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Abstract Doctors typically use non‐contrast‐enhanced computed tomography (NCECT) in the treatment of kidney cancer to map kidney and tumour structural information to functional imaging single‐photon emission computed tomography, which is then used to assess patient kidney function and predict postoperative recovery. However, the assessment of kidney function and formulation of surgical plans is constrained by the low contrast of tumours in NCECT, which hinders the acquisition of accurate tumour boundaries. Therefore, this study designed a radiomics feature‐enhanced level‐set evolution (RFLSE) to precisely segment small‐sample low‐contrast kidney tumours. Integration of high‐dimensional radiomics features into the level‐set energy function enhances the edge detection capability of low‐contrast kidney tumours. The use of sensitive radiomics features to control the regional term parameters achieves adaptive adjustment of the curve evolution amplitude, improving the level‐set segmentation process. The experimental data used low‐contrast, limited‐sample tumours provided by hospitals, as well as the public datasets BUSI18 and KiTS19. Comparative results with advanced energy functionals and deep learning models demonstrate the precision and robustness of RFLSE segmentation. Additionally, the application value of RFLSE in assisting doctors with accurately marking tumours and generating high‐quality pseudo‐labels for deep learning datasets is demonstrated.

Doctors typically use non‐contrast‐enhanced computed tomography (NCECT) in the treatment of kidney cancer to map kidney and tumour structural information to functional imaging single‐photon emission computed tomography, which is then used to assess patient kidney function and predict postoperative recovery. However, the assessment of kidney function and formulation of surgical plans is constrained by the low contrast of tumours in NCECT, which hinders the acquisition of accurate tumour boundaries. Therefore, this study designed a radiomics feature‐enhanced level‐set evolution (RFLSE) to precisely segment small‐sample low‐contrast kidney tumours. Integration of high‐dimensional radiomics features into the level‐set energy function enhances the edge detection capability of low‐contrast kidney tumours. The use of sensitive radiomics features to control the regional term parameters achieves adaptive adjustment of the curve evolution amplitude, improving the level‐set segmentation process. The experimental data used low‐contrast, limited‐sample tumours provided by hospitals, as well as the public datasets BUSI18 and KiTS19. Comparative results with advanced energy functionals and deep learning models demonstrate the precision and robustness of RFLSE segmentation. Additionally, the application value of RFLSE in assisting doctors with accurately marking tumours and generating high‐quality pseudo‐labels for deep learning datasets is demonstrated. [ABSTRACT FROM AUTHOR]

Although radiolabeled alpha-melanocyte stimulating hormone-analogue NAPamide derivatives are valuable melanoma-specific diagnostic probes, their rapid elimination kinetics and high renal uptake may preclude them from being used in clinical settings. We aimed at improving the pharmacokinetics of radiolabeled DOTA-NAPamide compounds by incorporating a 4-(p-iodo-phenyl)-butanoic acid (IPB) into the molecules. Followed by 68Ga-, 205/206Bi-, and 177Lu-labelling, the radiopharmaceuticals ([68Ga]Ga-DOTA-IPB-NAPamide, [205/206Bi]Bi-DOTA-IPB-NAPamide, [177Lu]Lu-DOTA-IPB-NAPamide) were characterized in vitro. To test the imaging behavior of the IPB-containing probes, B16F10 tumor-bearing C57BL/6 mice were subjected to in vivo microPET/microSPECT/CT imaging and ex vivo biodistribution studies. All tracers were stable in vitro, with radiochemical purity exceeding 98%. The use of albumin-binding moiety lengthened the in vivo biological half-life of the IPB-carrying radiopharmaceuticals, resulting in elevated tumor accumulation. Both [68Ga]Ga-DOTA-IPB-NAPamide (5.06 ± 1.08 %ID/g) and [205/206Bi]Bi-DOTA-IPB-NAPamide (4.50 ± 0.98 %ID/g) exhibited higher B16F10 tumor concentrations than their matches without the albumin-binding residue ([68Ga]Ga-DOTA-NAPamide and [205/206Bi]Bi-DOTA-NAPamide: 1.18 ± 0.27 %ID/g and 3.14 ± 0.32; respectively), however; the large amounts of off-target radioactivity do not confirm the benefits of half-life extension for short-lived isotopes. Enhanced [177Lu]Lu-DOTA-IPB-NAPamide tumor uptake even 24 h post-injection proved the advantage of IPB-based prolonged circulation time regarding long-lived radionuclides, although the significant background noise must be addressed in this case as well. [ABSTRACT FROM AUTHOR]

Simple Summary: In this literature review, we will provide a short overview of the role of nuclear medicine in the diagnosis of obstetric and gynecological cancers. Nuclear medicine is defined as the diagnosis and the treatment of disease using radiolabeled compounds known as radiopharmaceuticals. Single-photon emission computed tomography/computed tomography (SPECT/CT) and positron emission tomography/computer tomography (PET/CT) based radiopharmaceuticals have proven reliable in diagnostic imaging in nuclear medicine and cancer treatment. One of the most critical cancers that also relies on an early diagnosis is gynecological cancer. Given that approximately 25% of all cancers in developing countries are a subset of gynecological cancer, investigating this cancer subtype is of significant clinical worth, particularly in light of its high rate of mortality. With accurate identification of high grade distant abdominal endometrial cancer as well as extra abdominal metastases, 18F-Fluorodeoxyglucose ([18F]FDG) PET/CT imaging is considered a valuable step forward in the investigation of gynecological cancer. Considering these factors, [18F]FDG PET/CT imaging can assist in making management of patient therapy more feasible. In this literature review, we will provide a short overview of the role of nuclear medicine in the diagnosis of obstetric and gynecological cancers. [ABSTRACT FROM AUTHOR]

Abstract Robot‐assisted/endoscopic thyroidectomy causes irritation due to instruments or implantation of thyroid tissue on the anterior chest wall and lower neck. We present three patients who exhibited unexpected focal lesions on postablation Iodine‐131 single‐photon emission computed tomography/computed tomography without biochemical and structural diseases. Meticulous surgical techniques are important to prevent complications.

Accurate identification of spinal pain generators is critical to selecting the optimal treatment strategy for patients with persistent low back pain following instrumented lumbar fusion. Conventional diagnostic imaging modalities such as CT and MRI often yield equivocal results in this patient population. The purpose of this study is to assess the utility of Tc-99 SPECT/CT as an adjunct to conventional imaging modalities in the identification of spinal pain generators in patients with persistent low back pain after a lumbar fusion. A retrospective cohort review of 18 patients with a history of at least 1-year of persistent low back pain following a lumbar fusion surgery was conducted. All patients had MRI and/or CT scans that did not definitively identify a spinal pain generator. Tc-99 SPECT/CT imaging was subsequently performed in this cohort and treatment was determined according to imaging results. For patients undergoing revision fusion, pre- and post-operative visual analogue scores (VAS) at last follow-up were analyzed. All pain sites not clearly visualized on CT or MRI were identified by increased uptake of Tc-99 on SPECT/CT. According to anatomic location of uptake, six patients in this cohort underwent revision lumbar fusion. For patients undergoing revision lumbar fusion, preoperative VAS score averaged 8.5 ± 0.29 and declined after surgery to 4.75 ± 0.95. Patients in our series who suffered from failed lumbar spinal surgery syndrome, and subsequently underwent SPECT/CT imaging leading to the identification of pain generators amenable to surgical treatment experienced significant reduction in VAS scores after revision surgery.

Objective · To investigate the feasibility of single-photon emission computed tomography/computed tomography (SPECT/CT) quantitative imaging in the determination of SUV uptake and thyroid volume in patients with Graves' disease. Methods · Sixty-four Graves' disease patients were selected, including 21 males and 43 females, aged (44.1±14.1) years. All subjects were tested for serum FT3 and FT4 levels, as well as 131I rate at 2 h and 24 h. All patients underwent neck SPECT/CT and planar imaging after intravenous injection of (5.5±0.5)mCi [(204.2±16.8) MBq] 99mTcO4 - SPECT/CT radiograph. Thyroid quantitative SUVmean, SUVmax and three-dimensional thyroid volume (Vol3D) of Graves' disease patients were determined by 40% threshold method, and the correlation between SUVmean, SUVmax and serum thyroid hormone levels, 131I rate was analyzed. Vol3D and Vol2D thyroid volume were measured by Xeleris workstation (GE Healthcare) and conventional formulas, respectively, analyzed and compared. Results · The quantitative values of SUVmean and SUVmax in patients with Graves' disease were (262.5±110.2) g/mL and (471.4±192.1) g/mL, respectively. There was no significant correlation between serum thyroid hormone levels (FT3 and FT4), SUVmean and SUVmax (all P>0.05). There was week correlation between iodine uptake rate and SUVmean, SUVmax (all r >0 and all P=0.000). In addition, there was a positive correlation between thyroid Vol3D and Vol2D (r=0.853, P=0.000). Conclusion · Quantitative imaging of 99mTcO4 - SPECT/CT SPECT/CT for the determination of three-dimensional thyroid volume and quantitative uptake of SUV is simple and feasible, providing clinical basis for the diagnosis and treatment dose assessment of Graves' disease, which has important clinical diagnostic significance. [ABSTRACT FROM AUTHOR]

Robot‐assisted/endoscopic thyroidectomy causes irritation due to instruments or implantation of thyroid tissue on the anterior chest wall and lower neck. We present three patients who exhibited unexpected focal lesions on postablation Iodine‐131 single‐photon emission computed tomography/computed tomography without biochemical and structural diseases. Meticulous surgical techniques are important to prevent complications. [ABSTRACT FROM AUTHOR]

To assess the diagnostic potential of multi-slice single-photon emission computed tomography/computed tomography (SPECT/CT) for preoperative sentinel node (SN) mapping in early stage head and neck squamous cell carcinoma (HNSCC). Retrospective case-control study including data of consecutive HNSCC patients treated between November 2011 and December 2015. The diagnostic accuracy of multi-slice SPECT/CT was assessed with regard to the gold standard intraoperative gamma ray detection probe, using McNemar's test and calculating the area under the ROC curve. Additionally, the hot spot yield of SPECT/CT and planar lymphoscintigraphy (LS) was compared. Compared to the intraoperative gold standard, SPECT/CT showed an overall positive predictive value of 60.3% [confidence interval (CI) 46.6-73.0%)], a negative predictive value of 96.3% (CI 93.6-98.1%), and an accuracy of 90.8% (CI 89.1-92.4%). SPECT/CT detected more hot spots than LS and provided detailed anatomical information as well as relevant additional findings with potential impact on further patient management. Sentinel lymph node biopsy proved to be a reliable and safe procedure with an excellent SN excision rate (97%). Multi-slice SPECT/CT is a highly accurate diagnostic test and matches the gold standard intraoperative gamma ray detection probe. [ABSTRACT FROM AUTHOR]

Background: This study sought to examine whether iodine-123-labeled metaiodobenzylguanidine ( 123 I-MIBG) single-photon emission computed tomography/computed tomography (SPECT/CT), which is based on the International Society of Pediatric Oncology Europe Neuroblastoma (SIOPEN) score, could improve the diagnostic efficiency of children with neuroblastoma (NB), and to compare the diagnostic ability of minimal residual disease (MRD) detection and 123 I-MIBG SPECT/CT., Methods: We retrospectively analyzed 238 scans of patients who underwent 123 I-MIBG SPECT/CT at the Department of Nuclear Medicine, Beijing Friendship Hospital, from January 2021 to December 2021. The diagnostic study was not registered with a clinical trial platform, and the study protocol was not published. The standard was established based on pathology, other relevant imaging examinations, and follow-up. The SIOPEN scores were calculated separately based on planar and tomographic imaging., Results: In a comparison to the standard mentioned in the method, the diagnostic accuracy of planar and tomographic imaging was 151 of 238 (63.5%) and 228 of 238 (95.8%), respectively, and the κ values of the SIOPEN score were 0.468 and 0.855 (P<0.001), respectively. The SIOPEN scores differed significantly among the various subgroups. The polymerase chain reaction (PCR) method used to detect the bone marrow PHOX2B gene was able to find bone/bone marrow metastases (P=0.024, κ=0.282), while the flow cytometry (FCM) assay method was not statistically significant (P=0.417, κ=0.065)., Conclusions: 123 I-MIBG SPECT/CT, which relies on the semiquantitative assessment of the SIOPEN score, is of clinical importance in the management of pediatric NB. MRD detection can be used to detect early metastasis and recurrence in the bone or bone marrow; however, 123 I-MIBG SPECT/CT has better diagnostic value. We intend to conduct further investigations on their prognostic value in the future., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-22-1120/coif). The authors have no conflicts of interest to declare., (2023 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

(1) Background: To comparatively analyze the uptake of hepatocellular carcinoma (HCC) on pre-therapeutic imaging modalities, the arterial phase multi-detector computed tomography (MDCT), the parenchymal phase C-arm computed tomography (CACT), the Technetium99m-macroaggregates of human serum albumin single-photon emission computed tomography/computed tomography (SPECT/CT), and the correlation to the post-therapeutic Yttrium90 positron emission tomography/computed tomography (PET/CT) in patients with selective internal radiation therapy (SIRT). (2) Methods: Between September 2013 and December 2016, 104 SIRT procedures were performed at our institution in 74 patients with HCC not suitable for curative surgery or ablation. Twenty-two patients underwent an identical sequence of pre-therapeutic MDCT, CACT, SPECT/CT, and post-therapeutic PET/CT with a standardized diagnostic and therapeutic protocol. In these 22 patients, 25 SIRT procedures were evaluated. The uptake of the HCC was assessed using tumor-background ratio (TBR). Therefore, regions of interest were placed on the tumor and the adjacent liver tissue on MDCT (TBRMDCT), CACT (TBRCACT), SPECT/CT (TBRSPECT/CT), and PET/CT (TBRPET/CT). Comparisons were made with the Friedman test and the Nemenyi post-hoc test. Correlations were analyzed using Spearman's Rho and the Benjamini–Hochberg method. The level of significance was p < 0.05. (3) Results: TBR on MDCT (1.4 ± 0.3) was significantly smaller than on CACT (1.9 ± 0.6) and both were significantly smaller compared to SPECT/CT (4.6 ± 2.0) (pFriedman-Test < 0.001; pTBRMDCT/TBRCACT = 0.012, pTBRMDCT/TBRSPECT/CT < 0.001, pTBRCACT/TBRSPECT/CT < 0.001). There was no significant correlation of TBR on MDCT with PET/CT (rTBRMDCT/TBRPET/CT = 0.116; p = 0.534). In contrast, TBR on CACT correlated to TBR on SPECT/CT (rTBRCACT/TBRSPECT/CT = 0.489; p = 0.004) and tended to correlate to TBR on PET/CT (rTBRCACT/TBRPET/CT =0.365; p = 0.043). TBR on SPECT/CT correlated to TBR on PET/CT (rTBRSPECT/CT/TBRPET/CT = 0.706; p < 0.001) (4) Conclusion: The uptake assessment on CACT was in agreement with SPECT/CT and might be consistent with PET/CT. In contrast, MDCT was not comparable to CACT and SPECT/CT, and had no correlation with PET/CT due to the different application techniques. This emphasizes the value of the CACT, which has the potential to improve the dosimetric assessment of the tumor and liver uptake for SIRT. [ABSTRACT FROM AUTHOR]