Few studies have investigated the relationship between sarcopenia and mild to moderate renal decline. This study aimed to investigate the relationship between chronic kidney disease (CKD) and sarcopenia. In total, 123 patients hospitalized with CKD and 57 healthy volunteers who underwent physical examination during the same period (control group) were analyzed. Body compositions were measured by dual-energy X-ray absorptiometry, and the relative appendicular skeletal muscle index (RASMI) was calculated. Muscular strength was evaluated using hydraulic hand dynamometer. Walking speed within 6 m was measured for muscular function assessment. Single-photon emission computed tomography was performed to measure the glomerular filtration rate of CKD patients, who were then divided into CKD1 (55 patients in CKD stages 1 and 2) and CKD2 (68 patients in CKD stages 3–5). RASMI showed a downward trend with CKD progression (P = 0.001). Multivariate logistic regression analysis showed that age and CKD progression were independent risk factors for sarcopenia. The morbidity of sarcopenia was significantly greater in CKD patients than in healthy volunteers, and the degree of muscle loss was closely related to CKD progression.

The most common site of metastasis of prostate cancer (PCa) is bone. Skeletal-related events can increase the risk of death in patients with PCa by 28%. Due to the low detection rate of lesions in patients with low prostate-specific antigen (PSA) levels, the value of ^99mTc methylene diphosphonate (^99mTc-MDP) bone scintigraphy is limited. Prostate-specific membrane antigen (PSMA) is a small molecular probe that can efficiently and specifically detect PCa lesions. This prospective study aimed to evaluate the difference between ^99mTc-PSMA single-photon emission computed tomography (SPECT)/CT and ^99mTc-MDP SPECT/CT in the detection of bone metastasis in PCa. A total of 74 men with pathologically confirmed PCa from October 2019 to November 2021 were prospectively enrolled in this study. The median age was 70 (range, 55–87) years. All patients underwent both ^99mTc-PSMA SPECT/CT and ^99mTc-MDP SPECT/CT at an average interval of 12.1 (range, 1–14) days. The detected imaging-positive bone lesions were scored as “typical metastasis” or “equivocal metastasis” by a standard reporting schema. Subsequent therapy modality details were observed through follow-up. Twenty-five of the 74 patients were diagnosed with bone metastases. ^99mTc-PSMA SPECT/CT and ^99mTc-MDP SPECT/CT detected 20 and 18 bone metastases, with sensitivities of 80.0% (20/25) and 72.0% (18/25), specificities of 100.0% (49/49) and 81.3% (40/49), and AUCs of 88.0% and 84.9%, respectively. There was a significant difference in the AUC between the two imaging methods (P < 0.001). In an analysis of the number of bone metastasis lesions, the proportion of “typical metastasis” versus “equivocal metastasis” detected by the two imaging methods was 26.3:1 (PSMA) and 2.9:1 (MDP), and the difference was statistically significant (P = 0.005). There was a significant difference in the detection of bone metastatic lesions by ^99mTc-PSMA and ^99mTc-MDP when the maximum diameter of the lesions was ≤ 0.6 cm (P < 0.05). The optimal cut-off value for PSA was 2.635 ng/mL (PSMA) and 15.275 ng/mL (MDP). ^99mTc-PSMA SPECT/CT led to a change in management to a more individualized therapy modality for 11 of 74 men (14.9%). ^99mTc-PSMA SPECT/CT was superior to ^99mTc-MDP SPECT/CT in the detection of bone metastases in PCa, especially for small lesions and in patients with low PSA levels, and demonstrated an additional benefit of providing information on extraskeletal metastases. With regard to therapy, ^99mTc-PSMA scans might have utility in improving the subsequent therapy modality.

Purpose: This prospective study aimed to evaluate the difference between ^99mTc-PSMA single-photon emission computed tomography (SPECT)/CT and multiparametric magnetic resonance imaging (mpMRI) in the detection of primary prostate cancer (PCa).Materials and methods: Fifty-six men with suspected PCa between October 2019 and November 2022 were prospectively enrolled in this study. The median age of the patients was 70 years (range, 29-87 years). Patients were divided into high-(Gleason score>7, n=31), medium- (Gleason score=7, n=6) and low-risk groups (Gleason score < 7, n=6). All patients underwent ^99mTc-PSMA SPECT/CT and mpMRI at an average interval of 3 days (range, 1-7 days). The maximum standardized uptake value (SUV_max), the minimum apparent diffusion coefficient (ADC_min), and their ratio (SUV_max/ADC_min) were used as imaging parameters to distinguish benign from malignant prostatic lesions.Results: Of the 56 patients, 12 were pathologically diagnosed with a benign disease, and 44 were diagnosed with PCa. ^99mTc-PSMA SPECT/CT and mpMRI showed no significant difference in the detection of primary PCa (kappa =0.401, P=0.002), with sensitivities of 97.7% (43/44) and 90.9% (40/44), specificities of 75.0% (9/12) and 75.0% (9/12), and AUC of 97.4% and 95.1%, respectively. The AUC of SUV_max/ADC_min was better than those of SUV_max or ADC_min alone. When SUV_max/ADC_min in the prostatic lesion was >7.0×10³, the lesion was more likely to be malignant. When SUV_max/ADC_min in the prostatic lesion is >27.0×10³, the PCa patient may have lymph node and bone metastases. SUV_max was positively correlated with the Gleason score (r=0.61, P=0.008), whereas ADC_min was negatively correlated with the Gleason score (r=-0.35, P=0.023). SUV_max/ADC_min was positively correlated with the Gleason score (r=0.59, P=0.023). SUV_max/ADC_min was the main predictor of the high-risk group, with an optimal cut-off value of 15.0×10³.Conclusions: The combination of ^99mTc-PSMA SPECT/CT and mpMRI can improve the diagnostic efficacy for PCa compared with either modality alone; SUV_max/ADC_min is a valuable differential diagnostic imaging parameter.

Introduction: Epithelioid hemangioendothelioma (EHE) of the bone is a very rare malignant vascular neoplasm, with biologic behavior between that of locally aggressive epithelioid hemangioma and malignant epithelioid angiosarcoma. We report a case of a patient with EHE who underwent bone scintigraphy, try to identify the characteristics of it, to highlight the clinical importance of whole-body bone scintigraphy and single-photon emission computed tomography/computed tomography (SPECT/ CT) in the diagnosis and treatment of EHE. Patient concerns: A 67-year-old man with no history of trauma who reported pain in both lower limbs for 6 months, which had been worsening over the last 20 days. Anteroposterior and lateral radiographs of both lower limbs revealed numerous osteolytic lesions in the tibia and fibula bilaterally. ^99mTc-methylene diphosphonate (MDP) bone scintigraphy demonstrated increased tracer uptake in the pelvic and bilateral lower limb bones. SPECT/CT bone imaging showed numerous osteolytic lesions cluster in the same anatomic region, with high tracer uptake in lesion margins. Diagnosis: EHE of the bone. Interventions: Two months after the diagnosis was confirmed, the patient was rehospitalized. Nonopioid analgesic use had not provided pain relief. Magnetic resonance imaging (MRI) of both thighs showed the bone cortex was destroyed with numerous irregular lesions, and soft-tissue was involved. A second bone scintigraphy did not show any new lesions. He was administrated with recombination human endostatin injection 15 mg ivgtt qd for 14 days, combined with apatinib mesylate tablets 500 mg po qd for 18 days. Outcomes: He was discharged voluntarily and died 2 months later. Conclusion: EHE of the bone is a very rare malignant vascular neoplasm with no specific radiographic imaging features. Whole-body bone scintigraphy, especially SPECT/CT bone imaging, significantly reduces ambiguous diagnoses and is recommended before treatment.

Objectives: The prognostic value of thyroglobulin antibody (TgAb) and its trends during follow-up periods may guide the treatment plans in patients with differentiated thyroid cancer (DTC) following surgery, however, there is still a lack of sufficient data. This study aims to evaluate the impact of change trends in TgAb levels on the prognosis of patients with DTC and to explore its potential application in clinical practice.Materials and methods: A retrospective analysis was conducted on the medical records of 2,981 DTC patients who underwent surgery followed by ¹³¹I treatment. Among these, 248 patients with positive TgAb before treatment and had a follow-up period at least 12 months were included. Patients were categorized into four subgroups based on changes in TgAb levels: the Negative Conversion Group (TgAb shifted from positive to sustained negativity), the Decrease Group (TgAb decreased by more than 50% but remained positive), the Stable Group (TgAb fluctuated by ≤ 50% throughout follow-up), and the Increase Group (TgAb increased by 50% or more). Clinical and histopathological data among the four groups, as well as disease persistence/recurrence status after ¹³¹I treatment, were compared.Results: Pre-treatment TgAb levels in the Negative Conversion Group were significantly lower than those in the other three groups (P<0.001). Compared to the Negative Conversion Group, the Stable Group had more postoperative lymph node metastases (P<0.05). Although pre-treatment TgAb levels in the Increase Group were lower than those in the Decrease Group, the Increase Group required significantly more treatments and a higher total dose of ¹³¹I (P<0.05). Analysis of the relationship between TgAb trends and treatment outcomes revealed 34 cases of recurrent/persistent DTC. The Negative Conversion Group had significantly better outcomes than the Stable Group and Increase Group (P<0.001, P=0.007), while the Decrease Group showed better outcomes than the Stable Group (P=0.045).Conclusions: Negative conversion or a decrease in TgAb levels was associated with a favorable prognosis, whereas stable or increased TgAb levels indicated a higher risk of persistent/recurrent DTC. For patients with positive TgAb serum levels, monitoring the TgAb trend changes during follow-up should be a clinical priority, with timely adjustments to individualized treatment plans.

To explore the diagnostic performance of [^99mTc]Tc-FAPI SPECT/CT for gastrointestinal cancer, compared to [¹⁸F]FDG PET/CT. In this analysis of a prospective trial, consecutively recruited patients from a single center with pathologically confirmed gastrointestinal cancer were prospectively enrolled from September 2022 to June 2024 and underwent paired v and [¹⁸F]FDG PET/CT examinations at intervals of more than 1 day and within 7 days of each other.The activity of tracer accumulation in lesions was assessed by maximum standardized uptake value(SUV_max) and TBR (lesions SUV_max/ascending aorta SUV_mean). Histopathologic and clinical follow-up results were used as reference standards for final diagnoses. Seventy-eight patients (46 men; median age, 58.8 ± 14.5 years) were evaluated. Compared with the TBR for [¹⁸F]FDG uptake, TBR for [^99mTc]Tc-FAPI uptake was higher in primary tumor(4.6 ± 2.0 vs. 3.4 ± 1.7; P = 0.001) ,peritoneal spread (1.3 [1.1,7.3] vs. 1.1[1.1,1.1]; P = 0.001 ) and liver metastases( 2.5[1.1,8.5] vs. 1.1[1.1,3.4]; P = 0.031). For diagnostic accuracy in a total of 253 lesions in 78 patients, compared with [¹⁸F]FDG PET/CT, [^99mTc]Tc-FAPI SPECT/CT demonstrated a higher sensitivity (100% [15 of 15 lesions] vs. 20% [3 of 15]; P < 0.001), accuracy (100% [48 of 48 lesions] vs. 75% [36 of 48];P < 0.001), and negative predictive value (100% [33 of 33 lesions] vs. 69% [36 of 48 lesions]; P = 0 0.001) in detecting peritoneal spread, and a higher sensitivity (85% [17 of 20 lesions] vs. 50% [10 of 20]; P = 0.041) in detecting liver metastases. Patients with metastatic gastrointestinal carcinomas negative on the [^99mTc]Tc-FAPI scan showed improved clinical prognosis after immunotherapy (P<0.006). TBR-FDG/TBR-FAPI was the main predictor of better prognosis post-immunotherapy ([stable disease, SD]+[partial response, PR]), with an optimal cut-off of 3.82. [^99mTc]Tc-FAPI SPECT/CT can better evaluate peritoneal spread and liver metastases in gastrointestinal cancer. Furthermore, TBR-FDG/TBR-FAPI is a valuable imaging parameter for monitoring immunotherapy responses.