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Hormonal receptor positive human epidermal receptor 2 negative (HR+/HER2-) is the commonest molecular subtype of breast cancer (BC). Patients with HR+/HER2- BC may manifest clinically a late recurrence whose BC metastasizes 10-15 years post-operatively. We report one case who presented with pulmonary mass in upper lobe of lung and Horner syndrome 16 years after BC surgery. FDG PET/CT suggested pulmonary malignancy but could not differentiate between primary or metastatic cancer when invasive biopsy was quite risky. Novel 18F-FES PET/CT facilitated the non-invasive functional diagnosis of estrogen-receptor positive (ER+) pulmonary metastasis of BC, and the patient experienced partial response (PR) after CDK4/6 inhibitor and aromatase inhibitor as endocrine therapy. This article reviews the diagnosis and treatment process of this case, to provide guidance for non-invasive global evaluation of ER status among metastatic HR+/HER2- BC patients with 18F-FES PET/CT.

Transthyretin-related amyloid cardiomyopathy (ATTR-CM) is a disease caused by the depo-sition of insoluble amyloid fibers formed by the misfolding of transthyretin precursor protein in the intercellular space of cardiomyocytes. This lesion may lead to myocardial dysfunction, cogestive heart failure, and death.When diagnosed earlier, the patient can be treated with drugs as soon as possible to intervene in the progress of the disease, so as to effectively improve the patient's prognosis.99mtechnetium-pyrophosphate (99Tcm-PYP)single-photon emission computed tomography (SPECT) has been widely used in the imaging examination of cardiac amyloidosis (CA) in recent years. While achieving early non-invasive diagnosis, accurate pathological classification can be obtained through Perugini visual score analysis, semi-quantitative analysis of heart to contralateral lung (H/CL) ratio, and SPECT image analysis. This article presents the application, methods, and the precautions of 99Tcm-PYPSPECT in the diagnosis of ATTR-CM, aiming to provide clinical reference for the application of this technology.

Lateral movement of soil organic carbon (SOC) induced by soil erosion and runoff changes spatial distributions of SOC, and further changes the land‐atmosphere CO2 exchange and terrestrial carbon budget. However, current ecosystem models do not or only poorly integrate the process of SOC lateral movement and cannot simulate the impacts of soil erosion on the carbon cycle. This study integrated SOC erosion and deposition processes into a process‐based ecosystem model (i.e., Integrated BIosphere Simulator (IBIS)), and separately simulated the lateral movements of dissolved organic carbon (DOC) and particulate organic carbon (POC). The model was evaluated in three river basins in Northeast China that are dominated by cropland, forest, and grassland. The results showed that the model reproduced well the production, erosion, and deposition of DOC and POC. The annual SOC lateral movement (1.34–7.22 g C m−2 yr−1) induced by erosion in the three tested basins was 0.27%–1.45% of the annual net primary production. The model developed in this study has great implications for simulating the lateral movements of SOC in terrestrial ecosystems, which can improve model performance in projecting the terrestrial carbon budget. Plain Language Summary: Lateral movement of soil organic carbon (SOC) with soil erosion and runoff is an important process in estimating land carbon budget. However, the current ecosystem models are not or poorly integrated this process, and cannot simulate the impacts of lateral movement of SOC on carbon cycle. This study integrates SOC erosion and deposition processes into a process‐based ecosystem model (Integrated BIosphere Simulator (IBIS)), and separately simulates the lateral movements of dissolved organic carbon (DOC) and particulate organic carbon (POC). The model was evaluated at three river basins in Northeast China dominated by cropland, forest and grassland, respectively. The results showed the model can reproduce well the production, erosion, deposition of DOC and POC. The model developed in this study has great implications for simulating the lateral movements of SOC in terrestrial ecosystem, which can improve model performance on projecting terrestrial carbon budget. Key Points: Current ecosystem models inadequately depict the lateral movement of SOC, causing uncertainties in terrestrial carbon cycle modelingWe integrated SOC erosion and deposition into a process‐based ecosystem model and evaluated it in three Chinese river basinsModel simulations well represented observed data for the production, erosion, and deposition of organic carbon [ABSTRACT FROM AUTHOR]

Purpose: Anatomical and molecular staging strategies are needed for the personalized treatment of localized pancreatic ductal adenocarcinoma (PDAC). This study evaluated the performance of [68 Ga]Ga–FAPI-04 and [18F]F-FDG PET/CT on the disease staging and prognostic value of patients with localized PDAC on contrast-enhanced (CE)-CT images. Methods: Patients with suspected localized PDAC on CE-CT were recruited for static [68 Ga]Ga-FAPI-04 and 18[F]F-FDG and PET/CT, and select patients underwent simultaneous 60-min dynamic 68 Ga-FAPI-04 PET/CT. The diagnostic and staging performances of the static PET/CT results were evaluated by delineating regions of interest in the primary tumor, whole pancreas, and distal pancreas in both types of scans and then evaluating correlations between the PET/CT findings and clinicopathological characteristics. Furthermore, Kaplan–Meier and hazard ratio (log-rank) methods were used to evaluate the prognostic value of the combined dynamic [68 Ga]Ga-FAPI-04 and static [18F]F-FDG PET/CT method. Results: We included 49 patients with histologically confirmed PDAC adenocarcinomas; 32 underwent 60-min dynamic [68 Ga]Ga-FAPI-04 PET/CT imaging simultaneously. The static [68 Ga]Ga-FAPI-04 method had significantly higher accuracy and uptake values than the static [18F]F-FDG method for primary PDAC lesions, metastatic lymph nodes, and distal metastases. Furthermore, 18.4% and 10.2% of the patients' stages changed after using the [68 Ga]Ga-FAPI-04 and [18F]F-FDG PET/CT methodologies, respectively, compared to the CE-CT-designated stage. The Ki values obtained from dynamic [68 Ga]Ga-FAPI-04 PET/CT did not differ between PDAC and distal obstructive pancreatitis lesions. Pathologically enlarged tumor size, poor differentiation, and perineural invasion were associated with increased [68 Ga]Ga-FAPI-04 uptake but not with [18F]F-FDG uptake. The preoperative prognostic performance of [68 Ga]Ga-FAPI-04 was better than that of [18F]F-FDG. Interestingly, combined [68 Ga]Ga-FAPI-04 and [18F]F-FDG uptake results in the whole pancreas could further stratify patients based on their postoperative prognosis. Conclusion: 6[68 Ga]Ga-FAPI-04 PET/CT was more sensitive and accurate than [18F]F-FDG PET/CT for tumor, node, and metastasis staging of PDAC identified on CE-CT. Additionally, [68 Ga]Ga-FAPI-04 uptake was significantly associated with pathologically aggressive tumor features. Combined [68 Ga]Ga-FAPI-04 and [18F]F-FDG PET/CT findings improved the prognostic value, potentially providing a non-invasive guide for clinical management. Finally, increased fibroblast activity in PDAC-induced obstructive pancreatitis may be associated with poor patient survival rates. [ABSTRACT FROM AUTHOR]

Purpose: Our aim was to assess the prognostic value of [68 Ga]Ga-FAPI-04 positron emission tomography (PET) uptake in PDAC and to evaluate the correlation between in vivo lesional radioactivity with pathological characteristics of pancreatic ductal adenocarcinoma (PDAC). Methods: We retrospectively analyzed treatment‐naïve PDAC patients who underwent preoperative [68 Ga]Ga-FAPI-04 PET/CT followed by pancreatectomy. The tracer uptake was determined as maximum tumor standardized uptake value (SUVmax), FAPI-avid tumor volume (FTV), total lesion FAP expression (TLF) as well total pancreatic uptake (TSUVmax), total FAPI-avid pancreatic volume (FPV), and total pancreatic FAP expression (TPF). Spearman's correlation analysis was performed to evaluate the association between [68 Ga]Ga-FAPI-04 PET/CT imaging and ex vivo immunohistological FAP expression and pathological characteristics of surgical specimens (differentiation, size, vascularity, perineural invasion, and lymph node metastases). Kaplan–Meier and hazard ratio (HR, log-rank) methods were used to evaluate the prognostic value of [68 Ga]Ga-FAPI-04 PET/CT and clinicopathological factors. Results: Thirty-seven surgical PDAC patients were included. The ex vivo expression of FAP was significantly associated with the tumor SUVmax and TLF. FAP expression was more abundant in poorly differentiated PDAC than in well- to moderately differentiated neoplasms. Tumor SUVmax or TLF and pancreatic TSUVmax or TPF were significantly correlated with tumor size, differentiation, and perineural invasion, respectively. SUVmax had a significant independent prognostic value for recurrence-free survival (HR = 2.46, P < 0.05), while [68 Ga]Ga-FAPI-04 TPF predicted overall survival (HR = 12.82, P < 0.05). Conclusion: The in vivo [68 Ga]Ga-FAPI-04 uptake in localized PDAC showed a significant correlation with ex vivo FAP expression and aggressive pathological characteristics. [68 Ga]Ga-FAPI-04 PET/CT also presented a potential for postoperative prognostication of PDAC. Elevated fibroblast activity induced by obstructive pancreatitis might be associated with the patient's survival. [ABSTRACT FROM AUTHOR]

Purpose: To determine the optimal imaging tool for clinical evaluation of pancreatic neoplasm by comparing the performance of 18F-FDG PET/MRI and PET/CT.Procedures: Patients with suspected pancreatic neoplasms underwent PET/MRI and PET/CT in the same day prior to resection or endoscopic ultrasound-guided fine-needle aspiration. Histology served as the golden standard of lesion classification. Visual assessment on lesion type and lesion malignancy via PET/MRI and PET/CT images was compared. Standard uptake values (SUVs) of PET images from the two scanners were measured and their correlations were further evaluated.Results: Thirty-nine patients were included for the final analysis. In visual assessment, we found MRI achieved better performance than CT in differentiating solid and cystic neoplasms, with accuracy of 100% vs. 87%, respectively. In visual malignancy diagnosis, the accuracy of PET/CT was 92.3% for overall lesions and 90.9% for cysts, while the accuracy of PET/MRI was 92.3% and 86.4%, respectively. Besides, semi-quantitative analysis achieved better specificity than visual assessment for both hybrid modalities (100% vs. 87.5% for PET/CT; 100% vs. 81.5% for PET/MR). Furthermore, strong correlation of SUV was found between PET/CT and PET/MRI, with Pearson's correlation coefficients > 0.82.Conclusions: In this study, we found PET/MRI and PET/CT, both using 18F-FDG as tracer, had comparable overall performance in identification of pancreatic neoplasms. Interestingly, for patients who had suspected pancreatic neoplasm but invisible FDG uptake, PET/MRI had shown exceptionally better performance, probably because MR images could detect tiny abnormal structures to improve diagnosis. [ABSTRACT FROM AUTHOR]

This study discusses the interannual variation of spring precipitation in Northeast China (NECSP) from 1980 to 2016 and its relationship with Arctic sea ice based on observation data and numerical experiments. The observed results reveal that the leading mode of NECSP mainly exhibits a homogenous pattern with a significant interannual variation. The NECSP has a significant negative correlation with the preceding winter Barents Sea ice concentration (BSIC) at the interannual scale. In the preceding winter, the decreased BSIC resulted in positive geopotential height anomalies over the polar region, which could weaken the polar vortex and westerly winds, forming a cyclonic anomaly indirectly over West Siberia. The circulation anomalies resulted in a zonal dipole pattern of preceding winter snow water equivalent (SWE) anomalies in the mid‐high latitudes of Eurasia with less SWE over Eastern Europe and more SWE over West Siberia. The SWE anomalies in winter could persist to the subsequent spring and facilitate more precipitation over Northeast China (NEC) by local thermal processes affecting circulation anomalies over Eurasia. On the other hand, the negative preceding winter BSIC anomalies can persist to spring, increasing the NECSP by strengthening the cyclonic anomalies over NEC. In this study, the response of the atmosphere to the thermal effect of SWE is further verified by using the linear baroclinic model (LBM). The response of NECSP to BSIC loss is tested by using the Community Atmosphere Model version 5.3 (CAM5.3). [ABSTRACT FROM AUTHOR]