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Diagnostics
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Research Update on Nuclear Medicine
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Research Update on Nuclear Medicine

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

Deadline for manuscript submissions: 30 November 2025 | Viewed by 16289

Special Issue Editor

Dr. Francesco Dondi

E-Mail Website
Guest Editor
Division of Nuclear Medicine, Università degli Studi di Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
Interests: nuclear medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Nuclear medicine is a scientific field that, in recent years, has experienced expanding application and is constantly growing in terms of importance and extension. This particular branch of medicine is characterized by the ability to evaluate the metabolic behavior of different tissues, cells and organs and has demonstrated its usefulness for the assessment of a wide range of conditions. From a diagnostic point of view, its role in the diagnosis, evaluation of response to treatment, follow-up and ability to drive the therapeutic approach of different diseases has been proven in many different papers. Interestingly, new tracers able to analyze different metabolic pathways, and therefore to shape new fields of research, are constantly being produced and need to prove their value. In addition, texture analysis, radiomics and machine learning are new scientific tools that are changing nuclear medicine and the methods of imaging analysis in general. Moreover, radionuclide therapy is experiencing an increase in its application and new research highlighting its role in the management of different diseases and the development of new therapeutic agents is being published almost every day.

The aim of this Special Issue is, therefore, to collect research that aims to investigate new findings in the nuclear medicine field in both diagnostic and therapeutic settings.

Dr. Francesco Dondi
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 100 words) can be sent to the Editorial Office for announcement on this website.

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

  • nuclear medicine
  • diagnostic radiology
  • PET/CT
  • SPECT
  • PET
  • imaging

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Published Papers (6 papers)

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Research

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12 pages, 1472 KiB  
Article
Furosemide Reduces Radionuclide Activity in the Bladder in 18F-PSMA-1007-PET/CT: A Single-Center Retrospective Intra-Individual Comparative Study
by Martin A. Cahenzli, Andreas S. Kreusch, Philipp Huber, Marco Dressler, Janusch P. Blautzik and Gregor Sommer
Diagnostics 2025, 15(15), 1931; https://doi.org/10.3390/diagnostics15151931 - 31 Jul 2025
Viewed by 249
Abstract
Background/Objectives: 18F-PSMA-1007 is one of the more widely used radioligands in prostate cancer imaging with PET/CT. Its major advantage lies in the low urinary tracer activity due to primarily hepatobiliary clearance, but unexpectedly high tracer accumulation in the bladder can occur, [...] Read more.
Background/Objectives: 18F-PSMA-1007 is one of the more widely used radioligands in prostate cancer imaging with PET/CT. Its major advantage lies in the low urinary tracer activity due to primarily hepatobiliary clearance, but unexpectedly high tracer accumulation in the bladder can occur, potentially hindering assessment of lesions near the prostate bed. This study assesses the impact of furosemide on 18F-PSMA-1007 tracer accumulation in the bladder. Methods: In this single-center, retrospective, intra-individual comparative analysis, 18 patients undergoing two consecutive 18F-PSMA-1007 PET/CT scans for biochemical relapse (BCR) or persistence (BCP)—one with and one without prior furosemide administration—were included. Images were acquired 60 min post-injection of 250 MBq of tracer activity. Standardized Uptake Values (SUVmax, SUVpeak, SUVmean) were measured in the bladder and in tissues with physiological uptake by three readers. Differences were analyzed using Wilcoxon signed-rank tests. The inter-reader agreement was assessed using intraclass correlation coefficient. Results: Furosemide significantly decreased bladder SUVmax, SUVpeak, and SUVmean (all p < 0.001). Mean bladder SUVmax decreased from 13.20 ± 10.40 to 3.92 ± 3.47, SUVpeak from 10.94 ± 8.02 to 3.47 ± 3.13, and SUVmean from 8.74 ± 6.66 to 2.81 ± 2.56, representing a large effect size (r ≈ 0.55). Physiological tracer uptake in most organs was not significantly influenced by furosemide (all p > 0.05). Conclusions: Despite the predominantly hepatobiliary clearance of 18F-PSMA-1007, furosemide-induced forced diuresis leads to a significant reduction in tracer activity in the bladder, which in clinical practice could help in early detection of tumor recurrence. Full article
(This article belongs to the Special Issue Research Update on Nuclear Medicine)
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12 pages, 2314 KiB  
Article
Prognostic Values of Thalamic Metabolic Abnormalities in Children with Epilepsy
by Farshid Gheisari, Amer Shammas, Eman Marie, Afsaneh Amirabadi, Nicholas A. Shkumat, Niloufar Ebrahimi and Reza Vali
Diagnostics 2025, 15(15), 1865; https://doi.org/10.3390/diagnostics15151865 - 25 Jul 2025
Viewed by 366
Abstract
Background: Hypometabolism of the thalamus has been reported in epilepsy patients. This study aimed to investigate the prognostic value of thalamic metabolic activity in children with epilepsy. Methods: A total of 200 children with epilepsy and 237 children without epilepsy (sex- [...] Read more.
Background: Hypometabolism of the thalamus has been reported in epilepsy patients. This study aimed to investigate the prognostic value of thalamic metabolic activity in children with epilepsy. Methods: A total of 200 children with epilepsy and 237 children without epilepsy (sex- and age-matched control group) underwent 18F-FDG PET/CT in this study. Localization of the interictal hypometabolic epileptic focus was performed visually. Bilateral thalamic metabolic activity was evaluated qualitatively (thalamic FDG uptake in relation to the cerebral cortex) and semi-quantitatively (SUV max, normalized SUV (ratio to ipsilateral cerebellum), and absolute asymmetric index (AAI). Results: A total of 133 patients (66.5%) with epilepsy showed cerebral cortical hypometabolism in the interictal 18F-FDG PET study; there were 76 patients on the right side, 55 patients on the left side, and two patients on both sides. Of these 133 patients, 45 also had visually observed asymmetric hypometabolism in the thalamus. Semi-quantitatively, asymmetry was more prominent in epileptic patients. AAI was a more sensitive variable than other variables. Average AAIs were 3.89% and 7.36% in the control and epilepsy patients, respectively. Metabolic activity in the thalami was significantly reduced in epileptic patients compared to the control group. Associated hypometabolism of the ipsilateral thalamus was observed in 66.5% of epileptic patients with a focal cortical defect semi-quantitatively. Overall, 61 out of 200 patients showed thalamus hypometabolism. Some 51 out of 61 patients (83.6%) with thalamus hypometabolism showed refractory disease; however, the refractory disease was noted in 90 out of 139 (64.7%) patients without thalamus hypometabolism. Brain surgery was performed in 86 epileptic patients (43%). Some 35 out of 86 patients had thalamus hypometabolism. Recurrence of epilepsy was observed more in patients with thalamus hypometabolism (48% vs. 25%), with p ≤ 0.01. Conclusion: This study suggests that patients with thalamus metabolic abnormalities may be more medically resistant to therapy and less responsive to surgical treatments. Therefore, the thalamus metabolic abnormality could be used as a prognostic sign in pediatric epilepsy. Recent studies have also suggested that incorporating thalamic metabolic data into clinical workflows may improve the stratification of treatment-resistant epilepsy in children. Full article
(This article belongs to the Special Issue Research Update on Nuclear Medicine)
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11 pages, 4043 KiB  
Article
Characterizing Normal Upper Extremity Lymphatic Flow with 99mTc In-House Dextran: A Retrospective Study
by Wiroj Katiyarangsan, Putthiporn Charoenphun, Krisanat Chuamsaamarkkee, Suchawadee Musikarat, Kidakorn Kiranantawat, Chaninart Sakulpisuti, Kanungnij Thamnirat, Arpakorn Kositwattanarerk, Chanika Sritara and Wichana Chamroonrat
Diagnostics 2024, 14(17), 1960; https://doi.org/10.3390/diagnostics14171960 - 5 Sep 2024
Viewed by 1975
Abstract
Lymphoscintigraphy evaluates the lymphatic system using radiocolloid compounds like 99mTc-sulfur colloid and 99mTc-nanocolloid, which vary in particle size and distribution timing. A local in-house Dextran kit (15–40 nm) was developed in 2005 and began clinical use in 2008 to localize sentinel [...] Read more.
Lymphoscintigraphy evaluates the lymphatic system using radiocolloid compounds like 99mTc-sulfur colloid and 99mTc-nanocolloid, which vary in particle size and distribution timing. A local in-house Dextran kit (15–40 nm) was developed in 2005 and began clinical use in 2008 to localize sentinel lymph nodes; diagnose lymphedema; and detect lymphatic leakage. The normal drainage pattern remains unexplored. We retrospectively analyzed 84 upper extremity lymphoscintigraphies from 2008 to 2021. 99mTc in-house Dextran was intradermally injected into both hands, followed by whole-body imaging at specified intervals (≤15 min; 16–30 min; 31–45 min; 46–60 min), with some receiving delayed imaging. Visual and quantitative analyses recorded axillary and forearm lymph nodes and liver, kidney, and urinary bladder activity. Results showed 92% (77/84) upper extremity lymphatic tract visualization within 45 min. Axillary node detection rates increased from 46% (≤15 min) to 86% (46–60 min). Delayed imaging further revealed nodes. Epitrochlear or brachial node visualization was rare (4%, 3/84). Hepatic, renal, and urinary bladder activity was noted in 54%, 71%, and 93% at 1 h, respectively. The axillary node uptake ratio was minimal (<2.5% of injection site activity; median 0.33%). This study characterizes normal upper extremity lymphatic drainage using 99mTc in-house Dextran, offering insights into its clinical application Full article
(This article belongs to the Special Issue Research Update on Nuclear Medicine)
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Review

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20 pages, 1652 KiB  
Review
Technological Advances in SPECT and SPECT/CT Imaging
by Yassine Bouchareb, Afrah AlSaadi, Jawa Zabah, Anjali Jain, Aziza Al-Jabri, Peter Phiri, Jian Qing Shi, Gayathri Delanerolle and Srinivasa Rao Sirasanagandla
Diagnostics 2024, 14(13), 1431; https://doi.org/10.3390/diagnostics14131431 - 4 Jul 2024
Cited by 16 | Viewed by 10442
Abstract
Single photon emission tomography/computed tomography (SPECT/CT) is a mature imaging technology with a dynamic role in the diagnosis and monitoring of a wide array of diseases. This paper reviews the technological advances, clinical impact, and future directions of SPECT and SPECT/CT imaging. The [...] Read more.
Single photon emission tomography/computed tomography (SPECT/CT) is a mature imaging technology with a dynamic role in the diagnosis and monitoring of a wide array of diseases. This paper reviews the technological advances, clinical impact, and future directions of SPECT and SPECT/CT imaging. The focus of this review is on signal amplifier devices, detector materials, camera head and collimator designs, image reconstruction techniques, and quantitative methods. Bulky photomultiplier tubes (PMTs) are being replaced by position-sensitive PMTs (PSPMTs), avalanche photodiodes (APDs), and silicon PMs to achieve higher detection efficiency and improved energy resolution and spatial resolution. Most recently, new SPECT cameras have been designed for cardiac imaging. The new design involves using specialised collimators in conjunction with conventional sodium iodide detectors (NaI(Tl)) or an L-shaped camera head, which utilises semiconductor detector materials such as CdZnTe (CZT: cadmium–zinc–telluride). The clinical benefits of the new design include shorter scanning times, improved image quality, enhanced patient comfort, reduced claustrophobic effects, and decreased overall size, particularly in specialised clinical centres. These noticeable improvements are also attributed to the implementation of resolution-recovery iterative reconstructions. Immense efforts have been made to establish SPECT and SPECT/CT imaging as quantitative tools by incorporating camera-specific modelling. Moreover, this review includes clinical examples in oncology, neurology, cardiology, musculoskeletal, and infection, demonstrating the impact of these advancements on clinical practice in radiology and molecular imaging departments. Full article
(This article belongs to the Special Issue Research Update on Nuclear Medicine)
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Other

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30 pages, 510 KiB  
Systematic Review
The Role of [18F]FDG PET Imaging for the Assessment of Vegetative State or Unresponsive Wakefulness Syndrome: A Systematic Review
by Francesco Dondi, Nicola Latronico, Pietro Bellini, Silvia Lucchini, Luca Camoni, Michela Cossandi, Gian Luca Viganò, Giulia Santo and Francesco Bertagna
Diagnostics 2025, 15(11), 1406; https://doi.org/10.3390/diagnostics15111406 - 31 May 2025
Viewed by 635
Abstract
Background: Different evidence on the ability of [18F] fluorodeoxyglucose ([18F]FDG) positron emission tomography (PET) imaging to assess patients in the vegetative state (VS) or unresponsive wakefulness syndrome (UWS) has been reported. Therefore, this systematic review aimed to synthesize [...] Read more.
Background: Different evidence on the ability of [18F] fluorodeoxyglucose ([18F]FDG) positron emission tomography (PET) imaging to assess patients in the vegetative state (VS) or unresponsive wakefulness syndrome (UWS) has been reported. Therefore, this systematic review aimed to synthesize the existing literature on this topic. Methods: A wide literature search of the PubMed/MEDLINE, Scopus, and Embase databases was conducted to find relevant published articles investigating the role of [18F]FDG PET imaging in the assessment of VS/UWS. Results: Thirty-seven studies were included in the review, and the main fields of application of this imaging modality in these patients were the evaluation of hypometabolic patterns, differentiation of disorders of consciousness (DOC), prognostic value, and ability to assess the response to particular stimuli. Conclusions: The possible role of [18F]FDG PET imaging in the assessment of VS/UWS has emerged, in particular in the differential diagnosis of other DOC or prognosis. Some insights into its value in stimulation response and therapy evaluation have also been proposed. Standardization of protocols and larger prospective studies are needed to strengthen these clinical recommendations. Full article
(This article belongs to the Special Issue Research Update on Nuclear Medicine)
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6 pages, 747 KiB  
Case Report
Parathyroid Adenoma Detected in 68Ga-PSMA PET/CT but Not in the Dedicated Imaging Modalities
by Maja Cieślewicz, Natalia Andryszak, Kacper Pełka, Ewelina Szczepanek-Parulska, Marek Ruchała, Jolanta Kunikowska and Rafał Czepczyński
Diagnostics 2024, 14(15), 1690; https://doi.org/10.3390/diagnostics14151690 - 5 Aug 2024
Cited by 1 | Viewed by 1710
Abstract
Background: Primary hyperparathyroidism is a common endocrine disorder characterised by excessive parathormone secretion that results in hypercalcemia, primarily caused by parathyroid adenoma. Accurate localisation of hyperfunctioning tissue is essential for curative surgical treatment. Although conventional imaging modalities like ultrasonography and 99mTc-MIBI scintigraphy [...] Read more.
Background: Primary hyperparathyroidism is a common endocrine disorder characterised by excessive parathormone secretion that results in hypercalcemia, primarily caused by parathyroid adenoma. Accurate localisation of hyperfunctioning tissue is essential for curative surgical treatment. Although conventional imaging modalities like ultrasonography and 99mTc-MIBI scintigraphy (SPECT) along with 18F-fluorocholine PET/CT are commonly employed, there are cases with false-negative imaging results. Case presentation: This case report presents a patient with primary hyperparathyroidism and a parathyroid adenoma detected solely through 68Ga-PSMA-11 PET/CT, typically used for prostate cancer diagnosis. The lesion observed in the PET/CT was confirmed as a parathyroid adenoma through laboratory evaluation, while other imaging techniques failed to detect it. Conclusions: This finding suggests that the PSMA ligands’ particular affinity for neovascularisation in focal changes may facilitate the visualisation of parathyroid adenomas. The utilisation of 68Ga-PSMA-11 PET/CT in primary hyperparathyroidism could potentially improve the preoperative localization of parathyroid adenomas when conventional imaging methods are inconclusive. Full article
(This article belongs to the Special Issue Research Update on Nuclear Medicine)
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