Prostate-specific membrane antigen (PSMA), expressed in neovascular endothelial cells of various malignancies including lung cancer (LC), highlights its potential as a biomarker for neovascularization. This study aimed to investigate the diagnostic efficacy of PSMA PET/CT in primary lung cancer (PLC), as well as to explore its role in staging and neovascularization detection in PLC. This retrospective study included 39 patients (27 with PLC, 12 with benign lesions) who underwent PSMA PET/CT, with or without FDG PET/CT, between April 2021 and July 2024. Lesion characteristics and immunohistochemistry for PSMA, VEGFA, and CD31 were assessed in 11 surgical cases. Statistical analyses included the Mann-Whitney U test and Spearman correlation ( p <0.05). Our study demonstrated that PSMA PET/CT effectively differentiates PLC from benign lesions, achieving a high SUVmax AUC of 0.89 (cutoff: 2.3g/mL) and a mediastinal lymph node (LN) identification AUC of 0.86 (cutoff: 2.5g/mL). Compared with FDG PET/CT, PSMA PET/CT exhibited a lower false-positive LN detection rate, resulting in N-stage reclassification in 60% (12/20) of cases. PSMA PET uptake in intrapulmonary lesions correlated significantly with the PSMA H-score (R=0.63, p <0.05), CD31-assessed microvessel density (R=0.77, p <0.01), and VEGFA H-score (R=0.65, p <0.05), while FDG uptake showed no correlation. PSMA PET shows higher uptake in PLC than in benign lesions, improves LN staging, and reveals its potential as a biomarker for neovascularization and treatment optimization in LC.

To evaluate the role of FDG PET/CT in diagnosing and monitoring rhinocerebral mucormycosis (RCM) and its added value over conventional imaging. We conducted a prospective observational study of 47 adults with biopsy-confirmed rhinocerebral mucormycosis between July 2022 and September 2024. All patients underwent FDG PET/CT, and findings were compared with MRI/CT and correlated with microbiological or histopathologic results. PET/CT was used to assess disease extent, identify residual or recurrent disease, and monitor treatment response. Of the 47 patients (43 men, 4 women; mean age 49.4 ± 12.2 y), 3 were imaged preoperatively and 44 postoperatively. PET/CT detected metabolically active disease in 35 patients, including 6 (12.8%) with lesions not well visualized on MRI/CT. Preoperative SUVmax was higher than postoperative (8.12 vs 6.12), reflecting disease burden reduction after surgery. PET/CT confirmed disease resolution in 12 patients who remained recurrence-free on follow-up. In 32 patients, PET/CT identified residual or recurrent disease, influencing further surgical and medical management. Representative images demonstrate PET/CT detection of active lesions missed on MRI/CT. FDG PET/CT delineates disease extent, guides therapeutic decisions, and confirms treatment response. Incorporating PET/CT into routine clinical management may improve outcomes by enabling timely, targeted interventions.

This study aims to establish a prognostic prediction system for mucosal melanoma patients by integrating melanocyte-targeting PET with clinical parameters. A retrospective study was conducted on primary mucosal melanoma patients who underwent [ 18 F]PFPN PET scans between January 2021 and April 2024. Researchers manually delineated all lesions on the [ 18 F]PFPN PET images and recorded the imaging features. Kaplan-Meier survival analysis, Cox regression, and stepwise regression were used to analyze prognosis and construct the prediction model. Fifty patients (mean age 60.5±8.8y) were included, with a median follow-up of 13 months (1-39mo) and an average survival of 14.62 months. Multivariate analysis showed that lower Whole-body Melanotic Tumor Volume (WBMTV), earlier stage, younger age, immunotherapy, and head and neck or vulvar subtypes were associated with longer overall survival (OS, P <0.05). A simplified prognostic scoring system was developed based on 5 variables: stage (not detected or I/II/III/IV: 0/5/10/15 points), age (<60/≥60: 0/10), WBMTV (<1.52/≥1.52: 0/10), immunotherapy (yes/no: 0/5), and subtype (head and neck or vulva/others: 0/10). Patients were stratified into low (0-19), intermediate (20-29), and high-risk (30-50) groups. The model's concordance index was 0.85, outperforming the clinical staging (0.76). OS declined progressively from low-risk to high-risk groups, with 1-year survival from 100% to 74.6% and 3-year survival from 100% to 0%. [ 18 F]PFPN PET provides an accurate assessment of mucosal melanoma burden, and a prognostic model combining [ 18 F]PFPN PET features and clinical data offers reliable stratification of patient outcomes.

Von Hippel-Lindau (VHL) disease is a rare, autosomal dominant, multisystem cancer syndrome. A variety of benign and malignant tumors can develop in VHL, including cranial and spinal hemangioblastomas, retinoblastoma, endolymphatic sac tumor, pheochromocytoma, renal cell carcinoma, pancreatic neuroendocrine tumors, and renal, pancreatic, and genital cysts. Here we present a 57-year-old woman who was diagnosed with VHL and, in the same 68Ga-DOTATATE PET/CT, exhibits all these components of the syndrome: pheochromocytoma, pancreatic neuroendocrine tumor, pancreatic cysts, renal cysts, liver hemangioma, and hemangioblastoma in the medulla oblongata.

A 72-year-old woman was appointed for 18F-FDG PET/CT for restaging of lung adenocarcinoma. Initial whole-body 18F-FDG PET/CT revealed a focal hypermetabolic area in the right lung, suspicious for lung metastasis, while no abnormalities were present in the partially depicted skull. Since the patient presented with a massive headache during examination, an additionally performed cranial PET/CT scan without further tracer injection revealed an intracerebral hematoma and wedge-shaped glucose hypometabolism in the left occipital lobe. An additional contrast-enhanced cranial CT performed 45 minutes after cranial PET/CT scan revealed progressive hematoma of the complete left hemisphere, mid-line shift, and tentorial herniation.

Head and neck squamous cell carcinoma of unknown primary (HNSCCUP) comprises 2%-5% of head and neck squamous cell cancers (HNSCC). Its coexistence with abdominal paraganglioma is exceedingly rare. We report a unique case of a 48-year-old male with HNSCCUP presenting as cervical lymphadenopathy and a coexisting abdominal paraganglioma. 18F-FDG showed uptake in both lesions, while 68Ga-DOTATATE was avid only in paraganglioma, and 68Ga-DOTA-FAPI-04 was avid only in cervical nodes. These differential uptake patterns reflect distinct tumor biology and underscore the potential for tailoring theranostic treatment strategies with 177Lu/90Y isotopes for FAPI-avid squamous cell cancers (SCC) and DOTATATE-avid paragangliomas.

Drug-induced sarcoid-like reactions (DISRs) present complex challenges in clinical management. The most common presentation in FDG-PET/CT scan is bilateral symmetrical lymphadenopathy, and occasionally spleen and bone involvement. DISR presenting as fasciitis/ myofasciitis is extremely rare. We will discuss pre-chemo, post-chemo, and follow-up FDG-PET/ CT scans, exhibiting DISR-induced fasciitis and resolution of findings after cessation of immunotherapy. How to diagnose and manage DISR is still debatable. Histologic confirmation or short interval follow-up scans with resolution findings can lead to the diagnosis, depending on the severity of symptoms, cessation of therapy or continuation of therapy is instituted.

We report a 68-year-old man with clinically established Parkinson's disease who underwent PET/CT imaging of the dopamine transporter (DAT) with the novel radiopharmaceutical 18F-PR04.MZ. The scan showed the expected reduced striatal uptake, but also revealed unexpected, focal accumulation of the radiotracer in the right frontal bone. Corresponding CT identified a well-circumscribed, hypodense lesion, compatible with fibrous dysplasia. A follow-up CT performed 4 years later confirmed lesion stability.

Lymphomatoid granulomatosis is an extralymphatic angio-invasive B-cell-associated lymphoproliferative disease. It primarily affects the lungs, followed by the skin, CNS, renal, and liver, and rarely involves the musculoskeletal system. Here we report a young man with pyrexia of unknown origin in whom FDG PET/CT demonstrated an unusual combination of CNS, lung, and musculoskeletal involvement mimicking diffuse metastasis. He was diagnosed with lymphomatoid granulomatosis, grade I, on a guided biopsy of the lung nodule.

Radioactive iodine (RAI) therapy is the standard-of-care for metastatic differentiated thyroid cancer (DTC), but ~60% of patients show resistance before achieving satisfactory response. Eligible patients were randomly assigned to RAI therapy plus lenvatinib (RAI-L arm) or standard RAI therapy alone (RAI arm). All patients were administered RAI therapy (5.5-7.4GBq) every 6-9 months, and patients in RAI-L arm were additionally administered lenvatinib (10mg once daily). The primary endpoint was objective response rate (ORR). Secondary endpoints included progression-free survival (PFS), overall survival, quality of life, and toxicity. Fifty patients were enrolled (mean age 49.1±12.6y, range 21-67). ORR was significantly higher in the RAI-L arm compared with RAI arm (54.5% vs. 24%; P=0.03). Subgroup analysis indicated combination therapy was more beneficial in age older than or equal to 55 years (P=0.04), follicular thyroid carcinoma (P=0.04), presence of both pulmonary and extra-pulmonary metastases (P=0.007), and RAI therapy-naive (P=0.02) patients. Median PFS in the RAI-L arm was 36 months (95% CI: 24.5-47.5) versus 26 months (95% CI: 18.9-33.1) in the RAI arm (P=0.09). Grade ≥3 adverse events were more frequent in the RAI-L arm (45.5%) compared with RAI arm (8%, P=0.006), with hypertension (31.8%) and hand-foot skin reaction (13.6%) being the most common. Combining RAI therapy with lenvatinib improved ORR with clinically meaningful prolongation of PFS; however, it comes with a burden of treatment-related toxicity, underscoring the need for careful patient selection.