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Diagnostics
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Current Trends and Future Directions in Radiotheragnostic Research: A Special...
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Current Trends and Future Directions in Radiotheragnostic Research: A Special Issue in Collaboration with ISRT 2025

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (28 February 2026) | Viewed by 2886

Special Issue Editor

Prof. Dr. Kalevi Kairemo

E-Mail Website
Guest Editor
Department of Theranostics, Docrates Cancer Center, 00180 Helsinki, Finland
Interests: radionuclide imaging; PET; nuclear oncology; early response assessment; radionuclide therapies; dosimetry; dose planning; theranostics; prostate cancer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue will be a collection of the best presentations from the International Symposium on Radiopharmaceutical Therapy held in Baku, Azerbaijan from the 10th to the 12th of April 2025.

It will provide information on the newest developments in oncology and precision medicine studies. Its main topics lie in advanced areas of radiotheranostics, such as radioligand imaging and therapy for prostate cancer (PRLT) and peptide receptor therapy (PPRT) in neuroendocrine neoplasms. Theranostics concerns bridging diagnostic imaging with therapy. This requires multidisciplinary knowledge, e.g., in nuclear physics, radiochemistry and nuclear medicine. Regulatory issues, patient selection due to targeting characteristics, radiochemistry, and nuclide production and supply of radionuclides are essential elements in clinical practice. This Special Issue of Diagnostics welcomes data on biochemistry, molecular and cell biology, molecular biophysics, molecular medicine in targeted radionuclide therapy applications. Since Diagnostics is a diagnostic science journal, pure clinical therapy trials are not suitable for this Special Issue.

However, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following: new trends in bridging imaging and therapy in systemic PRLT and PPRT, and advances locoregional treatments.

I look forward to receiving your contributions by August the 31st 2025.

Prof. Dr. Kalevi Kairemo
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • precision oncology
  • oncology
  • positron emission tomography
  • radionuclide therapy
  • targeted therapy
  • targeted alpha therapy
  • PSMA
  • prostate cancer
  • neuroendocrine neoplasms
  • somatostatin analogs
  • daughter radionuclides
  • dosimetry
  • small-scale/micro-dosimetry
  • radiobiology
  • target chemistry

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Published Papers (2 papers)

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24 pages, 2875 KB  
Article
Yttrium-90 Selective Internal Radiation Therapy for Neuroendocrine Liver Metastases: An Institutional Case Series, Updated Systematic Review, and Meta-Analysis
by Xinlin Zheng, Fang Wen, Huan Xi, Joyce van Sluis, Reinoud P. H. Bokkers, Susanne Lütje, G. Matthijs Kater, Frederik J. H. Hoogwater, Annemiek M. E. Walenkamp, Derk-Jan A. de Groot, Simeon J. S. Ruiter and Walter Noordzij
Diagnostics 2026, 16(1), 111; https://doi.org/10.3390/diagnostics16010111 - 29 Dec 2025
Viewed by 2051
Abstract
Background/Objectives: To evaluate the efficacy, safety, and symptom impact of yttrium-90 selective internal radiation therapy (Y-90 SIRT) for neuroendocrine liver metastases (NELM) through an updated systematic review and meta-analysis integrated with our institutional data. Methods: We retrospectively analyzed 12 patients with [...] Read more.
Background/Objectives: To evaluate the efficacy, safety, and symptom impact of yttrium-90 selective internal radiation therapy (Y-90 SIRT) for neuroendocrine liver metastases (NELM) through an updated systematic review and meta-analysis integrated with our institutional data. Methods: We retrospectively analyzed 12 patients with NELM treated with Y-90 resin microspheres between 2019 and 2024. Outcomes included overall survival (OS), hepatic progression-free survival (HPFS), symptom improvement, and adverse events. Concurrently, a systematic review and meta-analysis of 43 studies (including our institutional cohort; total n = 2221; 2008–2025) was conducted following PRISMA guidelines. Pooled estimates for survival, tumor response, symptom improvement, and adverse events were derived using random- or fixed-effects models, with publication bias assessed by standard methods. Results: In our cohort, the median OS and HPFS were 33.3 and 15.3 months; 71.4% of symptomatic patients reported improvement, with no grade ≥ 3 toxicities. In the meta-analysis, pooled OS rates were 82%, 66%, 52%, and 34% at 1, 2, 3, and 5 years, and HPFS rates were 64%, 41%, and 29% at 1, 2, and 3 years. The pooled objective response rate (ORR) and disease control rate (DCR) were 40% and 87% by RECIST, and 56% and 91% by mRECIST. Patients treated with resin microspheres (ORR 38%, DCR 86%) and glass microspheres (ORR 39%, DCR 83%) showed comparable responses. Symptom improvement was observed in 77% of symptomatic patients, while reported grade ≥ 3 toxicities for individual adverse events were each below 5%. Conclusions: Y-90 SIRT is associated with promising survival outcomes, high disease control rates, and substantial symptom improvement in NELM with acceptable toxicity, suggesting its potential value as a liver-directed therapy option. Full article
(This article belongs to the Special Issue Current Trends and Future Directions in Radiotheragnostic Research: A Special Issue in Collaboration with ISRT 2025)
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14 pages, 1423 KB  
Case Report
Extraosseous 99mTc-MDP Uptake Guiding Intraoperative Sampling in Severe Inflammatory Myopathy: A Case Report and Literature Review
by Masha Maharaj, Sanvir Sirriram, Nav Govender, Trisha Govender, Babita D. Bhana and Nisaar Korowlay
Diagnostics 2026, 16(11), 1684; https://doi.org/10.3390/diagnostics16111684 - 29 May 2026
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Abstract
Background/Objectives: We report a case of severe dermatomyositis demonstrating characteristic widespread extraosseous uptake on 99mTc-methylene diphosphonate (99mTc-MDP) bone scintigraphy. This study highlights the diagnostic value of this modality in detecting active inflammatory myopathy when conventional muscle biopsy is inconclusive and [...] Read more.
Background/Objectives: We report a case of severe dermatomyositis demonstrating characteristic widespread extraosseous uptake on 99mTc-methylene diphosphonate (99mTc-MDP) bone scintigraphy. This study highlights the diagnostic value of this modality in detecting active inflammatory myopathy when conventional muscle biopsy is inconclusive and introduces its novel use for intraoperative gamma-probe-guided biopsy to precisely target metabolically active muscle. This approach may help target metabolically active muscle in heterogeneous idiopathic inflammatory myopathies (IIMs). Case Presentation: A 49-year-old man developed progressive proximal muscle weakness (Medical Research Council grade 2/5 proximally, 5/5 distally) beginning in June 2025 following influenza infection, accompanied by dysphagia, classic dermatomyositis cutaneous manifestations, back pain, and difficulty standing. Laboratory evaluation revealed elevated inflammatory markers (ESR 55 mm/hr, CRP 20 mg/L), leukocytosis (16.58 × 109/L), markedly raised creatine kinase (19,937 IU/L), and troponin T levels. An initial quadriceps muscle biopsy performed on 29 July 2025 was non-diagnostic. Three-phase 99mTc-MDP scintigraphy (~1110 MBq) demonstrated intense, diffuse extraosseous uptake involving bilateral deltoids (symmetric), biceps and triceps (patchy), paraspinal muscles (longitudinal), gluteal muscles, thighs (quadriceps and hamstrings), and gastrocnemius muscles, with relative suppression of appendicular skeletal uptake on delayed images due to soft-tissue tracer dominance—findings consistent with severe inflammatory myopathy. Following reinjection (~1100 MBq), intraoperative gamma-probe-guided biopsy targeted areas of highest uptake (left quadriceps femoris and distal triceps brachii; intraoperative counts 1300–1400 versus background ~500). Histopathology revealed histiocyte-predominant inflammation with myofibre necrosis and regeneration, sparse CD4+ T-cell infiltrates, and absence of fibrosis, consistent with necrotising myopathy. Positive antinuclear antibodies and strong anti-Mi-2 antibodies confirmed the diagnosis of dermatomyositis. Treatment included pulse methylprednisolone followed by oral prednisone taper, methotrexate, azathioprine, intravenous immunoglobulin, and planned rituximab therapy. Discussion: Whole-body 99mTc-MDP scintigraphy provided a complementary whole-body functional assessment of disease extent, revealing widespread muscular involvement. The novel application of intraoperative gamma-probe-guided biopsy enabled real-time targeting of metabolically active muscle, facilitating targeted sampling after an initial non-diagnostic biopsy and yielding supportive histopathological findings. This dual diagnostic and interventional role demonstrates the technical feasibility of gamma-probe guidance in a diagnostically challenging case of dermatomyositis. Conclusions: In our case, the integration of 99mTc-MDP scintigraphy with gamma-probe-guided biopsy enabled precise targeting of metabolically active muscle following an initial non-diagnostic biopsy. This multimodal approach may be useful in selected diagnostically challenging cases of severe inflammatory myopathy. Larger studies are needed to evaluate its reproducibility and added value. Full article
(This article belongs to the Special Issue Current Trends and Future Directions in Radiotheragnostic Research: A Special Issue in Collaboration with ISRT 2025)
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