搜索结果：Journal of nuclear medicine technology

The 2023 iteration of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) estimated prevalence, incidence, and health burden for 375 diseases and injuries, including 12 mental disorders. We assess past, current, and emerging trends in the prevalence and burden of mental disorders across sexes and age groups, for 21 regions, 204 countries and territories, and by Socio-demographic Index (SDI) quintile, from 1990 to 2023. Mental disorders included in GBD 2023 were anxiety disorders, major depressive disorder, dysthymia, bipolar disorder, schizophrenia, autism spectrum disorders, conduct disorder, attention-deficit hyperactivity disorder, anorexia nervosa, bulimia nervosa, idiopathic developmental intellectual disability, and a residual category of other mental disorders. A literature review identified epidemiological data for each disorder. These were analysed via a Bayesian meta-regression to estimate prevalence by disorder, sex, age, location, and year. Disorder-specific prevalence was multiplied by disability weights representing the severity of health loss associated with each disorder to estimate years lived with disability (YLDs). Deaths due to anorexia nervosa were assessed with a Cause of Death Ensemble modelling strategy to estimate deaths by sex, age, location, and year, and then multiplied by the standard life expectancy at age of death to estimate years of life lost (YLLs). YLDs equalled disability-adjusted life-years (DALYs) for all mental disorders except anorexia nervosa (the only mental disorder considered as an underlying cause of death in GBD), for which DALYs represented the sum of YLDs and YLLs. We presented prevalence, deaths, YLDs, YLLs, and DALYs as counts, age-specific rates per 100 000 population, and age-standardised rates per 100 000 population. We estimated 1·17 billion (95% uncertainty interval 1·06-1·31) prevalent cases of mental disorders globally in 2023, equivalent to an age-standardised prevalence rate of 14 210·7 cases (12 849·5-15 940·1) per 100 000 population. These estimates represented a 95·5% (75·0-121·2) increase in prevalent cases and 24·2% (11·4-41·4) increase in age-standardised prevalence rate between 1990 and 2023. All mental disorders showed increases in prevalent cases between 1990 and 2023, while notable increases were seen in age-standardised prevalence rates for anxiety disorders, major depressive disorder, dysthymia, anorexia nervosa, bulimia nervosa, schizophrenia, and conduct disorder. There were an estimated 171 million (127-228) DALYs due to mental disorders globally across sex and age in 2023, equivalent to an age-standardised DALY rate of 2070·5 DALYs (1519·1-2750·5) per 100 000 population. Mental disorders contributed to 6·1% (4·8-7·6) of all-cause DALYs in 2023, making them the fifth leading cause of global DALYs (up from 12th in 1990). DALYs were almost entirely composed of YLDs. Mental disorders were the leading cause of YLDs in 2023 (up from second in 1990), explaining 17·3% (14·8-20·6) of all-cause global YLDs. Leading causes of mental disorder DALYs were anxiety disorders (ranked 11th among the 304 diseases and injuries at Level 4 of the GBD cause hierarchy), major depressive disorder (15th), and schizophrenia (41st). Globally in 2023, mental disorder age-standardised DALY rates were higher among females (2239·6 [1643·7-3014·1] per 100 000) than among males (1900·2 [1399·8-2510·8] per 100 000), and peaked in the 15-19 years age group (2617·3 [1850·6-3696·8] per 100 000). All locations showed increased mental disorder DALY rates in 2023 compared with 1990, ranging across countries and territories from 1302·4 (952·7-1683·7) per 100 000 in Viet Nam to 3555·8 (2661·9-4715·0) per 100 000 in the Netherlands. Across SDI quintiles, DALY rates ranged from 1853·0 (1352·1-2469·3) per 100 000 for middle SDI to 2184·1 (1606·1-2890·3) per 100 000 for high SDI. A significant health burden was imposed by mental disorders in all countries and territories in 2023, irrespective of the health resources available. In some instances, this burden has increased over time and is unevenly distributed across populations. Stronger surveillance systems, particularly in low-income and middle-income countries, are required. Additionally, we need more coordinated and inclusive policies to reduce the burden through early treatment and prevention, tailored to sex and age differences across locations. Responding to the mental health needs of our global population, especially those most vulnerable, is an obligation, not a choice. Gates Foundation, Queensland Health, and University of Queensland.

The pace of surgical innovation appears ever faster. Innovation is being freed from the design constraints of the opposable digits of a surgeon's hand through the use of programmable binary digits. Surgeons must be the drivers of change and central to the application of innovations. We should collaborate with industry, engineers and scientists to think out of the box but must consider also expense, environmental impact, equity, and ethics. But we should not be blinded by shiny technology: innovation without impact is mere noise. The ultimate considerations are the diagnosis and management of surgical disease, of improving the care of our patients. Expert surgeons, scientists and engineers across the world were identified and invited to describe areas of innovation within surgery. They were given free rein to review their areas of expertise and to discuss both current and future applications of technology within surgical care. The Commission spans multiple surgical specialties and scientific domains. It reviews translational genomics, including the role of ctDNA, alongside microbiomic and proteomic applications in improving the diagnosis, treatment and monitoring of surgical disease. Applications to enhance surgical procedures are described, from medical micro/nanorobots for minimally invasive interventions, sensory-enriched surgery with visual optimization and molecular image-guidance to intelligent and semiautomated instruments. The expansion and broad influence of artificial intelligence in surgical writing, training and simulation, diagnosis and robotics is widely described. The role of surgical innovation and technology in driving personalized care for benign and malignant surgical disease from genomic profiling to bespoke surgical and non-surgical treatment pathways and surveillance is considered. The future of surgery is poised to become more precise, personalized, and effective. Collaboration with engineers, data scientists, and industry partners not only represents an exciting opportunity for surgeons to participate in team science but is critical to focus innovation goals on optimizing patient care and outcomes.

Maintenance-induced configuration drift detected during a 3-lot validation study is described, highlighting the role of nuclear medicine technologists and site engineers in its resolution. A radio-high-performance liquid chromatography system was used during validation of a new positron-emitting radiopharmaceutical. After routine maintenance, reduced peak intensity was observed despite otherwise normal operation. An investigation was conducted by nuclear medicine technologists and site engineers. The reduced peak intensity was traced to an unintended shift in the detector energy window from the standard 511 keV to approximately 400 keV. Peak intensities decreased to approximately 40%-60% of expected values. Restoration of the correct setting recovered normal performance. Maintenance may introduce configuration drift that is not detected through routine operational checks. Postmaintenance verification by nuclear medicine technologists is important, particularly during validation studies.

Gastric emptying is assessed in nuclear medicine by having patients consume a standardized radioactive meal, followed by imaging after meal ingestion (time 0) and at each hour up to 4 h. Usually, all of the meal is in the stomach at time 0. However, in some patients, a portion is in the small bowel at time 0. This study evaluates the effects of region-of-interest (ROI) placement on gastric retention percentages when meal is present in small bowel at time 0. Methods: In 624 patients who underwent gastric emptying scintigraphy, images were examined retrospectively for small bowel activity at time 0 (small bowel sign). We analyzed gastric retention by comparing time 0 ROIs drawn around the stomach and those drawn around the stomach plus small bowel. ROIs were drawn around the stomach at 1-4 h after meal ingestion. An equal number of age- and sex-matched patients without the small bowel sign were evaluated. Qualitative assessment was used to determine whether most counts were in the gastric fundus or antrum at time 0. Results: The small bowel sign was present in 8.3% of patients (52/624). Over 1-4 h, the mean initial ROIs without bowel analysis were significantly higher than those with bowel analysis (38% &#xb1; 36% vs. 30% &#xb1; 30%, P < 0.0001). A normal gastric retention value of no more than 10% at 4 h was found in 94.2% of patients (49/52) using the initial ROI without bowel analysis and in 100% of patients (52/52) using the initial ROI with bowel analysis. Rapid gastric transit (retention of &#x2264;30% at 1 h) was seen in 3.8% of cases (2/52) using the initial ROI without bowel analysis and in 9.6% of cases (5/52) using the initial ROI with bowel analysis (P not significant). At time 0, most counts were in the antrum in 33% of patients with the small bowel sign versus 8% in patients without the small bowel sign (P = 0.001). Conclusion: In patients with a portion of the meal in the small bowel on time 0 images, the exclusion of small bowel counts on ROI analysis can lead to spuriously high 1- and 4-h gastric retention values. This can lead to underdiagnosis of rapid gastric transit at 1 h and overdiagnosis of delayed gastric emptying at 4 h.

Simulation-based education has emerged as a strategic response to placement scarcity, workforce strain, and the increasing complexity of nuclear medicine practice. The theoretic principles and simulation architecture are transformed into practical implementation strategies across the nuclear medicine technologist training continuum. Simulation is positioned as a calibrated scaffold that reduces cognitive load, enhances safety, and strengthens readiness for authentic clinical engagement. A broad spectrum of simulation modalities are explored, including task trainers, human actor simulation, laboratory rehearsal, computer-based console simulators, immersive virtual and augmented realities, metaverse environments, synthetic data generation, artificial intelligence-enhanced adaptive simulation, and in situ departmental integration. Enrichment tools are presented as amplifiers that enhance feedback, fidelity, and personalization. Through applied case examples and reflective practice insights, simulation is conceptualized as a staged developmental framework aligned with regulatory expectations and workforce realities. The proposed SCAFFOLD (Simulation as a Calibrated Framework for Optimizing Learning and Development) framework offers a pragmatic blueprint for enhancing work-integrated learning readiness while preserving the irreplaceable value of authentic clinical experience.

Based on the observation that loss-of-function mutations of KMT2C and KMT2D (KMT2C/D) are enriched and co-occur in gastric adenocarcinoma, we developed genetically engineered mouse models (GEMMs) to conditionally knock out Kmt2c and Kmt2d in gastric epithelial cells. We observed that Kmt2c/d loss led to nuclear dysplasia, cellular crowding, and expansion of cells with mixed gastric lineage markers. When combined with Pten deletion, Kmt2c/d loss drove rapid development of muscle-invasive gastric adenocarcinoma as early as 3 weeks after Cre-mediated gene deletion. The adenocarcinoma exhibited decreased expression of gastric lineage markers and increased expression of intestinal differentiation markers, phenocopying human intestinal-type gastric adenocarcinoma. Bioinformatic integration of single-cell RNA-seq of our GEMMs and human gastric cancer datasets showed coclustering of normal and of cancerous gastric epithelial cells. Kmt2c/d knockout in gastric epithelium reduced protein synthesis but upregulated transcription of ribosomal proteins, rendering the cells hypersensitive to mTOR complex 1 (mTORC1) inhibitors. Additionally, Kmt2c/d knockout increased MHC class I molecule expression and enhanced antigen presentation. Combination of mTORC1 inhibition and anti-programmed cell death 1 immunotherapy markedly suppressed tumor growth in immune-competent mice. Together, these findings reveal the role of Kmt2c/d loss in gastric cancer initiation and suggest potential therapeutic strategies for KMT2C/D-deficient gastric cancer.

Simulation-based education has become widely embedded in health professional training and is increasingly positioned as a solution to clinical placement capacity constraints, patient safety imperatives, and growing procedural complexity. Yet the rapid expansion of simulation in nuclear medicine technologist education carries under-recognized risks. Evidence frequently demonstrates gains in confidence, knowledge, and short-term performance; however, transfer to workplace capability and sustained clinical outcomes is variable and depends strongly on program design, educator expertise, debriefing quality, and integration with authentic clinical experience. When misaligned with task demands, simulation can generate false confidence, fragile competence, inequitable access, and educational "theatre" that is expensive but difficult to justify. Emerging layers such as virtual reality and artificial intelligence add new implementation, safety, privacy, and bias concerns, including cybersickness, usability barriers, data governance risks, and unreliable automated feedback. In nuclear medicine, where errors can create patient harm, radiation safety incidents, workflow disruption, and learner psychological harm, simulation must be treated as a high-stakes educational technology requiring strong governance, rigorous evaluation, and explicit limits. This counterpoint argues that simulation should be framed as a disciplined adjunct to supervised workplace learning rather than a scalable substitute. The value of simulation is maximized when focused on targeted competencies, delivered under best-practice standards, and evaluated against defensible outcomes beyond learner satisfaction and confidence.

The partial-volume effect (PVE) is a major factor affecting quantitative accuracy in small-animal SPECT and PET imaging, leading to underestimation of activity in hot-rod images and overestimation in cold-rod images. However, a phantom capable of assessing image quality, including the PVE in both hot and cold regions, has not been available. This study aimed to determine whether a newly developed phantom can accurately evaluate image quality, including the PVE of hot- and cold-rod images, in small-animal SPECT and PET systems. Methods: The phantom consisted of a cylindric pool and rod sections. The rod section included 6 hot rods and 6 cold rods with diameters of 1-6 mm. The rod and pool sections were filled with solutions containing 99mTc and 18F, respectively. In the hot-rod section, the radioactive concentration ratio between rods and background was set to 4:1. Images were acquired for 30 min and reconstructed with a voxel size of 0.8 mm using a pixel-based ordered-subset expectation maximization algorithm. Image contrast, absolute and inverse recovery coefficients (RCs) (indicators of the PVE), and percent coefficient of variation (%CV) and signal-to-noise ratio (indicators of uniformity) were evaluated for both hot and cold rods. Results: The contrast of the hot rod for 99mTc and 18F showed lower values with decreasing rod diameters. Furthermore, the 99mTc image demonstrated a higher contrast than the 18F image and approached the true contrast. The cold-rod contrasts with 99mTc and 18F followed a similar trend. The RCs of 99mTc and 18F were lower as rod diameters decreased. The radioactive concentration in the 40-mm pool section was similar to that of the 6-mm hot rod for both radionuclides. The inverse RC was lower with a decreasing cold-rod diameter. Moreover, cold-rod images with 18F demonstrated lower inverse RCs than with 99mTc. The %CVs for the 99mTc and 18F images were 3.49% &#xb1; 0.03% and 6.29% &#xb1; 0.07%, respectively, with the 99mTc image displaying a lower %CV compared with the 18F image. Conclusion: We developed a phantom that allows the evaluation of physical phenomena in small-animal SPECT and PET images, providing reliable assessment of image contrast, PVE, and uniformity in both hot and cold rods.

The objective of this study was to evaluate the impact of 2 PET reconstruction methods-time of flight (TOF) and TOF with point-spread function (PSF) modeling (TOF + PSF)-on image quality and measured quantitative metrics in 68Ga-PSMA PET/CT for prostate cancer. Methods: This retrospective analysis included 36 patients with prostate cancer who underwent 68Ga-PSMA PET/CT at the Sultan Qaboos Comprehensive Cancer Care and Research Center between October 2022 and February 2024. PET data were reconstructed using TOF and TOF + PSF on a Biograph Vision 600 system. The quantitative parameters compared were SUVmean, prostate-specific membrane antigen tumor volume (PSMA-TV), total lesion uptake (TLU), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and lesion-to-background ratio (LBR; lesion SUVmean/background SUVmean). Paired t tests or Wilcoxon signed-rank tests were used as appropriate, and agreement between reconstructions was assessed using Bland-Altman analysis. Results: Compared with TOF, TOF + PSF yielded a significantly higher SUVmean (mean difference, 1.41; 95% CI, 1.08-1.75; P < 0.001), SNR (mean difference, 23.31; 95% CI, 18.34-28.28; P < 0.001), CNR (mean difference, 23.54; 95% CI, 18.62-28.47; P < 0.001), LBR (mean difference, 8.0; 95% CI, 5.85-10.16; P < 0.0001), and TLU (mean difference, 3.62; 95% CI, 2.40-4.84; P < 0.001). PSMA-TV showed no significant difference between reconstructions (mean difference, 0.0052; 95% CI, -0.0154 to 0.0257; P = 0.626). Bland-Altman analysis demonstrated a systematic positive bias for TOF + PSF in SUVmean, SNR, CNR, LBR, and TLU. Because PSF modeling can increase SUV-based measurements via resolution recovery and edge effects, these increases should be interpreted as reconstruction-dependent changes in relative contrast rather than confirmed improvements in absolute quantitative accuracy without ground-truth validation. Conclusion: TOF + PSF reconstruction improves image quality and increases SUV-based and contrast-related metrics in 68Ga-PSMA PET/CT and thus may enhance the conspicuity of small or low-contrast lesions. Phantom-based validation is recommended to determine the extent to which these reconstruction-dependent differences translate into improved absolute quantitative accuracy.

Hydrogen sulfide (H2S) has been reported to exert both protumor and antitumor functions. It is worthy to clarify the condition under which H2S exerts antitumor effects and its underlying mechanism. Our previous study connected the immune checkpoint indoleamine 2,3-dioxygenase 1 (IDO1) and H2S by revealing that H2S downregulates IDO1 expression, leading to our hypothesis that antitumor effect of H2S is associated with IDO1 expression in tumor cells. Apoptosis, cellular distribution of NR4A1, phosphorylation of IDO1, and the binding of phosphorylated IDO1 and SOCS3 are examined both in vitro and in vivo. In this study, we confirm our hypothesis by showing that H2S significantly reduces proliferation and induces apoptosis of tumor cells with high IDO1 expression. In tumor cells with high IDO1 expression, H2S promotes the translocation of NR4A1 out of nucleus and its binding with BCL-2, as well as the phosphorylation of IDO1 and the codegradation of phosphorylated IDO1 and SOCS3. Such mechanism by which H2S induces apoptosis of tumors with high IDO1 expression is also elucidated in tumor-bearing mice, where H2S shows great therapeutic effect against tumors with high IDO1 expression. H2S induces apoptosis of tumor cells with high expression of IDO1 by promoting NR4A1-BCL-2 apoptotic pathway and the codegradation of phosphorylated IDO1 and SOCS3. Our study provides new theoretical and experimental evidence for a strategy for tumor therapy with H2S.

Simulation-based education has evolved into a foundational component of nuclear medicine technologist training, driven by increasing procedural complexity, radiation safety imperatives, and growing pressure on clinical placement capacity. Nuclear medicine students must rapidly integrate cognitive, psychomotor, and interpersonal skills while working with radioactive materials and vulnerable patients in a complex regulatory environment. A diverse suite of modalities ranging from human actors through laboratory-based skills to virtual reality supports functional task alignment across the learning continuum. Evidence consistently demonstrates that simulation improves students' procedural accuracy, radiation-safety behaviors, clinical reasoning, emergency responsiveness, communication skills, and self-confidence while reducing placement-related anxiety and error risk. When conceptualized as an integrated ecosystem, simulation enhances learner outcomes, supports workforce resilience, and strengthens the transition to independent practice.

The rapid expansion of theranostics has increased the stress felt by many nuclear medicine departments. One significant challenge relates to the training of nuclear medicine technology students in new therapy procedures during a time when protocols and expectations are in flux. Nuclear medicine technologist education programs are being asked to graduate fully functional theranostics technologists before the resources for such training are available in the clinical sphere. This article describes the basic parameters under which education programs operate, namely the national scope of practice, programmatic accreditation standards, and credentialing examination content. The approaches and limitations of several programs around the country are presented. Despite considerable variability in the extent of student participation in theranostic procedures, the foundational elements of their nuclear medicine education remain firmly in place and reliable. Graduates will learn the specifics of each procedure in the workplace, as happens with already-credentialed nuclear medicine technologists.

Treatment-induced peripheral neuropathy (TIPN) significantly impairs patients' quality of life, compromises the treatment process, and adversely affects prognosis. The aim of this study was to evaluate the psychometric properties of the Treatment-induced Neuropathy Assessment Scale (TNAS) and establish cutpoints in Chinese patients with cancer. In a prospective cohort of 254 colorectal cancer patients receiving oxaliplatin, the TNAS was assessed for reliability and validity. Using patient-reported walking impairment and CTCAE grades as anchors, optimal cutpoints (CPs) for the numbness, sensory subscale, and interference subscale were derived. Group-Based Trajectory Modeling (GBTM) was subsequently used to examine the clinical utility of the cutpoints. The TNAS showed internal consistency (&#x3b1;&#x2009;=&#x2009;0.92) and repeatability (ICC&#x2009;=&#x2009;0.85) in Chinese patients. The scale significantly discriminated between patients with and without CTCAE-defined events (1.87&#x2009;&#xb1;&#x2009;1.60 vs. 1.15&#x2009;&#xb1;&#x2009;1.72, effect size&#x2009;=&#x2009;0.44; P&#x2009;<&#x2009;0.001). Mild, moderate, and severe numbness strata were defined as&#x2009;<&#x2009;3, 3-6, and&#x2009;&#x2265;&#x2009;7 using the walking anchor, and as&#x2009;<&#x2009;2, 2-4, and&#x2009;&#x2265;&#x2009;5 using the CTCAE anchor. For the sensory subscale, the corresponding CPs were&#x2009;<&#x2009;2.50, 2.50-5.49, and&#x2009;&#x2265;&#x2009;5.50 per the walking anchor, versus&#x2009;<&#x2009;0.83, 0.83-2.32, and&#x2009;&#x2265;&#x2009;2.33 per the CTCAE anchor. For the interference subscale, stratification CPs were&#x2009;<&#x2009;2.00, 2.00-4.66, and&#x2009;&#x2265;&#x2009;4.67 based on the walking anchor, and&#x2009;<&#x2009;1.67, 1.67-3.99, and&#x2009;&#x2265;&#x2009;4.00 based on the CTCAE anchor. These subgroups displayed distinct longitudinal trajectories across the chemotherapy course. The Chinese version of the TNAS is a valid and sensitive tool for TIPN assessment. Its established cutpoints provide a quantitative basis for defining responders in clinical trials and triggering early toxicity management. Treatment-induced peripheral neuropathy (TIPN) is one of the most common and severe adverse effects of various anticancer therapies and is associated with worse quality of life among cancer survivors. As current guidelines do not recommend a standard treatment regimen for TIPN, accurate and reliable assessment remains paramount. To ensure a comprehensive evaluation of TIPN, both patient-reported outcomes (PROs) and clinician-rated grading are recommended. Following these recommendations, we applied a dual-anchor approach in a Chinese prospective cohort to identify clinically meaningful cutpoints for the Treatment-induced Neuropathy Assessment Scale (TNAS). Our findings demonstrate that the Chinese version of the TNAS is a reliable and valid tool for TIPN assessment. These findings provide a practical basis for responder definition in trials and may help clinicians identify patients who need timely intervention in practice.

In addition to the standard viability assessment, cardiac [18F]FDG PET/CT is used in cases of infection, inflammation, innervation, and infiltrative pathologies. Unlike for myocardial viability assessment, these conditions require a specific patient preparation protocol aimed at suppressing physiologic myocardial glucose uptake. Despite adequate patient preparation, various patterns of [18F]FDG uptake are noted in the myocardium, which correlate with the cardiac physiology as reflected by the clinical, echocardiographic, and anatomic findings. Surgical manipulation with implantation of various prosthetic devices for conditions such as congenital heart disease, valvular pathologies, conduction abnormalities, and ischemic heart diseases make diagnostic imaging challenging because of the complex anatomy and presence of highly attenuating material. The high sensitivity of [18F]FDG PET/CT to detect physiologic alterations-such as in cases of infection, inflammation, or infiltration, despite the altered anatomy or presence of highly attenuating material-makes [18F]FDG PET/CT an essential tool for early and accurate diagnosis. This illustrative communication aims to highlight the different patterns of [18F]FDG uptake in various pathophysiologic conditions of the heart and in infection of prosthetic cardiac devices.

Purpose To apply a vendor-neutral Agatston score (vnAS) for aortic valve calcification across multiple CT systems and to aortic stenosis severity classification. Materials and Methods Anthropomorphic phantoms with varying degrees of calcification were scanned using seven different CT systems and a reference electron-beam CT system to determine the vnAS. The vnAS was calculated using a regression model, whose performance was evaluated by both the coefficient of determination and analysis of variance. The vnAS was subsequently validated on a retrospective patient sample from eight international centers. Thresholds of severe aortic valve stenosis were defined as 1274 and 2065 AU for women and men, respectively. Results The Agatston scores from all CT systems were strongly correlated with that of the reference system (R2 > 0.932). On the basis of their echocardiographic findings, 183 of 831 (22.0%) patients (mean age &#xb1; SD, 77 years &#xb1; 10; 351 of 831 [42.2%] women) had discordant echocardiographic aortic valve stenosis findings. Among women with discordant results, the vnAS was higher than the traditional aortic valve calcium score (median, 1693 AU [IQR, 908-2513 AU] vs 1181 AU [IQR, 726-1964 AU], respectively; P < .001). Similar findings were observed for men (median, 2658 AU [IQR, 1894-3822 AU] vs 2056 AU [IQR, 1408-3056 AU], respectively; P < .001). Using the vnAS, 8.5% of women and 17.8% of men with discordant echocardiographic findings were reclassified into the severe aortic stenosis group. Conclusion A previously developed calibration tool, the vnAS, was validated and reclassified patients with discordant echocardiographic findings into the severe aortic stenosis group. Keywords: CT, Echocardiography, Percutaneous, Cardiac, Valves, Calcifications/Calculi, Technology Assessment, Vendor-neutral Agatston Score, Aortic Stenosis, Aortic Valve Calcification, Phantoms Supplemental material is available for this article. &#xa9; RSNA, 2026 See also commentary by Jaltotage and Leipsic in this issue.

During the manipulation of dose preparation, there is always the possibility of error. Errors can include, but are not limited to, loss of activity to be administered or risk of contamination. This research focuses on reducing the loss of activity in the preparation of breast sentinel node injections by setting a standard recorded dose. The recorded dose is the measurement of activity after all manipulations (the dilution and change of the needle). Improving the likelihood of accurate readings and strengthening the reliability of sentinel node identification can lead to improved patient outcomes and procedural effectiveness.

Echinococcosis poses a significant public health threat, and its diagnosis relies on imaging. Non-invasive plasma detection of Echinococcus cell-free DNA (cfDNA) offers a promising diagnostic approach. We developed a low-cost multiplex PCR panel with 230 primer pairs targeting Echinococcus mitochondrial genomes and nuclear DNA repeat regions. We validated the panel using gradient dilutions of two pathogen species' DNA and 81 plasma samples (53 patients and 28 controls), differentiating species through sequencing analysis. Our method detected Echinococcus genomic DNA at an input as low as 1 fg per reaction, and tests of clinical samples showed a sensitivity of 68.42% and specificity of 92.86%. Based on our detection, 80% of the clinically confirmed cases were correctly identified as positive echinococcosis cases, and cfDNA levels correlated significantly with lesion size. This study highlights the potential of targeted cfDNA sequencing for non-invasive echinococcosis diagnosis and species differentiation and offers a promising tool for doubtful cases.

PSMA PET has become central to prostate cancer imaging as advanced disease incidence rises and prostate-specific membrane antigen (PSMA)-targeted theranostics expand clinical use, yet accurate interpretation requires an understanding of prostate anatomy and physiology that extends beyond rote imaging patterns. Here we review prostate zonal anatomy, multimodality imaging features from ultrasound, multiparametric MRI, and PSMA PET/CT, and the underlying biology of PSMA expression, and androgen receptor signaling, and tumor dedifferentiation. We highlight physiologic and pathologic variations in PSMA uptake, common diagnostic pitfalls, and characteristic imaging changes after androgen-deprivation therapy, radiation, and prostatectomy. By relating anatomy, molecular physiology, and treatment effects to PSMA PET findings, this article provides nuclear medicine practitioners with a practical foundation to improve diagnostic accuracy and optimize patient selection for PSMA-based imaging and therapy.

Myocardial perfusion scintigraphy and 2-dimensional (2D) echocardiography are used for evaluating left ventricular function and ejection fraction (EF). This study aimed to validate the semiquantitative and functional parameters derived from 3 available software packages (Emory Cardiac Toolbox, Cardiogam, and Myovation Evolution) and compare the software-derived EF with that obtained with 2D echocardiography. Methods: This prospective investigation included 370 patients who underwent myocardial perfusion scintigraphy. The participants were stratified into 3 groups on the basis of their left ventricular EF determined by 2D echocardiography. The semiquantitative parameters (summed rest score, summed stress score, summed difference score) and quantitative parameters (defect extent, transient ischemic dilation, EF, end-diastolic volume, end-systolic volume, and stroke volume) derived from each software platform were analyzed. Spearman rank correlation coefficient and Bland-Altman plot analysis were used to assess the relationships among these parameters within the entire cohort and across the 3 subgroups. Results: A strong correlation was found among the parameters across the 3 software programs. Groupwise comparison revealed that group 3 (EF < 50%) exhibited the highest consistency in parameter agreement across software packages. EFs also showed good concordance with 2D echocardiography, particularly in group 3. Among the software packages, Myovation Evolution demonstrated the closest alignment with 2D echocardiography for EF assessment. Conclusion: Although the Emory Cardiac Toolbox, Cardiogam, and Myovation Evolution showed strong correlation among each other and with 2D echocardiography for several parameters, notable differences exist in their diagnostic accuracy and levels of automation. To address these differences, we recommend using the same software for myocardial perfusion quantification method when assessing patients over time or comparing results between them.