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Medicina
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Diagnostic Imaging in the Theranostic Era: From 131I Scintigraphy...
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Diagnostic Imaging in the Theranostic Era: From 131I Scintigraphy to the Latest Innovations

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: 25 November 2025 | Viewed by 105

Special Issue Editors

Prof. Dr. Francesco Bertagna

E-Mail Website
Guest Editor
Nuclear Medicine, University of Brescia, ASST Spedali Civili Brescia, 25123 Brescia, Italy
Interests: theranostics; nuclear medicine therapy; thyroid cancer; neuroendocrine tumours; PET
Dr. Pietro Bellini

E-Mail Website
Guest Editor Assistant
Nuclear Medicine, University of Brescia, ASST Spedali Civili Brescia, 25123 Brescia, Italy
Interests: theranostics; nuclear medicine therapy; thyroid cancer; neuroendocrine tumours; PET

Special Issue Information

Dear Colleagues,

Nuclear medicine therapies are frequently conducted with radiotracers, exhibiting multiple spectra of radiation emissions, including gamma, beta, and/or alpha rays. The distinctive properties of these isotopes facilitate the concurrent acquisition of diagnostic images and the therapeutic effects. The advent of theranostics coincided with the inception of nuclear medicine therapies in the 1940s, starting with the utilisation of radioiodine in the treatment of thyroid cancer and hyperthyroidism. Subsequent radioiodine-labelled molecules, including 131I-MIBG for neuroblastoma and pheocromocitoma, further exemplify the evolution of theranostics. In recent years, this field has witnessed substantial advancements, exemplified by the approval of therapeutic agents such as 177Lu-oxodotreotide and 177Lu-vipivotide/tetraxetan, accompanied by their respective diagnostic PET tracers. The ability to visualise results, calculate dosimetry, and predict therapeutic effects at a single disease location represents a pivotal innovation. There have also been encouraging research results in relation to other prospective therapeutic targets and radiotracers, which has led to heightened interest in the field of theranostics. Overall, the increased utilisation of nuclear medicine therapies is leading to broader perspectives on their limitations and potential adverse effects.

This Special Issue will provide a platform for sharing expertise, principally through original research, reviews, and perspectives.

Prof. Dr. Francesco Bertagna
Guest Editor

Dr. Pietro Bellini
Guest Editor Assistant

Manuscript Submission Information

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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. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

  • theranostic
  • nuclear medicine therapy
  • thyroid cancer
  • DTC
  • neuroendocrine tumor
  • PET
  • PRRT
  • prostate cancer
  • radiotracers
  • dosimetry
  • narrative review
  • systematic review
  • comprehensive review
  • radioiodine

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Published Papers (1 paper)

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Review

16 pages, 702 KB  
Review
The Role of [18F]FDG PET-Based Radiomics and Machine Learning for the Evaluation of Cardiac Sarcoidosis: A Narrative Literature Review
by Francesco Dondi, Pietro Bellini, Roberto Gatta, Luca Camoni, Roberto Rinaldi, Gianluca Viganò, Michela Cossandi, Elisa Brangi, Enrico Vizzardi and Francesco Bertagna
Medicina 2025, 61(9), 1526; https://doi.org/10.3390/medicina61091526 - 25 Aug 2025
Abstract
Background/Objectives: Cardiac sarcoidosis (CS) is an inflammatory cardiomyopathy with a strong clinical impact on patients affected by the disease and a challenging diagnosis. Methods: This comprehensive narrative review evaluates the role of [18F]fluorodesoxyglucose ([18F]FDG) positron emission tomography (PET)-based radiomics and machine [...] Read more.
Background/Objectives: Cardiac sarcoidosis (CS) is an inflammatory cardiomyopathy with a strong clinical impact on patients affected by the disease and a challenging diagnosis. Methods: This comprehensive narrative review evaluates the role of [18F]fluorodesoxyglucose ([18F]FDG) positron emission tomography (PET)-based radiomics and machine learning (ML) analyses in the assessment of CS. Results: The value of [18F]FDG PET-based radiomics and ML has been investigated for the clinical settings of diagnosis and prognosis of patients affected by CS. Even though different radiomics features and ML models have proved their clinical role in these settings in different cohorts, the clear superiority and added value of one of them across different studies has not been demonstrated. In particular, textural analysis and ML showed high diagnostic value for the diagnosis of CS in some papers, but had controversial results in other works, and may potentially provide prognostic information and predict adverse clinical events. When comparing these analyses with the classic semiquantitative evaluation, a conclusion about which method best suits the final objective cannot be drawn with the available references. Different methodological issues are present when comparing different papers, such as image segmentation and feature extraction differences that are more evident. Furthermore, the intrinsic limitations of radiomics analysis and ML need to be overcome with future research developed in multicentric settings with protocol harmonization. Conclusions: [18F]FDG PET-based radiomics and ML show preliminary promising results for CS evaluation, but remain investigational tools since the current evidence is insufficient for clinical adoption due to methodological heterogeneity, small sample sizes, and lack of standardization. Full article
(This article belongs to the Special Issue Diagnostic Imaging in the Theranostic Era: From 131I Scintigraphy to the Latest Innovations)
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