Hybrid Imaging Research Articles

StegaCrypt Integrating Hybrid Cryptography and Image Steganography

This paper discusses the combination of cryptography and steganography for digital data security. Cryptography and steganography are two of the most significant techniques in information security, to be used differently: data is secured against unauthorized use and ensured integrity by way of transforming it into some unreadable format, whilst steganography hides a file inside another file. The project aim is to synthesize the techniques for a robust system to protect secure communication and data. We use RSA cryptography for the encryption, which is the asymmetric algorithm of high-level security, and image-based steganography to place the encrypted data within a digital image. The processes of cryptography will ensure decrypting the data only in the hands of authorized recipient parties, and steganography provides additional protection on the data invisibility front. This project shows that this integration of two technologies will safeguard sensitive information from all types of threats. In view of various methods to combine cryptography and steganography, this project puts forward the significance of incorporating multi-layer security to combat different types of cyber-attacks. The implementation also includes an elaborated coding using algorithms and development of a GUI to facilitate user interaction with the system. This further ensures that it is not only technically sound but also user-friendly. The last system is to send confidential data toward the broader field of secure communications and information protection, efficiently, securely, and in a user-friendly way

Possibilities of radiological methods of diagnosis of metastatic castration-resistant prostate cancer (Review Article).

Abstract Metastatic castration-resistant prostate cancer (mCRPC) is characterized by the progression of the tumor process when it becomes unresponsive to androgen-deprivation therapy. The incidence of bone metastases in these patients reaches up to 90%. Imaging modalities play a pivotal role in the diagnosis of this oncological condition. Computed tomography (CT) and magnetic resonance imaging (MRI) offer advantages in anatomical visualization; however, they face limitations in assessing the efficacy of prostate cancer treatment. Scintigraphy is applicable in screening for skeletal bone metastatic involvement but has limitations in assessing disease progression. Positron emission tomography combined with computed tomography (PET/CT) and single-photon emission computed tomography (SPECT/CT) are utilized for early detection of local or systemic spread of prostate cancer. The assessment of quantitative data on radiopharmaceutical uptake using PSMA PET imaging is used for predicting the efficacy of antitumor therapy. With the introduction of the radiopharmaceutical 177Lu-PSMA into clinical practice, the perspective of conducting radionuclide therapy with simultaneous efficacy evaluation through hybrid imaging methods has emerged. The capabilities of imaging modalities in assessing bone metastases present a particular interest for research and systematization of the data obtained to develop optimal parameters for conducting radioligand therapy and evaluating its efficacy. Aims: To explore the capabilities of imaging modalities in diagnosing metastatic castration-resistant prostate cancer. Conclusions: The analyzed literature data indicate that imaging methods for diagnosing mCRPC vary in sensitivity and specificity, have their advantages and disadvantages, which underscores the necessity for a comprehensive approach in their utilization. The development and advancement of methods for quantitative assessment of treatment efficacy, identification of prognostic markers can influence a more informed choice of treatment tactics and radiopharmaceutical selection, potentially leading to an increase in overall survival.

Rapid-response RNA-fluorescence in situ hybridization (FISH) assay platform for coronavirus antiviral high-throughput screening

Over the past 25 years, the global community has faced challenges posed by three distinct outbreaks of coronaviruses including severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The identification of a novel alphacoronavirus canine CoV (CCoV-HuPn2018) in human patients in Malaysia underscores the potential for crossover infections to humans. The threat of the ever-evolving nature of viral infections as well as the lingering health and socioeconomic effects of the recent SARS-CoV-2 pandemic emphasize the urgent need for advanced antiviral drug screening tools that can be quickly implemented to strengthen preparedness and preventive measures against future outbreaks. Here, we present the development and validation of a novel RNA-fluorescence in situ hybridization (FISH) imaging assay as a 384-well, high-throughput rapid response platform for antiviral drug discovery. RNA-FISH is a powerful tool to visualize specific mRNA in cultured cells using a high-content imaging platform. The flexibility of RNA-FISH probe sets allows for the rapid design of viral genome-specific probes, enabling in vitro assay development to test for inhibition of viral replication by either biologic or small molecule inhibitors. Screening of 170 antiviral compounds in concentration-response demonstrates a strong correlation between the RNA-FISH assay and an immunofluorescence assay (IFA) for both human coronaviruses HCoV-OC43 and HCoV-229E. Additionally, we successfully applied this methodology in the context of CCoV strain 1–71, proving rapid development and deployment, opening new avenues for the evaluation of antiviral drugs to potential future emerging threats.

Positron emission tomography-magnetic resonance imaging applications in pediatric musculoskeletal tumors.

The hybrid imaging positron emission tomography/magnetic resonance (PET/MR) is an important tool in the management of pediatric oncology patients, particularly in malignant musculoskeletal pathologies, because it combines the functional and metabolic information of tumor provided by PET with the high soft-tissue contrast and the functional information offered by magnetic resonance imaging (MRI). We performed an observational retrospective study that included pediatric patients diagnosed with primary bone or soft-tissue sarcomas in the Pediatric Hematology and Oncology Unit at the HM Montepríncipe University Hospital, Boadilla del Monte, Madrid (Spain) who underwent whole-body 18F-fluorodeoxyglucose (18F-FDG) PET/MRI as a staging study and for follow-up evaluation for treatment response from September 2017 to January 2023. This study explores the protocols, the practical application of the PET/MRI technique and our clinical experience at our center in the diagnosis and follow-up of primary bone tumors and soft-tissue sarcomas in children. Seventy-one 18F-PET/MR studies were performed on 39 patients. Most of them (55%) were initial extension studies and (45%) were follow-up studies. Most of the patients studied were male (74.4%) with a median age of 15 years. Of the 39 cases, 51% were primary bone tumors while 18% were Langerhans cell histiocytosis and 21% soft tissue tumors. Of the 71 studies, five showed metastases at the initial diagnosis, three presented lymph node involvement, one with local infiltration, and one with pulmonary metastasis. PET/MR has represented a significant advancement in the evaluation of pediatric malignant neoplasms, with specific applications in musculoskeletal tumors showing clear benefits over PET/CT. The primary advantage is the reduction in ionizing radiation doses and the assessment of soft tissues, making it an excellent option for malignant musculoskeletal pathologies in pediatric patients who often require long-term follow-up. It is particularly useful for early tumor detection and functional therapy monitoring in oncology. The development of new protocols is making studies increasingly faster and better tolerated, even without the need for anesthesia. PET/MRI has shown to increase diagnostic accuracy in primary bone and soft tissue tumors, as it allows for the comprehensive evaluation of their morpho-metabolic characteristics, locoregional, and distant involvement in a single study. It is also useful in surgical planning and post-treatment follow-up.

PO0211: Real Time Transrectal Ultrasound (TRUS) Guided Needle Insertion and Tracking in Hybrid Image Guided Adaptive Brachytherapy (IGABT) for Cervical Cancer Patients

PO0211: Real Time Transrectal Ultrasound (TRUS) Guided Needle Insertion and Tracking in Hybrid Image Guided Adaptive Brachytherapy (IGABT) for Cervical Cancer Patients

Safety and Feasibility of Interventional Hybrid Fluoroscopy and Nuclear Imaging in the Work-up Procedure of Hepatic Radioembolization.

Purpose To evaluate the safety and feasibility of a novel hybrid nuclear and fluoroscopy C-arm scanner to be used during the work-up procedure of hepatic radioembolization. Materials and Methods In this prospective first-in-human clinical study, 12 participants (median age, 67 years [range: 37-78 years]; nine [75%] male, three [25%] female) with liver tumors undergoing work-up for yttrium 90 radioembolization were included (ClinicalTrials.gov NCT06013774). Work-up angiography and technetium 99m-macroaggregated albumin injection were performed in an angiography suite equipped with a hybrid C-arm that could simultaneously perform fluoroscopy and planar nuclear imaging. Technetium 99m-macroaggregated albumin was injected under real-time hybrid imaging, followed by in-room SPECT imaging. Safety and feasibility were studied by assessing adverse events, technical performance, additional x-ray radiation dose, and questionnaires completed by radiologists and technologists. Results No adverse events were attributed to the hybrid C-arm scanner. The additional x-ray radiation dose was low (median, 19 Gy · cm2; minimum: 12 Gy · cm2; maximum: 21 Gy · cm2 for participants who completed all imaging steps). The interventional personnel considered use of the hybrid C-arm scanner safe and feasible, although the additional time spent in the intervention room was considered long (median, 64 minutes; minimum: 55 minutes; maximum: 77 minutes for participants who completed all imaging steps). Conclusion Use of the hybrid C-arm scanner during the work-up procedure of hepatic radioembolization was found to be safe and feasible in this first-in-human clinical study. Keywords: Angiography, Fluoroscopy, Interventional-Vascular, Radionuclide Studies, Radiosurgery, Gamma Knife, Cyberknife, SPECT, Instrumentation, Physics, Technical Aspects, Technology Assessment Supplemental material is available for this article. Published under a CC BY 4.0 license. Clinical trial registration no. NCT06013774.

Mapping the evolution of PET/MR research: a bibliometric analysis of publication trends, leading contributors, and conceptual frameworks (2011–2023)

BackgroundPositron emission tomography-magnetic resonance imaging (PET/MR) is a cutting-edge hybrid imaging technology with the potential to revolutionize medical diagnosis. This bibliometric study aims to map the research landscape of PET/MR by analyzing a curated set of Web of Science Core Collection documents from 2011 to 2023.MethodsWe conducted a bibliometric analysis to map the research landscape of PET/MR, leveraging a curated dataset of 3,600 documents retrieved from the Web of Science Core Collection spanning the period from 2011 to 2023. We employed quantitative methods to assess the quantity and distribution of PET/MR studies, including patterns of change, research status, and directions. Additionally, we utilized VOSviewer software to conduct keyword co-occurrence analysis, explore collaborative networks among authors and institutions, and identify influential journals in the field.ResultsResults: The analysis reveals several key insights: (1) a significant increase in the number of PET/MR publications over the past 12 years, highlighting the growing interest and activity in this field; (2) the United States and Germany as the leading countries in terms of research output and collaboration, with a growing presence of other countries such as China; (3) the Journal of Nuclear Medicine and the European Journal of Nuclear Medicine and Molecular Imaging as the most influential journals in the field; (4) a shift in research focus from imaging techniques to clinical applications, with an increasing emphasis on prostate cancer, PSMA, and FDG imaging.ConclusionsThis study provides a comprehensive overview of PET/MR research, identifying prominent trends, key researchers, and influential works. Based on these findings, we propose recommendations for future research directions in this rapidly evolving field.

Integrating VGG 19 U‐Net for Breast Thermogram Segmentation and Hybrid Enhancement With Optimized Classifier Selection: A Novel Approach to Breast Cancer Diagnosis

ABSTRACTEarly diagnosis of breast cancer is essential for improving patient survival rates and reducing treatment costs. Despite breast thermogram images having high quality, doctors in developing countries often struggle with early diagnosis due to difficulties in interpreting subtle details. Implementing a Computer‐Aided Diagnosis (CAD) system can assist doctors in accurately analyzing these details. This article presents an innovative approach to breast cancer diagnosis using thermal images. The proposed method enhances the quality and clarity of relevant features while preserving sharp and curved edges through U‐Net‐based segmentation for automatic selection of the ROI, advanced hybrid image enhancement techniques, and a machine learning classifier. Subjective analysis compares the processed images with five conventional enhancement techniques, demonstrating the efficiency of the proposed method. The quantitative analysis further validates the effectiveness of the proposed method against five conventional methods using four quality measures. The proposed method achieves superior performance with PSNR of 15.27 for normal and 14.31 for malignant images, AMBE of 6.594 for normal and 7.46 for malignant images, SSIM of 0.829 for normal and 0.80 for malignant images, and DSSIM of 0.084 for normal and 0.14 for malignant images. The classification phase evaluates four classifiers using 13 features from three categories. The Random Forest (RF) classifier with Discrete Wavelet Transform (DWT) based features initially outperformed other classifier features but had limited performance, with accuracy, sensitivity and specificity of 81.8%, 88.8%, and 91%, respectively. To improve this, three categories of features were normalized and converted into two principal components using Principal Component Analysis (PCA) to train the RF classifier, which then showed superior performance with 97.7% accuracy, 96.5% sensitivity, and 98.2% specificity. The dataset utilized in this article is obtained from the Indira Gandhi Centre for Atomic Research (IGCAR), Kalpakkam, India. The entire proposed model is implemented in a Jupyter notebook.

Hybrid Wavelet‐Deep Learning Framework for Fluorescence Microscopy Images Enhancement

ABSTRACTFluorescence microscopy is a powerful tool for visualizing cellular structures, but it faces challenges such as noise, low contrast, and autofluorescence that can hinder accurate image analysis. To address these limitations, we propose a novel hybrid image enhancement method that combines wavelet‐based denoising, linear contrast enhancement, and convolutional neural network‐based autofluorescence correction. Our automated method employs Haar wavelet transform for noise reduction and a series of adaptive linear transformations for pixel value adjustment, effectively enhancing image quality while preserving crucial details. Furthermore, we introduce a semantic segmentation approach using CNNs to identify and correct autofluorescence in cellular aggregates, enabling targeted mitigation of unwanted background signals. We validate our method using quantitative metrics, such as signal‐to‐noise ratio (SNR) and peak signal‐to‐noise ratio (PSNR), demonstrating superior performance compared to both mathematical and deep learning‐based techniques. Our method achieves an average SNR improvement of 8.5 dB and a PSNR increase of 4.2 dB compared with the original images, outperforming state‐of‐the‐art methods such as BM3D and CLAHE. Extensive testing on diverse datasets, including publicly available human‐derived cardiosphere and fluorescence microscopy images of bovine endothelial cells stained for mitochondria and actin filaments, showcases the flexibility and robustness of our approach across various acquisition conditions and artifacts. The proposed method significantly improves fluorescence microscopy image quality, facilitating more accurate and reliable analysis of cellular structures and processes, with potential applications in biomedical research and clinical diagnostics.

Breast tumor segmentation in ultrasound using distance-adapted fuzzy connectedness, convolutional neural network, and active contour

This study addresses computer-aided breast cancer diagnosis through a hybrid framework for breast tumor segmentation in ultrasound images. The core of the three-stage method is based on the autoencoder convolutional neural network. In the first stage, we prepare a hybrid pseudo-color image through multiple instances of fuzzy connectedness analysis with a novel distance-adapted fuzzy affinity. We produce different weight combinations to determine connectivity maps driven by particular image specifics. After the hybrid image is processed by the deep network, we adjust the segmentation outcome with the Chan-Vese active contour model. We find the idea of incorporating fuzzy connectedness into the input data preparation for deep-learning image analysis our main contribution to the study. The method is trained and validated using a combined dataset of 993 breast ultrasound images from three public collections frequently used in recent studies on breast tumor segmentation. The experiments address essential settings and hyperparameters of the method, e.g., the network architecture, input image size, and active contour setup. The tumor segmentation reaches a median Dice index of 0.86 (mean at 0.79) over the combined database. We refer our results to the most recent state-of-the-art from 2022–2023 using the same datasets, finding our model comparable in segmentation performance.

Initial results of the Hyperion IIDPET insert for simultaneous PET-MRI applied to atherosclerotic plaque imaging in New-Zealand white rabbits.

In preclinical research, in vivo imaging of mice and rats is more
common than any other animal species, since their physiopathology is very well-
known and many genetically altered disease models exist. Animal studies based on
small rodents are usually performed using dedicated preclinical imaging systems
with high spatial resolution. For studies that require animal models such as mini-
pigs or New-Zealand White (NZW) rabbits, imaging systems with larger bore
sizes are required. In case of hybrid imaging using Positron Emission Tomography
(PET) and Magnetic Resonance Imaging (MRI), clinical systems have to be used,
as these animal models do not typically fi t in preclinical simultaneous PET-MRI
scanners.
Approach. In this paper, we present initial imaging results obtained with the
Hyperion IID PET insert which can accommodate NZW rabbits when combined
with a large volume MRI RF coil. First, we developed a rabbit-sized image
quality phantom of comparable size to a NZW rabbit in order to evaluate the
PET imaging performance of the insert under high count rates. For this phantom,
radioactive spheres with inner diameters between 3.95 and 7.86 mm were visible
in a warm background with a tracer activity ratio of 4.1 to 1 and with a total
18-F activity in the phantom of 58MBq at measurement start. Second, we performed
simultaneous PET-MR imaging of atherosclerotic plaques in a rabbit in vivo using
a single injection containing 18-F-FDG for detection of infl ammatory activity,
and Gd-ESMA for visualization of the aortic vessel wall and plaques with MRI.
Main results. The fused PET-MR images reveal 18-F-FDG uptake within an
active plaques with plaque thicknesses in the sub-millimeter range. Histology
showed colocalization of 18-F-FDG uptake with macrophages in the aortic vessel wall lesions. 
Significance. Our initial results demonstrate that this PET insert
is a promising system for simultaneous high-resolution PET-MR atherosclerotic
plaque imaging studies in NZW rabbits.

Leveraging AI to Automate Detection and Quantification of Extrachromosomal DNA (ecDNA) to Decode Drug Responses.

Traditional drug discovery efforts have largely focused on targeting rapid, reversible protein-mediated adaptations to undermine cancer cells' resistance to therapy. However, cancer cells also exploit DNA-based strategies, typically viewed as slow, irreversible, and unpredictable changes like point mutations or the selection of drug-resistant clones. Contrary to this perception, extrachromosomal DNA (ecDNA) represents a form of DNA alteration that is rapid, reversible, and predictable, playing a crucial role in cancer's adaptive response. In this study, we present a novel post-processing pipeline for the automated detection and quantification of ecDNA in Fluorescence in situ Hybridization (FISH) images using the Microscopy Image Analyzer (MIA) tool. Our approach is particularly designed to monitor ecDNA dynamics during drug treatment, providing a quantitative framework to understand how ecDNA enables cancer cells to swiftly and reversibly adapt to therapeutic pressure. This pipeline not only offers a valuable resource for researchers aiming to automate ecDNA detection in FISH images but also sheds light on the adaptive mechanisms of ecDNA in response to epigenetic remodeling agents like JQ1.

Cell Population-resolved Multi-Omics Atlas of the Developing Lung.

The lung is a vital organ that undergoes extensive morphological and functional changes during postnatal development. To disambiguate how different cell populations contribute to organ development, we performed proteomic and transcriptomic analyses of four sorted cell populations from the lung of human subjects aged 0 to 8 years-old with a focus on early life. The cell populations analyzed included epithelial, endothelial, mesenchymal, and immune cells. Our results revealed distinct molecular signatures for each of the sorted cell populations that enable the description of molecular shifts occurring in these populations during post-natal development. We confirmed that the proteome of the different cell populations was distinct regardless of age and identified functions specific to each population. We identified a series of cell population protein markers, including those located at the cell surface, that show differential expression and distribution on RNA in situ hybridization and immunofluorescence imaging. We validated the spatial distribution of AT1 and endothelial cell surface markers. Temporal analyses of the proteomes of the four populations revealed processes modulated during postnatal development and clarified the findings obtained from whole tissue proteome studies. Finally, the proteome was compared to a transcriptomics survey performed on the same lung samples to evaluate processes under post-transcriptional control.

Hybrid cardiovascular imaging. A clinical consensus statement of the european association of nuclear medicine (EANM) and the european association of cardiovascular imaging (EACVI) of the ESC.

Hybrid imaging consists of a combination of two or more imaging modalities, which equally contribute to image information. To date, hybrid cardiovascular imaging can be performed by either merging images acquired on different scanners, or with truly hybrid PET/CT and PET/MR scanners. The European Association of Nuclear Medicine (EANM), and the European Association of Cardiovascular Imaging (EACVI) of the European Society of Cardiology (ESC) aim to review clinical situations that may benefit from the use of hybrid cardiac imaging and provide advice on acquisition protocols providing the most relevant information to reach diagnosis in various clinical situations.

Comparative Analysis of Large Language Models' Performance in Breast Imaging

Aim: To evaluate the performance of the flagship models, OpenAI's GPT-4o and Anthropic's Claude 3.5 Sonnet, in breast imaging cases. Materials and Methods: The dataset consisted of cases from the publicly available Case of the Month archive by the Society of Breast Imaging. Questions were classified as text-based or containing images from mammography, ultrasound, magnetic resonance imaging, or hybrid imaging. The accuracy rates of GPT-4o and Claude 3.5 Sonnet were compared using the Mann-Whitney U test. Results: Of the total 94 questions, 61.7% were image-based. The overall accuracy rate of GPT-4o was higher than that of Claude 3.5 Sonnet (75.4% vs. 67.7%, p=0.432). GPT-4o achieved higher scores on questions based on ultrasound and hybrid imaging, while Claude 3.5 Sonnet performed better on mammography-based questions. In tumor group cases, both models reached higher accuracy rates compared to the non-tumor group (both, p>0.05). The models' performance in breast imaging cases overall exceeded 75%, ranging between 64-83% for questions involving different imaging modalities. Conclusion: In breast imaging cases, although GPT-4o generally achieved higher accuracy rates than Claude 3.5 Sonnet in image-based and other types of questions, their performances were comparable.

A Simple and Fast Optical Clearing Method for Whole-Mount Fluorescence In Situ Hybridization (FISH)Imaging.

We report a single-step optical clearing method that is compatible with RNA fluorescence in situ hybridization (FISH) imaging. We previously demonstrated microscopy imaging with immunohistochemistry and genetic reporters using a technique called lipid-preserving refractive index matching for prolonged imaging depth (LIMPID). Our protocol reliably produces high-resolution three-dimensional (3D) images with minimal aberrations using high magnification objectives, captures large field-of-view images of whole-mount tissues, and supports co-labeling with antibody and FISH probes. We also custom-designed FISH probes for quail embryos, demonstrating the ease of fabricating probes for use with less common animal models. Furthermore, we show high-quality 3D images using a conventional fluorescence microscope, without using more advanced depth sectioning instruments such as confocal or light-sheet microscopy. For broader adoption, we simplified and optimized 3D-LIMPID-FISH to minimize the barrier to entry, and we provide a detailed protocol to aid users with navigating the thick and thin of 3D microscopy.

ESR Essentials: role of PET/CT in neuroendocrine tumors-practice recommendations by the European Society for Hybrid, Molecular and Translational Imaging.

Neuroendocrine neoplasms (NEN) originate from the secretory cells of the neuroendocrine system, with the majority arising in the gastrointestinal tract and pancreas. Given the heterogeneity in the biological behavior and morphological differentiation of these tumors, advanced imaging techniques are crucial for supporting the suspected diagnosis, accurate staging, and monitoring therapy. As most well-differentiated NEN demonstrate overexpression of somatostatin receptors (SSR) on the cell surface, SSR-directed PET/CT is considered the reference standard for imaging of this particular entity. SSR-PET/CT should be the imaging method of choice in every NEN G1 or G2 and considered for re-staging after both potentially curative and non-curative surgeries. The extent of SSR expression is also crucial for determining a patient's eligibility for peptide receptor radionuclide therapy (PRRT). PRRT utilizes [177Lu]Lu-DOTA-TATE to target the SSR receptor and can significantly prolong progression-free survival in patients with advanced, progressive neuroendocrine tumor of the gastroenteropancreatic system (GEP-NET). PET/CT is a central component of the multidisciplinary management of NEN. Variable follow-up intervals are recommended, considering that tumors with higher proliferation rates or advanced metastatic disease require more frequent assessments. The combination with other imaging modalities, like MRI, complements SSR-PET/CT, further enhancing overall diagnostic accuracy. KEY POINTS: Somatostatin receptor-PET/CT (SSR-PET/CT) is the guideline-recommended reference standard for imaging well-differentiated neuroendocrine tumors (NET). SSR-PET/CT should be the diagnostic imaging of choice for staging and post-therapy re-staging of grade 1 or 2 NET (G1 or G2). Variable follow-up intervals are recommended for NET G1 and G2. Tumors with higher proliferation rates or advanced metastatic disease necessitate more frequent assessments.

EANM/SNMMI guideline/procedure standard for [18F]FDG hybrid PET use in infection and inflammation in adults v2.0.

Hybrid [18F]FDG PET imaging is currently the method of choice for a wide variety of infectious and inflammatory disorders and was recently adopted in several clinical guidelines. A large amount of evidence-based articles, guidelines and appropriate use criteria have been published since the first version of this guideline in 2013. To provide updated evidence-based information to assist physicians in recommending, performing and interpreting hybrid [18F]FDG PET examinations for infectious and inflammatory disorders in the adult population. A systematic literature search of evidence-based articles using whole-body [18F]FDG hybrid imaging on the indications covered within this guideline was performed. All systematic reviews and meta-analyses published within the last 10 years until January 2023 were identified in PubMed/Medline or Cochrane. For each indication covered in this manuscript, diagnostic performance was provided based on meta-analyses or systematic reviews. If not available, results from prospective or retrospective studies were considered based on predefined selection criteria. RESULTSAND CONCLUSIONS: Hybrid [18F]FDG PET is extremely useful in the work-up and management of adults with infectious and inflammatory diseases, as supported by extensive and rapidly growing evidence-based literature and adoption in clinical guidelines. Practical recommendations are provided describing evidence-based indications as well as interpretation criteria and pitfalls.Monitoring treatment response is the most challenging but insufficiently studied potential application in infection and inflammation imaging.

ESR Essentials: staging and restaging with FDG-PET/CT in oncology-practice recommendations by the European Society for Hybrid, Molecular and Translational Imaging.

Positron emission tomography (PET) stands as the paramount clinical molecular imaging modality, especially in oncology. Unlike conventional anatomical-morphological imaging methods such as computed tomography (CT) and magnetic resonance imaging (MRI), PET provides detailed visualizations of internal activity at the molecular and cellular levels. 18-fluorine-fluorodeoxyglucose ([18F]FDG)-PET combined with contrast-enhanced CT (ceCT) significantly improves the detection of various cancers. Appropriate patient selection is crucial, and physicians should carefully assess the appropriateness of [18F]FDG-PET/CT based on specific clinical criteria and evidence. Due to its high diagnostic accuracy, [18F]FDG-PET/CT is indispensable for evaluating the extent of disease, staging, and restaging known malignancies, and assessing the response to therapy. PET/CT imaging offers significant advantages in patient management, particularly by identifying occult metastases that might otherwise go undetected. This can help prevent unnecessary surgeries, allowing many patients to be redirected to systemic chemotherapy instead. However, it is important to note that the gold standard for surgical planning remains CT and/or MRI, depending on the body region. These imaging modalities, with or without associated angiography, provide superior contrast and spatial resolution, essential for detailed surgical preparation and planning. [18F]FDG-PET/CT has a central role in the precise and early diagnosis of cancer, contributing significantly to personalized treatment plans. However, it has limitations, including non-tumor-specific uptake and the potential to inaccurately capture the metabolic activity of certain tumor types due to low uptake in some well-differentiated tumor cell lines. Therefore, it should be utilized in clinical scenarios where it offers crucial diagnostic insights not readily available with other imaging modalities. KEY POINTS: Use [18F]FDG-PET/CT selectively based on clinical appropriateness criteria and existing evidence to optimize resource utilization and minimize patient exposure. Employ [18F]FDG-PET/CT in treatment planning and monitoring, particularly for assessing chemotherapy or radiotherapy response in FDG-avid lymphoma and solid tumors. When available, [18F]FDG-PET/CT can be integrated with other diagnostic tools, such as MRI, to enhance overall diagnostic accuracy.

A review of proposed mechanisms for neurodegenerative disease.

Neurodegenerative diseases, such as Alzheimer's, Parkinson's, and amyotrophic lateral sclerosis (ALS) affect millions and present significant challenges in healthcare and treatment costs. The debate in the field pivots around two hypotheses: synaptic spread and selective vulnerability. Pioneers like Virginia Lee and John Trojanowski have been instrumental in identifying key proteins (tau, alpha-synuclein, TDP-43) central to these diseases. The synaptic spread hypothesis suggests a cell-to-cell propagation of pathogenic proteins across neuronal synapses, influencing disease progression, with studies highlighting the role of proteins like alpha-synuclein and amyloid-beta in this process. In contrast, the selective vulnerability hypothesis proposes inherent susceptibility of certain neurons to degeneration due to factors like metabolic stress, leading to protein aggregation. Recent advancements in neuroimaging, especially PET/MRI hybrid imaging, offer new insights into these mechanisms. While both hypotheses offer substantial evidence, their relative contributions to neurodegenerative processes remain to be fully elucidated. This uncertainty underscores the necessity for continued research, with a focus on these hypotheses, to develop effective treatments for these devastating diseases.