Lutetium-177 (¹⁷⁷Lu)-prostate specific membrane antigen (PSMA)-617 is a small-molecule radioligand therapy (RLT) drug targeting PSMA. By selectively delivering the β^－ radiation emitted by ¹⁷⁷Lu to PSMA-positive prostate cancer cells, it induces tumor cell death. The agent has been approved in multiple nations and regions for the treatment of PSMA-positive metastatic castration-resistant prostate cancer, thereby expanding therapeutic options for this patient population. This review outlines the development, pharmacological properties, and current clinical applications of ¹⁷⁷Lu-PSMA-617, aiming to provide a theoretical basis for the clinical practice of RLT in prostate cancer treatment.

ObjectiveTo explore the epidemiological characteristics of poisoning cases in Qingpu District, Shanghai, and to provide a scientific basis for the prevention and control of poisoning within the district. MethodsA retrospective study was conducted to collect the information of 3 415 poisoning cases admitted to sentinel hospitals from 2018 to 2024. Descriptive statistical analyses were performed regarding the causes of poisoning, types of toxicants, gender and age distribution, and temporal distribution. Chi-square tests were used to analyze differences among groups. ResultsMales accounted for 64.30% of the poisoning cases, and the 20‒39 years old group (51.27%) constituted the largest proportion. The top three causes of poisoning were alcohol abuse (61.00%), suicide (15.20%), and accidental ingestion (9.93%). The distribution of poisoning causes varied significantly by gender and age groups (P<0.001). Among cases aged 10 years old and below, the main causes of poisoning were accidents/disasters and accidental ingestion; among cases aged 20 to 69 years old, alcohol abuse was the primary cause; among cases aged 11 to 19 years old and 70 years old and above, suicide was the primary cause of poisoning. The categories of toxic subtances included alcohol (61.41%), drugs (21.93%), pesticides or rodenticides (6.21%), toxic gases or liquids (5.68%), and venomous animals (3.95%). The composition of toxic subtance categories differed by gender (χ²=714.8, P<0.001): males were primarily poisoned by alcohol (78.32%), while females were primarily poisoned by drugs (45.53%). Poisoning occurred most frequently in January, July, and August. Alcohol poisoning peaked in January; pesticide or rodenticide poisoning peaked in June‒July; toxic gas or liquid poisoning (CO accounted for 69.59%) peaked in December and January; venomous animal poisoning (bee stings accounted for 97.78%) peaked from June to August. There were 8 deaths for the poisoning cases, with a case fatality rate of 0.23%. ConclusionThe situation of poisoning in this district was relatively severe. Prevention and control measures targeting the characteristics of poisoning in different populations and the distinct peak periods should be implemented to reduce the incidence of poisoning in the district.

The recombinant human thyroid-stimulating hormone (rhTSH) can be used for differentiated thyroid cancer (DTC) preparation before ¹³¹I therapy, and follow-up. Since its approval by the American Food and Drug Administration (FDA) in 1998, rhTSH has been clinically used in European countries, the United States, and other countries for nearly 30 years. In April 2024, China’s first independently developed rhTSH agent was approved. Based on clinical experience and evidence from domestic and international studies, an expert consensus on the application of rhTSH has been developed following thorough consultations among experts. The consensus offers evidence-based recommendations to guide the appropriate use of rhTSH in clinical practice.

The translocator protein (TSPO) positron emission tomography (PET) can noninvasively detect neuroinflammation associated with epileptogenesis and epilepsy. This study explored the role of the TSPO-targeting radioligand [¹⁸F]F-TFQC, an m-trifluoromethyl ER176 analog, in the PET neuroimaging of epileptic rats. Initially, [¹⁸F]F-TFQC was synthesized with a radiochemical yield of 8%-10% (EOS), a radiochemical purity of over 99%, and a specific activity of 38.21 ± 1.73 MBq/nmol (EOS). After determining that [¹⁸F]F-TFQC exhibited good biochemical properties, [¹⁸F]F-TFQC PET neuroimaging was performed in epileptic rats at multiple time points in various stages of disease progression. PET imaging showed specific [¹⁸F]F-TFQC uptake in the right hippocampus (KA-injected site, i.e., epileptogenic zone), which was most pronounced at 1 week (T/NT 1.63 ± 0.21) and 1 month (T/NT 1.66 ± 0.20). The PET results were further validated using autoradiography and pathological analysis. Thus, [¹⁸F]F-TFQC can reflect the TSPO levels and localize the epileptogenic zone, thereby offering the potential for monitoring neuroinflammation and guiding anti-inflammatory treatment in patients with epilepsy.

68Ga-DOTATATE/18F-FDG two-day low-dose total-body PET/CT imaging is increasingly employed to facilitate the diagnosis,prognosis,and heterogeneity assessment of neuroendocrine neoplasms.We present a consensus on operational guideline for a two-day combined imaging from experts in low-dose/ultra-low-dose total-body PET/CT from several domestic medical institutions.

Objective:To investigate whether the image quality of total-body PET/CT (TB PET/CT) with 1 min acquisition can meet the clinical diagnostic requirements.Methods:From May 2019 to September 2021, a total of 90 malignant tumor patients (60 males, 30 females, age 31-86 years) with primary lesions confirmed by pathological diagnosis in Zhongshan Hospital, Fudan University were respectively analyzed. All patients underwent conventional PET/CT (C PET/CT) scan with conventional clinical acquisition and TB PET/CT scan with 1 min acquisition after injecting 18F-FDG in random order. Paired t test or Wilcoxon signed rank test was used to analyze the image quality of these two scans. Results:SUV max of primary lesions in TB PET/CT group was significantly higher than that in C PET/CT group (15.9(7.9, 24.6) vs 12.5(5.8, 16.6); z=8.14, P<0.001), so were signal-to-noise ratio (SNR) of the blood pool, liver, muscles (9.3±3.0, 11.4(9.5, 14.2), 8.3(7.3, 10.1) vs 6.2±1.7, 9.4(7.7, 11.8), 6.0(4.9, 7.1)), tumor-to-blood pool ratio (TBR) (9.3(4.3, 14.8) vs 8.5(4.3, 11.1)), tumor-to-liver ratio (TLR) (6.7(3.0, 10.4) vs 6.1(2.9, 7.7)), tumor-to-muscle ratio (TMR) (23.2(11.5, 38.0) vs 18.3(9.6, 26.6); t=9.36, z values: 4.44-7.40, all P<0.001). Conclusion:The image quality of TB PET/CT scan with 1 min acquisition can meet the diagnostic requirements, and is better than the C PET/CT image quality with conventional clinical acquisition.

Liver cancer has high morbidity and mortality worldwide.Traditional morphological imaging can offer crucial anatomical information for the diagnosis and treatment of liver cancer,and when combined with the functional data shown by PET imaging,the diagnostic accuracy of tumors can be further improved and assisted in treatment selection.Fibroblast activation protein(FAP),a signature protein of cancer-associated fibroblasts,is highly expressed in a variety of malignant tumors of epithelial origin and is an important target for tumor diagnosis and treatment.Compared with routinely applied 18F-fluorodeoxyglucose(FDG)PET imaging,FAP inhibitor(FAPI)PET imaging has the advantages of high image contrast and independence from blood glucose.In recent years,a variety of radiopharmaceuticals targeting FAP have been continuously expanded in the diagnosis,staging and targeted therapy of different liver cancer types,and the progress of their related applications is reviewed in this paper.

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

Objective:To investigate the value of 68Ga-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid- D-Phe1-Tyr3-Thr8-octreotide (DOTATATE) combined with 18F-FDG total-body PET/CT imaging in the diagnosis and heterogeneity assessment of primary foci of neuroendocrine neoplasms (NEN). Methods:Clinical, imaging and pathological data of 39 patients with pathological diagnosis (30 NEN and 9 non-NEN, 18 males and 21 females, age (54.0±11.4) years) who underwent 1/10 activity 18F-FDG and 1/2 activity 68Ga-DOTATATE total-body PET/CT combined imaging in Zhongshan Hospital, Fudan University from August 2020 to March 2023 were retrospectively analyzed. The NEN primary foci were classified as neuroendocrine tumor (NET) G1, G2, G3, and neuroendocrine carcinoma (NEC). Diagnostic efficacy of combined dual-low activity dual-tracer imaging for NEN primary foci and its value for evaluating tumor heterogeneity were analyzed. Results:The sensitivities, specificities, and accuracies of 68Ga-DOTATATE alone and in combination with 18F-FDG total-body PET/CT for the diagnosis of NEN primary foci were 81.2%(26/32), 7/9, 80.5%(33/41) and 90.6%(29/32), 7/9, 87.8%(36/41), respectively. Ten NET G1 and seven NET G2 lesions showed 68Ga-DOTATATE uptake and no 18F-FDG uptake; two NET G2 lesions showed no 68Ga-DOTATATE uptake but 18F-FDG uptake; and two NET G1 and six NET G2 lesions showed both 68Ga-DOTATATE and 18F-FDG uptake. The radiation doses of 68Ga-DOTATATE, 18F-FDG and a single examination of CT were (1.59±0.50), 0.49(0.44, 0.58) and 11.46(10.53, 12.85) mSv, respectively. Conclusion:Combining total-body PET/CT imaging with dual tracers can effectively diagnose NEN primary foci and assess inter-tumor heterogeneity.

Objective:To explore the feasibility of one-tenth dose 18F-FDG total-body PET/CT (TB PET/CT) in patients with malignant tumors. Methods:A retrospective analysis was carried out on 34 preliminarily diagnosed cancer patients (30 males, 4 females, age (64.0±1.6) years) who underwent one-tenth dose (0.37 MBq/kg) 18F-FDG TB PET/CT examination between April 2020 and September 2022 in Zhongshan Hospital, Fudan University. The raw data were reconstructed into 15 min and initial 2 min PET images (G15 and G2, respectively). A matched cohort of 34 preliminarily diagnosed malignant tumor patients (27 males, 7 females, age (63.3±2.1) years) undergoing full dose (3.70 MBq/kg) 18F-FDG conventional digital PET/CT (C PET/CT) examination with a PET scan rate of 2-3 min/bed position, were analyzed in line with the same pathological types. Signal-to-noise ratios (SNR) of G15, G2 and C PET/CT groups were compared, and based on the pathological results, the detection rates of those 3 groups for lesions were also compared. The χ2 test, independent sample t-test, Mann-Whitney U test, and Wilcoxon rank sum test were used for data analysis. Results:The significant differences in gender, age, body mass index (BMI), blood sugar level and postinjection waiting time between TB PET/CT group and C PET/CT group were not found ( χ2=0.98, t values: 0.08, -1.05, z values: 0.68, 0.41, all P>0.05). The SNR, from G15 to C PET and G2 groups, decreased gradually, which were 16.0(11.3, 20.0), 10.5(8.2, 13.5) and 8.4±0.3 respectively ( z values: 5.09, 3.31, -4.24, all P<0.05). All primary lesions and hepatic metastases were detected by G15 and G2 imaging (100%, 37/37) as well as by C PET/CT (100%, 36/36). The detection rates for lymph node metastasis lesions were 10/15 in the G2/G15 groups, which were higher than the detection rate in the C PET/CT group (64.4%(29/45); χ2=62.03, P=0.002). Conclusion:One-tenth dose 18F-FDG TB PET/CT with a 2-minute acquisition is feasibility in the clinical practice.