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.

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.

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 explore the imaging features of 18F-fluorodeoxyglucose (FDG) PET/CT (high-resolution CT, HRCT) imaging in focal organizing pneumonia (FOP). Methods:Patients with solid nodular FOP ( n=45; 33 males, 12 females, age (58±9) years) and early peripheral non-mucinous solid lung adenocarcinoma ( n=47; 21 males, 26 females, age (63±10) years) confirmed by postsurgical pathology between May 2012 and December 2018 in Zhongshan Hospital, Fudan University were retrospectively analyzed. All patients underwent 18F-FDG PET/CT (HRCT) imaging followed by surgery within 3 weeks. The imaging findings and characteristics of the lesions were recorded. Differences of the maximum standardized uptake value (SUV max) and maximum diameter between FOP and adenocarcinoma were analyzed by Mann-Whitney U test or t′ test. Spearman correlation or Pearson correlation analysis was performed to analyze the relation between SUV max and maximum diameter. Binary logistic regression analysis was performed to identify the predictive factors for FOP. Finally, the receiver operating characteristic (ROC) curve analysis was used for evaluation of diagnostic efficiency. Results:The SUV max of FOP was lower than that of lung adenocarcinoma (3.1(1.7, 4.9) vs 6.5(3.8, 9.3); z=-4.598, P<0.01), and the maximum diameter of FOP was smaller than that of lung adenocarcinoma ((18.0±6.3) mm vs (21.8±4.3) mm; t′=-3.424, P<0.01). The SUV max was positively correlated with the maximum diameter in FOP group ( r s=0.509, P<0.01), while the SUV max of lung adenocarcinoma was not correlated with the lesion size ( r=0.076, P>0.05). HRCT of the PET/CT system showed the fusiform shape were more common in FOP ( χ2=9.549, P<0.05). Multivariate regression analysis identified that SUV max≤7.1, diameter≤18.3 mm, and fusiform shape were independent factors to predict FOP, with odds ratio ( OR) of 10.585, 4.674, 9.073, respectively (all P<0.05). ROC curve analysis showed that the area under the curve (AUC) of SUV max≤7.1 combined with diameter≤18.3 mm and fusiform nodule was 0.860, and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 97.8%(44/45), 70.2%(33/47), 75.9%(44/58), 97.1%(33/34), and 83.7%(77/92), respectively. Conclusion:SUV max≤ 7.1 combined with maximum diameter≤ 18.3 mm and fusiform shape may predict solid nodular FOP.

Objective To evaluate the diagnostic value of 18F-FDG PET/CT in patients with pancreatic neoplasm.Methods Fifty-three patients (36 males,17 females; age:(60.3±8.9) years) who underwent 18F-FDG PET/CT examination for suspected pancreatic tumor were retrospectively analyzed.Thirtytwo of them underwent dual-time point imaging.The characteristics of PET/CT images and serum CA19-9 were reviewed.Pathological results were used as a gold standard for evaluating the diagnostic value of PET/CT.Two-sample t test,paired t test and ROC curve analysis were used for data analysis.Results Thirtynine patients were finally diagnosed with pancreatic cancer and the other fourteen patients with benign disease.With SUVmax cutoff value of 3.13,the sensitivity and specificity of single-time point 18F-FDG PET/CT for diagnosis of pancreatic cancer were 92.3％ (36/39) and 9/14,respectively.The SUVmax was significant different between pancreatic cancer group and benign disease group (6.16±2.89 vs 3.37± 1.58; t =4.46,P＜0.01).Combined with the level of CA19-9,the diagnostic sensitivity and specificity were 69.2％ (27/39)and 13/14,respectively.The SUVmax of the early scan (5.45±2.43) was significantly different from that of the delayed scan (6.87±2.93) in pancreatic cancer group (t =8.25,P＜0.01),whereas no difference could be found in the benign group (3.18±1.28 vs 4.18±2.49; t=2.24,P＞0.05).With the SUVmax cutoff value of 3.3,the sensitivity,specificity and accuracy in the early scan were 87.0％ (20/23),6/9 and 81.2％ (26/32),respectively.While with the SUVmax cutoff value of 3.0,the sensitivity,specificity and accuracy in the delayed scan were 95.7％ (22/23),5/9 and 84.4％ (27/32),respectively.Conclusion 18 F-FDG PET/CT is a useful tool in the differential diagnosis of benign from malignant pancreatic diseases.

Objective To assess the memory function of hyperthyroid patients at different disease durations and investigate the value of cerebral blood flow (CBF) imaging in the detection of memory dysfunction in related regions.Methods Thirty-seven hyperthyroid patients (10 males,27 females; mean age (39.27± 10.58) years) and 28 healthy volunteers (8 males,20 females; mean age (35.80±9.41) years) were enrolled into this prospective study.The patients were divided into two subgroups: short duration group (duration ≤ 6 months; n =15),long duration group (duration ＞6 months ; n =22).Wechsler memory scale was used for memory assessment,and cancellation test was used for attention assessment.Self-rating depressions scale (SDS) and self-rating anxiety scale (SAS) were used for mood disorder assessment.99Tcm-ECD SPECT CBF imaging was performed at rest for all patients and controls on the same day.SPM 2.0 was used to investigate the differences of rCBF between the two groups.Two independent samples t test was used for the comparisons of memory and attention scores between patients and controls,also between patients with short and long disease durations.Multiple stepwise regression was used for factor analysis of memory state.Results Scale total score (92.27±17.50 vs 101.75±11.70; t=-2.476)and memory quotient (91.32±17.76 vs 100.29±9.43 ; t =-2.421) were significant different between patients and controls (both P＜0.05).The scale total score and memory quotient in patients with long disease duration were significant lower than those of controls(88.77±16.69 vs 101.75±11.70,t=-3.231; 86.18±16.73 vs 100.29±9.43,t=3.770,both P＜0.05).The memory quotient was significant lower in patients with long disease duration than those with short disease duration(86.10± 17.13 vs 98.87± 17.00; t =2.212,P＜0.05).There was no significant difference in memory quotient and scale total score between short duration group and controls (t=-0.754,0.910,both P＞0.05).CBF was reduced in the limbic system of hyperthyroid patients and the involved area was larger in patients with long disease duration.Age,attention score,serum FT4 level and reduced CBF in left pulvina nuclei,left lateral geniculate body and right amygdale were the statistically significant factors for impaired memory function in hyperthyroid patients (b=-0.393-0.685,all P＜0.05).Conclusions Memory impairment could be significant in hyperthyroid patients with long disease duration.CBF imaging could reflect the degree of dysfunction at specific brain regions responsible for memory impairment in these patients.

Objective:To analyze the 99 Tcm-methylene diphosphonate single photon emission computed tomography/spiral computed tomography (SPECT/CT)fusion imaging of bone metastases in patients with lung cancer and to evaluate the value of SPECT/CT in differentiating metastases from benign bone lesions.Methods:A total of 113 patients with bone metastases from lung cancer confirmed by pathology underwent bone scintigraphy and SPECT/CT imaging.Metastatic bone sites,quantity,up-take of radiotracer,and CT manifestations of each lesion were analyzed via bone scintigraphy imaging and SPECT/CT fusion imaging.Results:A total of 482 lesions from 113 patients were analyzed in this study.Among them,429 lesions were metasta-ses.Metastatic sites included spine(50.6%),thorax (29.1% ),pelvis (17.0%),extremities (2.1%),and skull(2.1%).CT manifestations were osteoblastic (41.0%),osteolytic (50.3%),mixed (4.0%),and normal (4.7%).Among these lesions, the proportion of hot spots displayed on SPECT/CT pictures was 90.7%(389/429),and the proportion of lesions with normal uptake of radiotracer was 9.3%(40/429).There were 53 benign lesions in 23 patients with bone metastasis.Conclusions:The most frequent metastatic sites in patients with lung cancer are spine and thorax.Bone metastasis from squamous carcinoma is more com-mon than from other types of lung cancer.The common CT manifestations are osteoblastic.The sensitivity and specificity of SPECT/CT fusion images for the diagnosis of bone metastatic lesions of lung cancer are high.

To study the pharmacokinetics of ~(131)I-Metuximab injection (Licartin) combined with transarterial chemoembolization (TACE) for treatment of hepatocellular carcinoma (HCC). MethodsLicartin (27.75 MBq/kg) and the mixture of anticancer drug and Lipiodol were sequentially administered with interval of 20 minutes to 15 patients with HCC via a transfemoral catheter.After the Licartin was administrated, the pharmacokinetic and biodistribution data were evaluated through venous blood samples,urine collections,and 4 γ-scintigraphies (SPECT) over 7 days. The pharmacokinetic parameters were determined from integration of the blood radioactivity-time curves using the SPSS 12.0 software. The tumor-no-tumor ratio (T/NT) was calculated by ROI. Absorbed doses in organ were estimated according to the medical internal radiation dose formalism. The biodistribution of licartin within patient's body at different time points was compared for various organs using analysis of variance for repeated measures, as well as the T/NT ratio. ResultsThe blood radioactivity-time curves followed the dynamics two-compartment model, with the major pharmacokinetic parameters including t_(1/2)α(1.96±1.65) h, and t_(1/2)α(19.07±5.91) h,and t_(1/2)β (57.09±10.92) h, and C_(max) 2.113×10~9min~(-1)·L~(-1), and AUC_(0-∞) 1.302×10~(11) h·min~(-1)·L~(-1), respectively. The accumulated urine radioactivity was 52.2% of administrated dosage during 144 h after administration. There were statistical significant difference of biodistribution of licartin and T/NT ratio between organs at different time points (F=6.583, P<0.01 and F=3.546, P<0.01). SPECT scans showed the significant accumulation of the radioconjugate in liver tumor and faint uptake in other organs for 14 days. Tumor-to-liver ratio decreased from 2.88±1.02 at 3 h to 1.64±0.40 at 168 h (n=7). Organ absorbed dose was (3.19±1.01) Gy in liver (n=12) and (0.55±0.09) Gy in red marrow (n=7). ConclusionLicartin combined with TACE for treatment of HCC is helpful to significantly accrete the radioconjugate in liver tumor, and protect normal organs from radiotoxictiy.