Nuclear Imaging Research Articles

A Banner Year for Nuclear Medicine, Molecular Imaging, and Theranostics.

A Banner Year for Nuclear Medicine, Molecular Imaging, and Theranostics.

Publication Pressure in Nuclear Medicine.

The aims of this study were to determine the publication pressure perceived by nuclear medicine scientists and to identify associated determinants. Corresponding authors who published in Clinical Nuclear Medicine, Journal of Nuclear Medicine, or European Journal of Nuclear Medicine and Molecular Imaging between 2021 and 2023 were invited to participate in this survey study. Publication pressure was assessed using the revised Publication Pressure Questionnaire in the domains of "publication stress" (stress due to perceived pressure to publish), "publication attitude" (attitude regarding current publication culture), and "publication resources" (resources when working on publications or experiencing stress when working on publishing), with 5-point Likert scales. A total of 181 individuals participated. Median Publication Pressure Questionnaire scores in the domains "publication stress," "publication attitude," and "publication resources" were 3.33, 3.33, and 2.17, respectively. None of the researchers' characteristics were significantly associated with publication stress. Age >65 years was significantly associated with a more positive view on the publication climate (β coefficient of -0.552, P = 0.007). Several variables were significantly associated with a perception of fewer factors available to alleviate publication pressure: age 45-54 years (β coefficient of 0.249, P = 0.030), age 55-64 years (β coefficient of 0.421, P = 0.002), associate professor position (β coefficient of 0.398, P < 0.001), fellow/resident position (β coefficient of 0.355, P = 0.007), <5 years of research experience (β coefficient of 0.410, P = 0.026), and 5-10 years of research experience (β coefficient of 0.361, P = 0.003). Publication pressure among nuclear medicine scientists is appreciable. Several researcher characteristics appear to be associated with vulnerability to publication pressure.

Genetic Biomarkers in Heart Failure: From Gene Panels to Polygenic Risk Scores.

This review aims to provide a comprehensive overview of the current understanding of genetic markers associated with heart failure (HF) and its underlying causative diseases, such as cardiomyopathies. It highlights the relevance of genetic biomarkers in diagnosing HF, predicting prognosis, potentially identifying its preclinical stages and identifying targets to enable the implementation of individualized medicine approaches. The prevalence of HF is increasing due to an aging population but with greater access to disease-modifying therapies. Advanced diagnostic tools such as cardiac magnetic resonance, nuclear imaging, and AI-enabled diagnostic testing are now being utilized to further characterize HF patients. Additionally, the importance of genetic testing in HF diagnosis and management is increasingly being recognized. Genetic biomarkers, including single nucleotide polymorphisms (SNPs) and rare genetic variants, are emerging as crucial tools for diagnosing HF substrates, determining prognosis and increasingly directing therapy. These genetic insights are key to optimizing HF management and delivering personalized treatment tailored to individual patients. HF is a complex syndrome affecting millions globally, characterized by high mortality and significant economic burden. Understanding the underlying etiologies of HF is essential for improving management and clinical outcomes. Recent advances highlight the use of multimodal assessments, including AI-enabled diagnostics and genetic testing, to better characterize and manage HF. Genetic biomarkers are particularly promising in identifying preclinical HF stages and providing personalized treatment options. The genetic contribution to HF is heterogeneous, with both monogenic and polygenic bases playing a role. These developments underscore the shift towards personalized medicine in HF management.

Review of nuclear medicine imaging used in medical diagnostics

In this review, we will provide an overview of the role of nuclear medicine in Medical Diagnostics. Nuclear medicine is defined as the diagnosis and treatment of disease using radiolabeled compounds known as radiopharmaceuticals. Nuclear imaging produces images by detecting radiation from different parts of the body after a radioactive tracer material is administered. The images are recorded on a computer and film. Different types of nuclear imaging tests have different preparation instructions. Nuclear imaging is used primarily to diagnose or treat illnesses. Conditions diagnosed by nuclear medicine imaging include: Blood disorders, Thyroid disease. including hypothyroidism, Heart disease, Gallbladder disease, Lung problems, Bone problems, and kidney disease. Nuclear medicine, in combination with radiological modalities, gives extra information for diagnosis, prognosis, staging, treatment management, and the evaluation of responses to therapy in a non-invasive manner.

Influence of Fly Ash Content on Macroscopic Properties and Microstructure of High-Performance Concrete

To investigate the influence of the fly ash (FA) content on the performance of high-performance concrete (HPC), seven groups of tests were conducted, aiming to evaluate both the macroscopic properties (workability and compressive strength) and microscopic pore structure. Low-field nuclear magnetic resonance (NMR) technology and SEM images were employed to analyze the changes in the internal pore structure of the concrete. The results showed that the workability of HPC initially increased and then decreased with the increase in the FA content. When the FA content was 15%, the slump of HPC reached a maximum of 264 mm, and the 28-day compressive strength exhibited a 23.2% increase compared to the 7-day compressive strength. The pore size distribution of the concrete varied with different fly ash content. At 15% FA content, secondary hydration of the FA was sufficient, refining the pores to between 0 and 0.1 µm. Excessive FA substitution deteriorated the internal structure of the HPC matrix and reduced the workability and mechanical properties of the HPC. When the content of FA was 35%, the slump of HPC decreased to 176 mm, while the macropores within the matrix significantly increased, resulting in porosity of 6.81%.

Improving charge transfer efficiency in CCDs: A SILVACO-based numerical study

In this study, we investigate the charge transfer efficiency (CTE) of a radiation-damaged charge-coupled device (CCD) subjected to proton radiation levels typical of space-borne experiments, nuclear imaging, and particle detection. The primary factor affecting CTE in such damaged CCDs is the trapping of charge carriers by bulk states. Our analysis examines CTE as a function of temperature, and radiation-created traps (trap levels). We employed a two-dimensional numerical model using the SILVACO semiconductor simulation software to simulate the dynamic transfer process in a buried-channel CCD (BCCD) with a three-phase clock pulse driver. After setting the appropriate physical models and the suggested deep traps levels in the channel region. The simulations demonstrate that the CTE shows a nonlinear dependence on temperature, with a charge transfer inefficiency (CTI) peaking at 7x10-6 at 135 K and reaching a minimum value of 2x10-6 around 200 K. These simulated results closely match the experimental data found in the literature, providing a comprehensive understanding of the impact of radiation-induced traps on the dynamic charge transfer processes in CCDs.

Nuclear Molecular Imaging for Evaluating T Cell Exhaustion.

T cells are indispensable for the therapeutic efficacy of cancer immunotherapies, including immune checkpoint blockade. However, prolonged antigen exposure also drives T cells into exhaustion, which is characterized by upregulated inhibitory molecules, impaired effector functions, reduced cytotoxicity, altered metabolism, etc. Noninvasive monitoring of T cell exhaustion allows a timely identification of cancer patients that are most likely to benefit from immunotherapies. In this Review, we briefly explain the biological cascades underlying the modulation of inhibitory molecules, present a concise update on the nuclear molecular imaging tracers of T cell exhaustion, and then discuss the potential opportunities for future development.

EANM perspective on clinical PET and SPECT imaging in schizophrenia-spectrum disorders: a systematic review of longitudinal studies.

There is a need for biomarkers in psychiatry to improve diagnosis, prognosis and management, and with confirmed value in follow-up care. Radionuclide imaging, given its molecular imaging characteristics, is well-positioned for translation to the clinic. This systematic review lays the groundwork for integrating PET and SPECT imaging in the clinical management of schizophrenia-spectrum disorders. Systematic search of PubMed, Embase, Web of Science and Cochrane library databases was conducted from the earliest date available until February 2024. The focus was on longitudinal studies evaluating PET or SPECT imaging in individuals with a schizophrenia-spectrum or another psychotic disorders. Quality assessment was done using the Newcastle-Ottawa Scale (NOS), NIH scale for before-after studies and Cochrane Risk of Bias tool version 2 (Cochrane RoB2). Studies were further categorised into three groups: preclinical and diagnosis, predicting disease course or personalising treatment. Fifty-six studies were included in the systematic review investigating in total 1329 patients over a median of 3 months. Over two-thirds used PET tracers, whereas the remaining studies employed SPECT tracers. The most frequently investigated system was dopaminergic transmission, followed by cerebral metabolism and blood flow. [18F]FDOPA demonstrated large effect size in predicting conversion of subjects at risk and treatment response. Additionally, treatment dosage could be optimised to reduce side effects using [123I]IBZM or [11C]raclopride. Molecular imaging holds significant promise for real-life application in schizophrenia, with two particularly encouraging avenues being the prediction of conversion/response to antipsychotic medication and the improved management of antipsychotic dosage. Further longitudinal studies and clinical trials will be essential for validating both the clinical effectiveness and economic sustainability, as well as for exploring new applications.

The Impact of Active Ascertainment on Sex-Specific Differences in the Prevalence and Phenotype of Transthyretin Cardiac Amyloidosis: The SCAN-MP Study

Transthyretin cardiac amyloidosis (ATTR-CA) is disproportionately diagnosed in older adult men. However, studies suggest that the true prevalence of ATTR-CA in women may be higher than previously reported. The Screening for Cardiac Amyloidosis with Nuclear Imaging in Minority Populations (SCAN-MP) study utilizes nuclear scintigraphy to identify ATTR-CA in self-identified Black and Caribbean Hispanic participants ≥60 years old with heart failure and left-ventricular hypertrophy. We characterized the sex distribution and phenotypic characteristics of ATTR-CA in this active ascertainment cohort in comparison to a population of ATTR-CA patients who were referred to a tertiary care academic center outpatient clinic. Compared to the referral clinic cohort, the active ascertainment SCAN-MP cohort had a greater proportion of women (31.3% vs 13.3%, p=0.016). This was mainly attributed to the higher proportion of women with wild-type disease [ATTRwt-CA] (27.8% vs 7.1%, p=0.012). Women with ATTR-CA in the active ascertainment cohort exhibited higher left ventricular ejection fraction than those in the referral cohort (61% vs 50%, p = 0.011); lower left ventricular mass index (110 g/m2 vs 148 g/m2, p = 0.014); and lower posterior wall thickness (1.4 cm vs 1.6 cm, p = 0.01). An active ascertainment strategy for ATTR-CA identification demonstrated a greater proportion of women than did a referral cohort, driven predominantly by the greater proportion of women with ATTRwt-CA, and echocardiographic evidence of a less severe phenotype. In conclusion, efforts for early identification of ATTR-CA in women are critical for reducing sex disparities in this clinically treatable disease.

Effects of different freezing methods on the damage in potato tissues impregnated with trehalose

In this study, four freezing methods were evaluated: −40 °C contact plate freezing (−40°C-CPF), −80 °C contact plate freezing (−80°C-CPF), liquid nitrogen freezing (LNF), and vacuum freezing (VF). Potato slices treated with trehalose impregnation underwent freeze-thaw experiments to compare their freezing characteristics, water status, cell activity, and microstructure. The treatment/control groups were denoted as −40°CTre/CK, −80°CTre/CK, LNFTre/CK, and VFTre/CK, respectively. The results showed that the addition of trehalose significantly increased the freezing rate of VF, while VF had greater freezing damage. The −40°CTre sample had a lower drip loss, a lower relative electrical conductivity, and a greater hardness. After freeze-thawing, the change in the peak area proportion of the −40°CTre sample was found to be minimal, which was beneficial for the retention of water, as evidenced by low-frequency nuclear magnetic resonance (LF-NMR) and magnetic resonance imaging (MRI) analyses. Observing the microstructure, it was found that the cell structures of the −40°CTre sample was relatively complete, with good preservation of cell wall morphology. In addition, the presence of cell membranes was clearly observed in the −80°CTre and LNFTre samples. Under freezing conditions of −40°C-CPF, potatoes treated with trehalose showed minimal freezing damage.

Phosphonate-Based Aza-Macrocycle Ligands for Low-Temperature, Stable Chelation of Medicinally Relevant Rare Earth Radiometals and Radiofluorination.

Radioisotopes of fluorine (18F), scandium (43/44Sc, 47Sc), lutetium (177Lu), and yttrium (86Y, 90Y) have decay properties ideally suited for targeted nuclear imaging and therapy with small biologics, such as peptides and antibody fragments. However, a single-molecule strategy to introduce these radionuclides into radiopharmaceuticals under mild conditions to afford inert in vivo complexes is critically lacking. Here, we introduce H4L2 and H4L3, two small-cavity macrocyclic chelator structural isomers bearing a single phosphonate functional group. Potentiometry and spectrophotometry were employed to determine H4L2 and H4L3's ability to form a single [M(L)]- species with metals of different sizes (Sc3+, Lu3+, and Y3+) under physiologically relevant conditions. NMR spectroscopy and density functional theory (DFT) calculations suggest modulation of H4L2 and H4L3's inner-sphere hydration across the Sc3+/Lu3+/Y3+ series. Radiochemical labeling experiments with 18F, 44Sc, 177Lu, and 86Y reveal that H4L2 selectively chelates radioscandium at room temperature with high apparent molar activity (AMA, 462 mCi/μmol), while radiofluorination remains inaccessible. In contrast, H4L3 enables room temperature radiochelation 44Sc, 177Lu, and 86Y (AMA: 96-275 mCi/μmol) and incorporates 18F via the Sc-18F methodology to form [18F][ScF(L3)]2-. In vivo biodistribution analysis at 1 h postinjection confirms the broad utility of H4L3: all four radiochemical complexes clear off-target organs and remain >98% intact in urine metabolite analyses. The scope of room temperature radiochemical labeling, paired with facile 18F incorporation, to afford in vivo compatible complexes exceeds the clinical gold standard chelator DOTA and previously reported acyclic chelators, rendering H4L3 promising for prospective radiopharmaceutical applications.

Dosimetric and biological impact of activity extravasation of radiopharmaceuticals in PET imaging.

The increasing use of nuclear medicine and PET imaging has intensified scrutiny of radiotracer extravasation. To our knowledge, this topic is understudied but holds great potential for enhancing our understanding of extravasation in clinical PET imaging. This work aims to (1) quantify the absorbed doses from radiotracer extravasation in PET imaging, both locally at the site of extravasation and with the extravasation location as a source of exposure to bodily organs and (2) assess the biological ramifications within the injection site at the cellular level. A radiation dosimetry simulation was performed using a whole-body 4D Extended Cardiac-Torso (XCAT) phantom embedded in the GATE Monte Carlo platform. A 10-mCi dose of 18F-FDG was chosen to simulate a typical clinical PET scan scenario, with 10% of the activity extravasated in the antecubital fossa of the right arm of the phantom. The extravasation volume was modeled as a 5.5mL rectangle in the hypodermal layer of skin. Absorbed dose contributions were calculated for the first two half-lives, assuming biological clearance thereafter. Dose calculations were performed as absorbed doses at the organ and skin levels. Energy deposition was simulated both at the local extravasation site and in multiple organs of interest and converted to absorbed doses based on their respective masses. Each simulation was repeated ten times to estimate Monte Carlo uncertainties. Biological impacts on cells within the extravasated volume were evaluated by randomizing cells and exposing them to a uniform radiation source of 18F and 68Ga. Particle types, their energies, and direction cosines were recorded in phase space files using a separate Geant4 simulation to characterize their entry into the nucleus of the cellular volume. Subsequently, the phase space files were imported into the TOPAS-nBio simulation to assess the extent of DNA damage, including double-strand breaks (DSBs) and single-strand breaks (SSBs). Organ-level dosimetric estimations are presented for 18F and 68Ga radionuclides in various organs of interest. With 10% extravasation, the hypodermal layer of the skin received the highest absorbed dose of 1.32±0.01Gy for 18F and 0.99±0.01Gy for 68Ga. The epidermal and dermal layers received absorbed doses of 0.07±0.01Gy and 0.13±0.01Gy for 18F, and 0.14±0.01Gy and 0.29±0.01Gy for 68Ga, respectively. In the extravasated volume, 18F caused an average absorbed dose per nucleus of 0.17±0.01Gy, estimated to result in 10.58±0.50 DSBs and 268.11±12.43 SSBs per nucleus. For 68Ga, the absorbed dose per nucleus was 0.11±0.01Gy, leading to an estimated 6.49±0.34 DSBs and 161.24±8.12 SSBs per nucleus. Absorbed doses in other organs were on the order of micro-gray (µGy). The likelihood of epidermal erythema resulting from extravasation during PET imaging is low, as the simulated absorbed doses to the epidermis remain below the thresholds that trigger such effects. Moreover, the organ-level absorbed doses were found to be clinically insignificant across various simulated organs. The minimal DNA damage at the extravasation site suggests that long-term harm, such as radiation-induced carcinogenesis, is highly unlikely.

Noninvasive anatomical assessment for ruling out hemodynamically relevant coronary artery anomalies in adults – A comparison of coronary-CT to invasive coronary angiography: The NARCO study design

BackgroundAnomalous aortic origin of a coronary artery (AAOCA) is a rare congenital heart disease, potentially leading to myocardial ischemia and adverse cardiac events. As the sole presence of AAOCA does not always imply a revascularization, a detailed anatomical and functional analysis is crucial for clinical decision-making. Currently, invasive coronary angiography is the gold-standard method for a thorough hemodynamic assessment of AAOCA. However, due to its invasive nature, the development of noninvasive diagnostic alternatives is desired. MethodsIn the NARCO trial, patients with AAOCA will undergo coronary computed tomography angiography (CCTA) to assess anatomical high-risk features followed by a vessel-based (i.e. invasive measurement with fractional flow reserve and intravascular imaging under a dobutamine-volume challenge) and a myocardium-based (i.e. nuclear imaging) ischemia testing. Comparison of noninvasive and invasive imaging will be performed. Additionally, explorative analysis of post-processing advanced computational fluid dynamics (CFD) and 3D printing will be performed to unravel the pathophysiologic mechanism of myocardial ischemia in AAOCA. AimsOur primary aim is to define characteristics of anatomical high-risk features (using CCTA) to rule out noninvasively hemodynamically relevant anomalous vessels in AAOCA patients. The secondary aim is to investigate the underlying pathophysiology of AAOCA-related hemodynamic relevance using advanced techniques such as CFD and 3D printing. ConclusionsThe NARCO trial will help to optimize AAOCA patient selection for revascularization by improving risk stratification and ruling out hemodynamic relevance noninvasively and, therefore, preventing unnecessary downstream testing and/or costly interventions in patients with AAOCA.

Cardiac amyloidosis.

Cardiac amyloidosis is a disease characterised by the accumulation of amyloid protein in the heart tissue. There are several types of amyloidosis, but the most common types affecting the heart are ATTR amyloidosis (caused by transthyretin protein) and AL amyloidosis (caused by abnormal immunoglobulin light chains). Cardiac amyloidosis causes typical signs and symptoms of heart failure. Diagnosis involves a combination of imaging tests such as echocardiography and cardiac magnetic resonance imaging, as well as nuclear imaging scans and tissue biopsies to confirm the presence of amyloid deposits in the heart. Treatment of cardiac amyloidosis depends on the type and severity of the disease and includes medications to manage symptoms as well as treatments targeting the underlying cause of amyloidosis. Importantly, cardiac amyloidosis is a serious condition requiring specialised care from a multidisciplinary team including cardiologists and haematologists as well as other specialists familiar with the management of this rare disease. This is crucial, as early diagnosis and treatment are important for improving outcomes.

Exploring the Link Between Diabetes and Striatopathy: A Case Report

Diabetic striatopathy (DS) is known as a hyperglycemia-based chorea/ballism. Its classical demonstration is striatal hyper density on computed tomography, or hyperintensity on T1- weighted magnetic resonance imaging. It characterises a somewhat rare hyperglycemia condition that is linked to hyperdensity on computed tomography (CT) and/or hyperintensity on T1-weighted nuclear magnetic resonance imaging (MRI) as well as chorea/ballism and basal ganglia. Patients having a hyperglycaemic condition linked to even one of the following would also be included in DS, per a recent systematic study: (1) ballet or chorea; hyperintensity on T1-weighted MRI or (2) striatal hyperdensity in CT. Additionally, there has been a recent proposal for a potential categorisation of DS. There aren&amp;apos;t many case series on this subject that have been documented in the literature yet. It is thought that the prevalence of DS, which has been reported to be 1 in 100,00010, is underreported since most doctors are unaware of the disorder and may mistake it for typical intracerebral hemorrhage. It has been shown that older women with type 2 diabetes mellitus (DM) are more likely to develop the disease. Here, we describe an acute case of DS along with its characteristic radiological features, clinical presentation, imaging and instrumental exams, and treatment strategy. This case report serves as a helpful reminder to medical professionals to take diabetes patients with poor control into account when they exhibit symptoms including altered sensorium, sudden-onset choreiform movement, and ballistic motions.

Advancing Cancer Vaccines with Radionuclide Imaging.

Cancer vaccines are emerged as a beacon of hope in the fight against cancer. However, the lack of effective methods to directly observe their in vivo behavior and monitor therapeutic responses hinders their translation into clinical settings. Radionuclide imaging allows for non-invasive and real-time visualization of vaccine biodistribution and immunological response, offering valuable insights into the effectiveness of cancer vaccines and aiding in patient stratification. In this review, the latest advances and potential applications of radionuclide imaging in cancer vaccines are discussed, with a specific focus on strategies for visualizing the spatiotemporal distribution of vaccines in vivo and monitoring treatment efficacy. The challenges and considerations for implementing these techniques in clinical practice are also highlighted, aiming to inform and guide future research in this field.

Noninvasive Immunotyping and Immunotherapy Monitoring of Lung Cancers via Nuclear Imaging of LAG-3 and PD-L1.

Immunotherapy has significantly improved cancer patient survival, while its efficacy remains limited due to the reliance on a single marker like PD-L1 as well as its spatiotemporal heterogeneity. To address this issue, combining lymphocyte activation gene-3 (LAG-3) with PD-L1 is proposed for identifying immunotypes and monitoring immunotherapy through nuclear imaging. In short, 99mTc-HYNIC-αLAG-3 and 99mTc-HYNIC-αPD-L1 probes are synthesized using anti-human LAG-3 and PD-L1 antibodies, respectively. With high radiochemical purity and in vitro stability, these probes are confirmed to specifically bind to LAG-3 or PD-L1 in LAG3+ A549, LAG3- A549, and H1975 cells. SPECT/CT imaging of both probes showed specific in vivo tumor uptake in multiple lung cancer models, with significant linear correlation with ex vivo tumor uptake and immunohistochemical expression levels of LAG-3/PD-L1. Based on this, dual-index imaging was performed to simultaneously quantify LAG-3 and PD-L1. SPECT/CT imaging of 99mTc-HYNIC-αLAG-3 and 125I-αPD-L1 successfully distinguished four immunotypes. In addition, SPECT/CT imaging revealed LAG-3 upregulation in LLC-bearing LAG-3 humanized mice resistant to immunotherapy. In conclusion, this study demonstrates the feasibility of nuclear imaging of LAG-3 and PD-L1 for both noninvasive immunotyping and immunotherapy monitoring, thus offering novel perspectives on forecasting immunotherapy response, uncovering resistance mechanism, and optimizing combination treatment regimens.

Recommendations for the use of nuclear medicine imaging in patients with neuroblastoma.

Neuroblastoma (NB) is the most common extracranial solid cancer in children. Despite intensive multimodality treatment, long-term survival of patients with high-risk NB, which comprises more than half of all cases, remains poor. Nuclear medicine is key in diagnosis, staging, response assessment and long-term follow-up of NB. The emergence of novel tracers and the increasing complexity of studies require updated guidelines for nuclear medicine imaging in NB. Standardising diagnostic techniques are essential for improving study comparability and ensuring test quality. This article aims to provide a comprehensive review of NB radionuclide diagnostic imaging, including its characteristics, accuracy, advantages, and limitations. It offers practical recommendations to multidisciplinary teams responsible for treating patients with NB. This review summarises the opinions of leading experts from the Neuroblastoma Spanish Group within the Spanish Society of Paediatric Haematology and Oncology (SEHOP) and the Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM).

Can ChatGPT help patients understand radiopharmaceutical extravasations?

A previously published paper in the official journal of the Society of Nuclear Medicine and Molecular Imaging (SNMMI) concluded that the artificial intelligence chatbot ChatGPT may offer an adequate substitute for nuclear medicine staff informational counseling to patients in an investigated setting of 18F-FDG PET/CT. To ensure consistency with the previous paper, the author and a team of experts followed a similar methodology and evaluated whether ChatGPT could adequately offer a substitute for nuclear medicine staff informational counseling to patients regarding radiopharmaceutical extravasations. We asked ChatGPT fifteen questions regarding radiopharmaceutical extravasations. Each question or prompt was queried three times. Using the same evaluation criteria as the previously published paper, the ChatGPT responses were evaluated by two nuclear medicine trained physicians and one nuclear medicine physicist for appropriateness and helpfulness. These evaluators found ChatGPT responses to be either highly appropriate or quite appropriate in 100% of questions and very helpful or quite helpful in 93% of questions. The interobserver agreement among the evaluators, assessed using the Intraclass Correlation Coefficient (ICC), was found to be 0.72, indicating good overall agreement. The evaluators also rated the inconsistency across the three ChatGPT responses for each question and found irrelevant or minor inconsistencies in 87% of questions and some differences relevant to main content in the other 13% of the questions. One physician evaluated the quality of the references listed by ChatGPT as the source material it used in generating its responses. The reference check revealed no AI hallucinations. The evaluator concluded that ChatGPT used fully validated references (appropriate, identifiable, and accessible) to generate responses for eleven of the fifteen questions and used generally available medical and ethical guidelines to generate responses for four questions. Based on these results we concluded that ChatGPT may be a reliable resource for patients interested in radiopharmaceutical extravasations. However, these validated and verified ChatGPT responses differed significantly from official positions and public comments regarding radiopharmaceutical extravasations made by the SNMMI and nuclear medicine staff. Since patients are increasingly relying on the internet for information about their medical procedures, the differences need to be addressed.

Preclinical evaluation of antigen-sensitive B7-H3-targeting nanobody-based CAR-T cells in glioblastoma cautions for on-target, off-tumor toxicity

BackgroundGlioblastoma is the most common lethal primary brain tumor, urging evaluation of new treatment options. Chimeric antigen receptor (CAR)-T cells targeting B7 homolog 3 (B7-H3) are promising because of the...