Diabetic polyneuropathy (DPN) is a common and disabling complication of type 2 diabetes mellitus (T2DM). Vitamin D deficiency has been implicated as a potential modifiable risk factor. This study aimed to investigate the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and DPN using the radioimmunoassay (RIA) method. One hundred twenty T2DM patients (80 with DPN and 40 without neuropathy) have been enrolled, while 40 healthy volunteers served as group control. Neuropathy diagnosis was based on clinical assessment (through Michigan neuropathy screening instrument (MNSI) - both questionnaire and examination) and nerve conduction studies. Serum 25(OH)D levels were quantified using RIA. Vitamin D levels were significantly lower in DPN patients (mean 13.2ng/mL) compared to diabetic (18.3ng/mL) and healthy controls (31.2ng/mL, P<0.001). Vitamin D deficiency (<10ng/mL) was found in 72.5% of DPN patients. Apart from severe neuropathy, other factors (age, body mass index -BMI- and HbA1c) have all been mildly inversely correlated to Vitamin D levels. Vitamin D deficiency is significantly associated with the presence and severity of DPN. These findings support the clinical value of assessing and potentially improving vitamin D status in diabetic patients, particularly in those with severe neuropathy.

Prognosis evaluation in cervical cancer is crucial for treatment decisions. This study aims to develop and validate a combined model using positron emission tomography (PET)-derived intratumoral and peritumoral radiomic parameters to predict cervical cancer prognosis based on the Shapley additive explanations (SHAP) method. A retrospective cohort of 114 patients with cervical cancer from two institutions was used, with one institution's data designated for training and the other for testing. Semi-automatic segmentation of fluorine-18-fluorodeoxyglucose (18F-FDG) PET images was performed to delineate the primary intratumoral and peritumoral regions, defined by expanding the tumor boundary by 2mm, 4mm, 6mm, and 8mm. Radiomic features were extracted from each region. Six machine learning algorithms were employed to construct intratumoral and peritumoral radiomic models, with the optimal model selected based on performance evaluated through receiver operating characteristic (ROC) and calibration curves. Area under the curve (AUC) values were compared using the DeLong test. The SHAP method was used to identify the key features influencing prognosis. Among the intratumoral and peritumoral radiomic models, the Gradient Boosting Machine (GBM) algorithm showed superior performance. The 4mm peritumoral model exhibited the best performance among the four peritumoral models, with a testing AUC of 0.762 (95% CI: 0.582-0.944). The integrated model combining the intratumoral and 4mm peritumoral regions emerged as the optimal radiomic model for predicting cervical cancer prognosis, achieving the highest AUC of 0.954 (95% CI: 0.882-1.000) in the testing set. At the patient level, SHAP force plots provided valuable insights into the combined model's predictive ability for prognosis. The integrated radiomic model, particularly for the 4mm peritumoral region, was validated as the optimal approach for predicting overall survival in cervical cancer. The application of the SHAP method enhanced interpretability, allowing for the identification of key features influencing prognosis and offering transparent insights for guiding personalized treatment strategies.

Chronic kidney disease (CKD) progression is accelerated by renal fibrosis, which causes abnormal extracellular matrix (ECM) accumulation. Non-invasive precision in measuring renal fibrosis is now possible with the help of advanced imaging techniques like magnetic resonance imaging (MRI) and ultrasound elastography. Fluorine-18-fibroblast activation protein (18F-FAP) is a promising Philips ingenuity TF positron emission tomography/computed tomography (PET/CT) scanner imaging target in activated fibroblasts associated with fibrotic disorders. Real-time quantification with FAP-targeted imaging improves kidney fibrosis diagnosis and guides anti-fibrotic therapies. The aim of this study is to develop reliable diagnostic and treatment techniques for renal fibrosis, Philips ingenuity TF PET/CT scanner imaging with FAP is useful. Positron emission tomography data from 100 patients in our hospital (October 2022-September 2023) was analyzed to see if renal radiotracer uptake correlated with CKD progression. Fluorine-18-FAPI-04 synthesis and Philips ingenuity TF PET/CT scanner imaging were standard. One person determined CKD stage and glomerular filtration rate (GFR) after imaging processing. Imaged renal radiotracer distribution using maximum standardized uptake value (SUVmax) and mean SUV (SUVmean). The study sought to improve renal radiotracer dispersion estimation for CKD assessment. The study reveals a complex relationship between GFR and radiotracer uptake in kidneys. At lower GFR, substantial uptake is seen, but a GFR of 15mL/min/1.73m2 shows a drop to zero. Higher GFR generally correlate with increased uptake, peaking at GFR of 75 and 90mL/min/1.73m2. Yet, at GFR of 115 and 120mL/min/1.73m2, there is a reduction in radiotracer uptake, suggesting a nuanced association with renal function. Varied kidney SUVmax and SUVmean were significant for 18F-FAPI C (P<0.001), while baseline SUV readings were not significant. Fluorine-18-L-dihydroxyphenylalanine (18F-DOPA) and gallium-68 (68Ga) 18F-prostate specific membrane antigen (PSMA) had significant kidney SUVmax values (P=0.05). Results suggest diverse absorption patterns for different radiotracers in kidneys and tissues. Fluorine-18-FAPI is a promising noninvasive approach for evaluating and quantifying CKD grades. Its excellent CKD severity correlation and renal insights make it a transformative diagnostic tool.

To develop a fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) radiomics-based nomogram model for predicting progression-free survival (PFS) in locally advanced cervical squamous cell carcinoma (LACSC) patients undergoing concurrent chemoradiotherapy (CCRT). A retrospective study included 241 LACSC patients treated with CCRT, divided into training (n=168) and validation (n=73) sets. Lesion segmentation, radiomics feature extraction and screening were performed on 18F-FDG PET images of each patient, and radiomics scores (Rad-scores) were calculated.Univariate and multivariate Cox regression analyses were used to identify independent prognostic factors and create a combined model and nomogram. Predictive performance was assessed using time-dependent receiver operating characteristic (ROC) curves, area under the curve (AUC), and consistency index (C-index). Calibration curves evaluated nomogram accuracy, and decision curve analysis (DCA) assessed nomogram clinical applicability. The Rad-score calculated from five optimal radiomics features and FIGO stage were independent predictors of PFS in LACSC patients.The C-index values for the FIGO stage, Rad-score, and combined model were 0.586, 0.692, and 0.727 in the training set, and 0.612, 0.668, and 0.698 in the validation set, respectively. The combined model showed excellent predictive ability for PFS at 12, 18, and 24 months, with training set AUCs of 0.805, 0.738, and 0.719, and validation set AUCs of 0.670, 0.744, and 0.741, respectively. The calibration curves confirmed a good agreement between predicted and actual progression probabilities, with DCA revealing significant clinical net benefits. The 18F-FDG PET radiomics-based nomogram effectively predicted PFS in LACSC patients and could support individualized treatment decisions and accurate prognostic evaluations.

Early detection of mild cognitive impairment (MCI) is crucial for initiating therapeutic interventions that may slow or prevent further cognitive deterioration. Mild cognitive impairment represents a transitional phase between normal cognitive aging and more severe forms of dementia, such as Alzheimer's disease (AD). Positron emission tomography (PET) can provide insight into the pathophysiology and progression of neurodegenerative processes associated with dementia and MCI using either fluorine-18 (18F)-florbetapir, which detects beta-amyloid plaque burden, or 18F-fluorodeoxyglucose (18F-FDG), which measures glucose metabolism. However, there are limited comparative studies using the two radiotracers to quantify cognitive decline. This case study presents an 83-year-old female with a clinical diagnosis of MCI and a mini-mental state examination (MMSE) score of 26, at the lower boundary for normal cognitive function; she was assessed with PET/computed tomography (CT) using both radiotracers. Although global assessments did not reveal significant abnormalities, localized findings showed hypometabolism in key brain regions, such as the posterior cingulate cortex, and beta-amyloid plaque accumulation in the anterior cingulate cortex. These results highlight the limitations of conventional cognitive assessments, like the MMSE, and underscore the potential value of PET imaging as a complementary diagnostic tool. The study supports the role of 18F-FDG as a stronger indicator of cognitive impairment due to its correlation with cognitive scores, while recognizing the need for further research to evaluate the predictive value of both PET tracers in early MCI detection and their potential to improve diagnostic accuracy.

This study aimed to identify factors influencing salivary gland uptake in fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT). We retrospectively reviewed patients aged 20-95 years diagnosed with T1N0M0 or T2N0M0 glottic carcinoma between July 2019 and March 2025, who underwent PET/CT for initial staging and radiotherapy planning. Maximum standardized uptake value (SUVmax) and total lesion glycolysis (TLG) were measured and compared based on gender, smoking history, hypertension, diabetes mellitus, dyslipidemia, stage, and primary tumor site. A total of 61 patients were included (mean age, 68.3±12.4 years; 57 male, 4 female). The cohort included 41 patients with T1N0M0 and 20 with T2N0M0 disease. Hypertension status was negative in 32, positive in 28, and unknown in 1; diabetes status was negative in 54, positive in 6, and unknown in 1; dyslipidemia status was negative in 51, positive in 9, and unknown in 1. Smoking history was negative in 7, positive in 53, and unknown in 1. Primary tumor accumulation was observed in 44 patients, while 17 showed no uptake at the primary site. The mean SUVmax of the right submandibular gland was 3.16±0.70 on the left, it was 3.05±0.76. In the right gland, median SUVmax was significantly higher in patients without hypertension 3.350 than in those with hypertension 2.725; P<0.01). In the left gland, median SUVmax was significantly higher in patients without hypertension 3.18 than in those with hypertension 2.56; P<0.01. In T1N0M0-T2N0M0 glottic carcinoma, 18F-FDG uptake in the submandibular glands is reduced in patients with hypertension.

Primary perivascular epithelioid cell tumors (PEComas) originating in the pericardium are extremely rare. We present a rare case of a malignant PEComa arising from the pericardium, with abnormal fluorine-18-fluorodeoxyglucose (18F-FDG) uptake maximum standardized uptake value (SUVmax 23.1) on positron emission tomography/computed tomography (PET/CT) scan, indicating its highly aggressive nature. Imaging revealed a soft tissue mass in the left atrial appendage with poorly defined borders to adjacent structures. The patient underwent CT-guided biopsy, and histopathological examination confirmed the diagnosis of malignant PEComa. This case underscores the atypical imaging features of a malignant pericardial PEComa, which, due to its elevated 18F-FDG uptake, should be considered in the differential diagnosis of cardiac masses with similar PET/CT characteristics, as well as for distinguishing between benign and malignant lesions.

Lymph node (LN) staging in lung cancer is crucial for treatment decisions. To develop and validate a positron emission tomography/computed tomography (PET/CT) radiomics model for preoperative estimation of LN metastasis in non-small cell lung cancer (NSCLC). A retrospective analysis of 252 NSCLC patients with 548 pathologically confirmed LN, including 227 occult LN, was performed. Clinical and PET/CT features were collected. Eight machine learning models were used for feature selection and radiomics signature (R-signature) construction. Models were developed for both the overall and occult LN groups. Model performance was evaluated using area under the curve (AUC), calibration, and decision curve analysis. The random forest-enhanced logistic regression (RFELR) model, based on 20 features, showed the best performance in predicting LN metastasis in both groups. The combined model demonstrated the highest predictive efficacy, with AUC of 0.94 (overall LN) and 0.89 (occult LN) in the training cohort, and 0.95 (overall LN) and 0.78 (occult LN) in the validation cohort. The combined model outperformed clinical, CT, and PET models (P<0.05) in both cohorts. Decision curve analysis showed a greater net benefit across a wider range of threshold probabilities for LN metastasis prediction. The combined model, integrating clinical, conventional PET/CT, and radiomics features, significantly enhances LN metastasis diagnosis. It shows promise in predicting occult LN metastasis and offers valuable support for personalized therapeutic decisions in NSCLC patients.

Hereditary transthyretin amyloidosis (hATTR) is considered a rare disease. This is precisely why there are cases of undiagnosed transthyretin amyloidosis, in patients present with restrictive cardiomyopathy, with or without neurological or other symptoms. There are cases of incidental detection of hATTR in patients with cardiac or neurological symptoms using whole-body scintigraphy with diphosphonates. In this paper, we present the accidental detection of hATTR in a 65-year-old patient with neurological and cardiac symptoms, who was referred for skeletal scintigraphy with skeletally avid radiopharmaceuticals due to skeletal pain of unknown origin. Significantly increased uptake of radiopharmaceuticals in the myocardium was observed, corresponding to a Perugini score of 3, with semi-quantification of the heart/contralateral lung fixation ratio (H/CL) of 2.6 in the second hour after radiopharmaceutical application. Ultrasound of the heart was in favor of concentric cardiomyopathy. Due to the high suspicion of hATTR, a genetic test was performed, which showed a pathological mutation of the gene for transthyretin. Hereditary hTTR is probably a more common disease than reported in the literature. Using hATTR detection algorithms and raising awareness of the possible existence of this disease, timely diagnosis using scintigraphy with bone avid radiopharmaceuticals and appropriate therapy can help patients and their close relatives.