Experience of rescue therapy with [Lu]Lu-rhPSMA-10.1 in patients with primary or acquired resistance to [Lu]Lu-PSMA-I&T.

Purpose: Radioligand therapy is an increasingly important option for the treatment of metastatic castrate-resistant prostate cancer (mCRPC). Radiohybrid ligands targeting prostate-specific membrane antigen (PSMA) are a novel group of theranostic radioligand therapy agents for which higher tumour absorbed radiation doses have been demonstrated compared to established PSMA ligands. Here, we report data from ten patients who were treated within a compassionate use program with the radiohybrid PSMA-ligand [Lu]Lu-rhPSMA-10.

[Ga]Ga-RAYZ-8009: A Glypican-3-Targeted Diagnostic Radiopharmaceutical for Hepatocellular Carcinoma Molecular Imaging-A First-in-Human Case Series.

To date, the imaging and diagnosis of hepatocellular carcinoma (HCC) rely on CT/MRI, which have well-known limitations. Glypican-3 (GPC3) is a cell surface receptor highly expressed by HCC but not by normal or cirrhotic liver tissue. Here we report initial clinical results of GPC3-targeted PET imaging with [Ga]Ga-DOTA-RYZ-GPC3 (RAYZ-8009), a peptide-based GPC3 ligand in patients with known or suspected HCC.

C-X-C Motif Chemokine Receptor 4-Directed Scintigraphy Using [Tc]Tc-Pentixatec in Primary Aldosteronism: A Proof-of-Concept Study.

C-X-C motif chemokine receptor 4 (CXCR4)-directed imaging has gained clinical interest in aiding clinical diagnostics in primary aldosteronism (PA). We retrospectively evaluated the feasibility of CXCR4-directed scintigraphy using the novel CXCR-4 ligand [Tc]Tc-pentixatec in patients with PA. Six patients (mean age ± SD, 49 ± 15 y) underwent CXCR4-directed scintigraphy (including planar imaging and SPECT/CT) 30, 120, and 240 min after injection of 435 ± 50 MBq of [Tc]Tc-pentixatec.

Added value of FDG-PET for detection of progressive supranuclear palsy.

Background: Diagnostic criteria for progressive supranuclear palsy (PSP) include midbrain atrophy in MRI and hypometabolism in [F]fluorodeoxyglucose (FDG)-positron emission tomography (PET) as supportive features. Due to limited data regarding their relative and sequential value, there is no recommendation for an algorithm to combine both modalities to increase diagnostic accuracy. This study evaluated the added value of sequential imaging using state-of-the-art methods to analyse the images regarding PSP features.

Biodistribution and Radiation Dosimetry for 68 Ga-DOTA-CCK-66, a Novel CCK 2 R-Targeting Compound for Imaging of Medullary Thyroid Cancer.

Abstract: Cholecystokinin 2 receptor (CCK 2 R) is a promising target for imaging and treatment of medullary thyroid cancer due to its overexpression in over 90% of tumor cells. 68 Ga-DOTA-CCK-66 is a recently introduced PET tracer selective for CCK 2 R, which has shown favorable pharmacokinetics in vivo in preclinical experiments. In order to further investigate safety and suitability of this tracer in the human setting, whole-body distribution and radiation dosimetry were evaluated.

Biodistribution and radiation dosimetry of [Tc]Tc-N4-BTG in patients with biochemical recurrence of prostate cancer.

Background: In patients with prostate cancer (PCa), imaging with gastrin-releasing peptide receptor (GRPR) ligands is an alternative to PSMA-targeted tracers, particularly if PSMA expression is low or absent. [Tc]Tc-N4-BTG is a newly developed GRPR-directed probe for conventional scintigraphy and single photon emission computed tomography (SPECT) imaging. The current study aims to investigate the safety, biodistribution and dosimetry of [Tc]Tc-N4-BTG in patients with biochemical recurrence (BCR) of PCa.

First Safety and Efficacy Data with the Radiohybrid Lu-rhPSMA-10.1 for the Treatment of Metastatic Prostate Cancer.

We recently published the first dosimetry data, to our knowledge, for the radioligand therapy agent Lu-rhPSMA-10.1, providing an intrapatient comparison with Lu-PSMA-I&T in patients with metastatic prostate cancer. Here, we report efficacy and safety findings from these patients.

Preclinical Evaluation of Minigastrin Analogs and Proof-of-Concept [Ga]Ga-DOTA-CCK-66 PET/CT in 2 Patients with Medullary Thyroid Cancer.

Because of the need for radiolabeled theranostics for the detection and treatment of medullary thyroid cancer (MTC), and the yet unresolved stability issues of minigastrin analogs targeting the cholecystokinin-2 receptor (CCK-2R), our aim was to address in vivo stability, our motivation being to develop and evaluate DOTA-CCK-66 (DOTA-γ-glu-PEG-Trp-(-Me)Nle-Asp-1-Nal-NH, PEG: polyethylene glycol) and DOTA-CCK-66.2 (DOTA-glu-PEG-Trp-(-Me)Nle-Asp-1-Nal-NH), both derived from DOTA-MGS5 (DOTA-glu-Ala-Tyr-Gly-Trp-(-Me)Nle-Asp-1-Nal-NH), and clinically translate [Ga]Ga-DOTA-CCK-66. Cu and Ga labeling of DOTA-CCK-66, DOTA-CCK-66.

An Intrapatient Dosimetry Comparison of Lu-rhPSMA-10.1 and Lu-PSMA-I&T in Patients with Metastatic Castration-Resistant Prostate Cancer.

As the use of radioligand therapy moves earlier in the prostate cancer timeline, minimizing the absorbed dose to normal organs while maintaining high tumor radiation doses becomes more clinically important because of the longer life expectancy of patients. We performed an intrapatient comparison of pretherapeutic dosimetry with the novel radiohybrid prostate-specific membrane antigen-targeting radiopharmaceutical Lu-rhPSMA-10.1, along with Lu-PSMA-I&T, in patients with metastatic castration-resistant prostate cancer.

Value of [18F]FDG PET/CT in Diagnosis and Management of Spondylodiscitis.

Vertebral osteomyelitis is the third most common form of osteomyelitis in patients over 50 years of age.Whereas prompt (pathogen-directed) therapy is crucially associated with better outcomes, the heterogeneous clinical presentation of disease with unspecific symptoms often delays adequate treatment initiation. Diagnosis requires a careful investigation of medical history, clinical findings and diagnostic imaging, including magnetic resonance imaging and nuclear medicine techniques.

Automatic covariance pattern analysis outperforms visual reading of F-fluorodeoxyglucose-positron emission tomography (FDG-PET) in variant progressive supranuclear palsy.

Background: To date, studies on positron emission tomography (PET) with F-fluorodeoxyglucose (FDG) in progressive supranuclear palsy (PSP) usually included PSP cohorts overrepresenting patients with Richardson's syndrome (PSP-RS).

Objectives: To evaluate FDG-PET in a patient sample representing the broad phenotypic PSP spectrum typically encountered in routine clinical practice.

Methods: This retrospective, multicenter study included 41 PSP patients, 21 (51%) with RS and 20 (49%) with non-RS variants of PSP (vPSP), and 46 age-matched healthy controls.

In-Vivo Somatostatin-Receptor Expression in Small Cell Lung Cancer as a Prognostic Image Biomarker and Therapeutic Target.

Background: Given the dismal prognosis of small cell lung cancer (SCLC), novel therapeutic targets are urgently needed. We aimed to evaluate whether SSTR expression, as assessed by positron emission tomography (PET), can be applied as a prognostic image biomarker and determined subjects eligible for peptide receptor radionuclide therapy (PRRT).

Methods: A total of 67 patients (26 females; age, 41-80 years) with advanced SCLC underwent SSTR-directed PET/computed tomography (somatostatin receptor imaging, SRI).

Value of [18F]FDG PET/CT in diagnosis and management of spondylodiscitis.

Vertebral osteomyelitis is the third most common form of osteomyelitis in patients over 50 years of age.Whereas prompt (pathogen-directed) therapy is crucially associated with better outcomes, the heterogeneous clinical presentation of disease with unspecific symptoms often delays adequate treatment initiation. Diagnosis requires a careful investigation of medical history, clinical findings and diagnostic imaging, including magnetic resonance imaging and nuclear medicine techniques.

177 Lu-rhPSMA-10.1 Induces Tumor Response in a Patient With mCRPC After PSMA-Directed Radioligand Therapy With 177 Lu-PSMA-I&T.

177 Lu-rhPSMA-10.1 is a novel PSMA-targeting radiopharmaceutical that has been optimized in terms of pharmacological and pharmacokinetic properties and may be therefore advantageous in treatment of metastatic castrate-resistant prostate cancer. In this image, we present the case of an 86-year-old man with metastastic castrate-resistant prostate cancer undergoing 177 Lu-PSMA-I&T treatment.

Lung perfusion assessed by SPECT/CT after a minimum of three months anticoagulation therapy in patients with SARS-CoV-2-associated acute pulmonary embolism: a retrospective observational study.

Background: Anticoagulant treatment is recommended for at least three months after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related acute pulmonary embolism (PE), but the persistent pulmonary clot burden after that time is unknown.

Methods: Lung perfusion was assessed by ventilation-perfusion (V/Q) SPECT/CT in 20 consecutive patients with SARS-CoV-2-associated acute PE after a minimum of three months anticoagulation therapy in a retrospective observational study.

Results: Remaining perfusion defects after a median treatment period of six months were observed in only two patients.