary thyroid carcinoma (MTC) and small-cell lung cancer (SCLC). This review summarises clinical evidence, translational advances, and future perspectives for PRRT as a cornerstone of precision nuclear oncology. Emphasis is placed on expanding indications, integrating α-emitters, improving safety and dosimetry, and developing novel theragnostic ligands that enable personalised treatment strategies for NETs patients.
Limitations in diagnostics and quantification of small lesions with low uptake in the clinical context of prostate F/Ga-PSMA PET/MRI
Lindemann ME, Jentzen W, Küper A, Costa PF, Gratz M, Umutlu L, Nagarajah J, Nekolla SG, Rausch I, Herrmann K, Quick HH and Kersting D
Limitations in diagnostics and quantification of small lesions with low uptake in the clinical context of prostate F/Ga-PSMA PET/MRI
Lindemann ME, Jentzen W, Küper A, Costa PF, Gratz M, Umutlu L, Nagarajah J, Nekolla SG, Rausch I, Herrmann K, Quick HH and Kersting D
The aim of this study was to investigate the limits of diagnostics and therapy planning for patients with prostate cancer using non-time-of-flight F/Ga-PSMA PET/MRI under clinically challenging imaging conditions with small lesion sizes and low uptake. Lesion detectability and quantification accuracy were evaluated for different acquisition and reconstruction parameters in a systematic phantom study and subsequent on patient data.
Paving the Way for CCK2R-Targeted Peptide Receptor Radionuclide Therapy with [Lu]Lu-DOTA-MGS5 in Patients with Small Cell Lung Cancer
Zavvar TS, Santo G, Gruber L, Kronthaler A, Hagenbuchner J, Skvortsova I, Piro I, Steiger K, Martinovic V, Minasch D, Löffler-Ragg J, di Santo G, Virgolini IJ and von Guggenberg E
Paving the Way for CCK2R-Targeted Peptide Receptor Radionuclide Therapy with [Lu]Lu-DOTA-MGS5 in Patients with Small Cell Lung Cancer
Zavvar TS, Santo G, Gruber L, Kronthaler A, Hagenbuchner J, Skvortsova I, Piro I, Steiger K, Martinovic V, Minasch D, Löffler-Ragg J, di Santo G, Virgolini IJ and von Guggenberg E
: Peptide receptor radionuclide therapy (PRRT) is an established treatment for neuroendocrine tumors (NETs), enabling targeted radiation delivery via radiolabeled peptides. Small cell lung cancer (SCLC) remains a major therapeutic challenge due to its aggressive nature and poor prognosis. Despite advances, relapse rates are high and effective therapies are limited. We previously demonstrated the diagnostic potential of the cholecystokinin-2 receptor (CCK2R)-targeting minigastrin analog [Ga]Ga-DOTA-MGS5 in PET/CT imaging of different NETs. Building on this, we developed and evaluated [Lu]Lu-DOTA-MGS5 as a therapeutic PRRT agent. : Preclinical studies investigating the receptor-mediated cellular internalization and intracellular distribution over time in A431 cells with and without CCK2R expression were performed using the fluorescent tracer ATTO-488-MGS5. Short- and long-term cytotoxic effects of [Lu]Lu-DOTA-MGS5 were evaluated on the same cell line using trypan blue exclusion and clonogenic survival assays. CCK2R expression was assessed by immunohistochemistry in 42 SCLC tissue specimens. In addition, the first PRRT with [Lu]Lu-DOTA-MGS5 was conducted in a patient with extensive disease SCLC (ED-SCLC) after confirming CCK2R-positive uptake in [Ga]Ga-DOTA-MGS5 PET/CT. : Rapid binding and internalization into A431-CCK2R cells, with progressive accumulation in intracellular compartments, was observed for ATTO-488-MGS5. Short-term irradiation effects of [Lu]Lu-DOTA-MGS5 were comparable for 4 h and 24 h incubation and were between the effects obtained with 2 and 4 Gy of external beam radiotherapy (EBRT). Clonogenic survival of A431-CCK2R cells incubated with increasing activity of [Lu]Lu-DOTA-MGS5 decreased in a dose-dependent manner. Immunohistochemistry on SCLC specimens confirmed moderate to high CCK2R expression in 16 out of 42 SCLC samples. In the first patient with SCLC treated with four cycles of [Lu]Lu-DOTA-MGS5 with a total activity of 17.2 GBq, an improvement in clinical symptoms was observed. : The preclinical and clinical results confirm the feasibility of [Lu]Lu-DOTA-MGS5 PRRT in patients with SCLC and support further clinical studies investigating the therapeutic value and clinical applicability of this new CCK2R-targeted theranostic approach in larger patient cohorts.
Epidermal radionuclide therapy with rhenium-188 in non-melanoma skin cancer: a short narrative review
Castellucci P, Vetrone L, Baraldi C, Dika E, Zagni F, Strigari L, Martínez Albero E, Vega Pérez D, Mirzaei S and Fanti S
Epidermal radionuclide therapy with rhenium-188 in non-melanoma skin cancer: a short narrative review
Castellucci P, Vetrone L, Baraldi C, Dika E, Zagni F, Strigari L, Martínez Albero E, Vega Pérez D, Mirzaei S and Fanti S
Non-melanoma skin cancer (NMSC), represents the most common malignancy in fair-skinned populations and constitutes a growing public health burden. Although surgery remains the standard of care, a significant proportion of patients are poor surgical candidates due to age, comorbidities, tumor location or personal preference, highlighting the need for effective non-surgical alternatives.