2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T6be,To evaluate clinical profile and coronary perfusion of patients with ostial occlusion of all epicardial coronary arteries. From 2009-2025, 165 adults (age=72±9.8 years; n=152[92%] male) with prior CABG had complete ostial occlusion of right coronary artery (RCA) and either left main (n=120[73%]) or left main equivalent (n=45[27%]). An additional patient without prior CABG presented in cardiogenic shock and was bridged to transplant. Graft patency and collateralization (Rentrop and collateral connections scores) were assessed by angiography and ischemia and scar burden by stress positron emission tomography (PET; n=89). Of the 165, 88(53%) presented with symptoms primarily related to ischemia, 67(41%), with symptoms primarily related to heart failure; 19(12%) were asymptomatic; 64/89(72%) had positive stress imaging. Of 543 existing grafts, 344(63%) were patent. Of 64 patients with a patent ITA to LAD and had PET tests, 9(14%) showed scar only, 25(39%) ischemia only, and 19(30%) both. Collaterals supplied LAD, circumflex, and RCA territories in 50, 83, and 100 patients, respectively, with LAD 28/50(56%) receiving collaterals from RCA. Of 233 collaterals, 103(44%) were Rentrop grade 1 (filling without epicardial vessels); 81/165(49%) had complete vascularization (patent grafts or high-grade collaterals to all territories). Post-diagnosis, 14(8.4%) patients underwent CABG, 50(30%) percutaneous intervention, and 100(61%) medical management, with median survival of 7.6, 6.0, and 3.0 years, respectively (P=.027). Patent bypass grafts can sustain survival in patients even after ostial occlusion of all epicardial coronary arteries, an advantage not previously reported by other coronary disease therapies.31:T4e3,Biomarkers identify Alzheimer's disease pathology in cognitively unimpaired adults, but the timing and rate of cognitive decline vary widely. This study aimed to identify subgroups of cognitive decline and baseline predictors of heterogeneity in preclinical progression. Data were drawn from the Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease Study, which enrolled amyloid beta-positive (Aβ+) participants, and the Longitudinal Evaluation of Amyloid Risk and Neurodegeneration (LEARN) Study, which enrolled amyloid beta-negative (Aβ-) individuals. Latent class mixed-effects models identified cognitive trajectory classes. Associations between class membership and demographic, clinical, and biomarker variables were evaluated. The primary outcome was change in the Preclinical Alzheimer Cognitive Composite. Three trajectory classes were identified: stable, slow decliners, and fast decliners. Higher phosphorylated tau at 217 (p-tau217), smaller hippocampal volume, and elevated tau positron emission tomography were associated with declining classes. About 70% of Aβ+ individuals were stable. Latent class modeling reveals substantial heterogeneity in preclinical trajectories with important implications for prevention trial design.32:T76d,Abstract INTRODUCTION Biomarkers identify Alzheimer's disease pathology in cognitively unimpaired adults, but the timing and rate of cognitive decline vary widely. This study aimed to identify subgroups of cognitive decline and baseline predictors of heterogeneity in preclinical progression. METHODS Data were drawn from the Anti‐Amyloid Treatment in Asymptomatic Alzheimer's Disease Study, which enrolled amyloid beta‐positive (Aβ+) participants, and the Longitudinal Evaluation of Amyloid Risk and Neurodegeneration (LEARN) Study, which enrolled amyloid beta‐negative (Aβ−) individuals. Latent class mixed‐effects models identified cognitive trajectory classes. Associations between class membership and demographic, clinical, and biomarker variables were evaluated. The primary outcome was change in the Preclinical Alzheimer Cognitive Composite. RESULTS Three trajectory classes were identified: stable, slow decliners, and fast decliners. Higher phosphorylated tau at 217 (p‐tau217), smaller hippocampal volume, and elevated tau positron emission tomography were associated with declining classes. About 70% of Aβ+ individuals were stable. DISCUSSION Latent class modeling reveals substantial heterogeneity in preclinical trajectories with important implications for prevention trial design. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Positron Emission Tomography: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Positron Emission Tomography (modality). Clinician-written summaries and actionable practice insights. 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clinical applicability is not assessed.","value_numeric":null},{"paper_doi":"10.1177/0271678x261490246","tag_type":"warning","value":"This is a narrative review with no original data or quantitative synthesis; conclusions on modality superiority reflect expert opinion rather than meta-analytic evidence.","value_numeric":null}],"summaries":{"what_studied":"This review evaluates preclinical in-vivo cerebrovascular imaging techniques used in rodent models of Alzheimer's disease (AD), comparing modalities including two-photon microscopy, multi-exposure speckle imaging, optical coherence tomography, MRI, PET, contrast-enhanced ultrasound, and ultrafast ultrasound localisation microscopy (ULM) for assessing cerebral microvascular flow.","key_result":"No single modality meets all needs; ultrafast ultrasound localisation microscopy is identified as the best-positioned technique for standardised, longitudinal, multiscale cerebral microvascular imaging in rodents, offering a favourable balance of resolution, sensitivity, depth, and non-invasiveness.","limitations":"- Review is preclinical and rodent-specific; direct translation to human imaging is not addressed.\n- No systematic meta-analysis or quantitative comparison of modalities is performed.\n- Anaesthetic and methodological variability across studies limits cross-study comparability, a problem acknowledged but not resolved by this review.","practice_takeaway":"When designing preclinical AD studies requiring longitudinal cerebrovascular imaging, ultrafast ultrasound localisation microscopy offers the strongest combination of resolution, depth, and non-invasiveness. Researchers should standardise anaesthetic protocols and modality selection criteria using the framework provided to improve cross-study comparability."}},{"doi":"10.1200/jco-25-03080","pmid":"42636421","title":"Omitting Bone Marrow Sampling in FDG-Avid Rhabdomyosarcoma With 2-[\n ¹⁸\n F]FDG PET-Negative Marrow: Results From an International Retrospective Study","journal_title":"Journal of Clinical Oncology","journal_issn":"0732-183X","published_at":"2026-08-24T00:00:00.000Z","url":"https://doi.org/10.1200/jco-25-03080","source_score":64,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-30T06:20:00.568Z","updated_at":"2026-08-30T06:20:00.568Z","tags":[{"paper_doi":"10.1200/jco-25-03080","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1200/jco-25-03080","tag_type":"brand","value":"FDG","value_numeric":null},{"paper_doi":"10.1200/jco-25-03080","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1200/jco-25-03080","tag_type":"condition","value":"Rhabdomyosarcoma","value_numeric":null},{"paper_doi":"10.1200/jco-25-03080","tag_type":"generic","value":"fludeoxyglucose F18","value_numeric":null},{"paper_doi":"10.1200/jco-25-03080","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1200/jco-25-03080","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1200/jco-25-03080","tag_type":"modality","value":"PET/CT","value_numeric":null},{"paper_doi":"10.1200/jco-25-03080","tag_type":"modality","value":"PET/MRI","value_numeric":null},{"paper_doi":"10.1200/jco-25-03080","tag_type":"modality","value":"Positron Emission Tomography","value_numeric":null},{"paper_doi":"10.1200/jco-25-03080","tag_type":"sample_size","value":"n=301","value_numeric":301},{"paper_doi":"10.1200/jco-25-03080","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1200/jco-25-03080","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1200/jco-25-03080","tag_type":"warning","value":"Age breakdown of the 301-patient cohort is not reported in the abstract; it is unclear what proportion were pediatric vs. adult, which may affect generalizability.","value_numeric":null},{"paper_doi":"10.1200/jco-25-03080","tag_type":"warning","value":"BMAB (bilateral iliac crest) was used as the gold standard, but patchy marrow disease in ~1/3 of cases suggests BMAB itself may underestimate true disease burden, slightly inflating PET specificity.","value_numeric":null},{"paper_doi":"10.1200/jco-25-03080","tag_type":"warning","value":"'FDG' tagged as a brand is a widely used abbreviation, not a formal proprietary name; included for search discoverability.","value_numeric":null}],"summaries":{"what_studied":"This international retrospective study evaluated whether [¹⁸F]FDG PET/CT or PET/MRI can replace bilateral bone marrow aspirates/biopsies (BMAB) for bone marrow staging in 301 patients with FDG-avid rhabdomyosarcoma (RMS), recruited across Europe and North America.","key_result":"FDG PET achieved 98% sensitivity and 90% specificity for bone marrow metastasis detection vs. BMAB as gold standard. PET and BMAB agreed on metastases in 54 patients, PET alone detected disease in 24, and BMAB alone in only 1 of 301 patients; 222 had concordantly negative results.","limitations":"Retrospective design with inherent selection bias; BMAB served as the gold standard despite known sampling limitations (patchy marrow disease in ~1/3 of cases); image re-review was institution-based rather than central, which may introduce variability.","practice_takeaway":"In FDG-avid RMS, a negative FDG PET of the bone marrow is sufficient to forgo routine bone marrow biopsy. If FDG-avid marrow lesions are present, follow up with MRI and/or targeted biopsy rather than standard bilateral iliac crest sampling."}},{"doi":"10.1001/jamaoto.2026.2316","pmid":"42623057","title":"Intentional Imaging for Primary Hyperparathyroidism","journal_title":"JAMA Otolaryngology–Head & Neck Surgery","journal_issn":"2168-6181","published_at":"2026-08-20T00:00:00.000Z","url":"https://doi.org/10.1001/jamaoto.2026.2316","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-26T06:19:53.575Z","updated_at":"2026-08-26T06:19:53.575Z","tags":[{"paper_doi":"10.1001/jamaoto.2026.2316","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.2316","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.2316","tag_type":"condition","value":"Primary Hyperparathyroidism","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.2316","tag_type":"generic","value":"choline C-11","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.2316","tag_type":"generic","value":"technetium Tc 99m sestamibi","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.2316","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.2316","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.2316","tag_type":"modality","value":"Computed Tomography","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.2316","tag_type":"modality","value":"Nuclear Medicine Imaging","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.2316","tag_type":"modality","value":"Positron Emission Tomography","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.2316","tag_type":"modality","value":"Ultrasonography","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.2316","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1001/jamaoto.2026.2316","tag_type":"warning","value":"No original patient data are presented; radiation dose ranges are drawn from referenced sources, not a pooled analysis. Sensitivity/specificity values for each modality are discussed qualitatively but not formally compared. The 'practice_changing' flag reflects the authors' explicit recommendation to limit imaging to confirmed diagnoses and select modalities intentionally — this represents expert opinion, not a trial result.","value_numeric":null}],"summaries":{"what_studied":"A review of preoperative parathyroid imaging modalities for primary hyperparathyroidism (pHPT), comparing radiation exposure (in mSv) across ultrasonography, Tc-99m sestamibi SPECT ± CT, 4D-CT, and choline-based PET ± CT in patients planning parathyroidectomy or revision surgery.","key_result":"Radiation doses vary widely by modality: ultrasound (0 mSv), Tc-99m sestamibi SPECT ± CT (8.6–12.1 mSv), 4D-CT (9.3–20.2 mSv), and choline-based PET ± CT (6.7–11.8 mSv). Authors recommend imaging only after confirmed diagnosis and advocate for intentional, individualized modality selection.","limitations":"This is a narrative review without a systematic meta-analysis or original patient data; radiation exposure ranges are reported but sensitivity/specificity data are referenced rather than pooled. No direct cost-effectiveness analysis is provided.","practice_takeaway":"Confirm the diagnosis of pHPT before ordering any imaging, and start with ultrasound (zero radiation) as the first-line localization study. Reserve higher-dose modalities like 4D-CT or choline PET for revision/complex cases, weighing local expertise and cost alongside radiation burden."}},{"doi":"10.1038/s41568-026-00950-y","pmid":"42373751","title":"Imaging the hallmarks of cancer","journal_title":"Nature Reviews Cancer","journal_issn":"1474-175X","published_at":"2026-06-29T00:00:00.000Z","url":"https://doi.org/10.1038/s41568-026-00950-y","source_score":72,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-07T13:26:15.358Z","updated_at":"2026-07-07T13:26:15.358Z","tags":[{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"brand","value":"Lutathera","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"condition","value":"Breast Cancer","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"condition","value":"Cancer","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"condition","value":"Glioblastoma","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"condition","value":"Melanoma","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"condition","value":"Neuroendocrine Tumors","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"condition","value":"Non-Small Cell Lung Cancer","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"condition","value":"Prostate Cancer","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"generic","value":"5-aminolevulinic acid","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"generic","value":"atezolizumab","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"generic","value":"fluorodeoxyglucose F-18","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"generic","value":"lutetium Lu-177 dotatate","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"generic","value":"lutetium Lu-177 PSMA-617","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"generic","value":"pafolacianine","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"modality","value":"Fluorescence-Guided Imaging","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"modality","value":"Immune Checkpoint Inhibitor","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"modality","value":"Magnetic Resonance Imaging","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"modality","value":"Optoacoustic Imaging","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"modality","value":"Positron Emission Tomography","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"modality","value":"Radiomics","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"modality","value":"Radiopharmaceutical Therapy","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"modality","value":"Ultrasound","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"warning","value":"Full text was inaccessible; all extracted content is based on the abstract, reference list, glossary, and publisher page — key data, figures, and tables could not be reviewed.","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"warning","value":"Study design tagged as 'Narrative Review' based on abstract language; no systematic search strategy or PRISMA methodology was described, so formal classification as a systematic review is not supported.","value_numeric":null},{"paper_doi":"10.1038/s41568-026-00950-y","tag_type":"warning","value":"The paper is dated June 2026 and cites several articles from 2025–2026, including some that may themselves be preprints or early publications; clinical readiness of some discussed technologies may change rapidly.","value_numeric":null}],"summaries":{"what_studied":"This review evaluates non-invasive diagnostic imaging technologies mapped to the hallmarks of cancer framework — covering PET, MRI, ultrasound, optoacoustics, and fluorescence imaging — as tools to detect, monitor, and stratify tumors across the full spectrum of cancer biology.","key_result":"Multiple hallmarks can now be imaged directly (e.g., HER2/PSMA/KRAS via PET probes, tumor metabolism via FDG-PET and hyperpolarized ¹³C-MRI, immune checkpoints via PD-L1 PET) or indirectly (e.g., angiogenesis via DCE-MRI, tumor stiffness via elastography); AI-assisted radiomics and radiogenomics further enable non-invasive molecular subtyping and therapy response prediction.","limitations":"- Full text was not accessible; the summary is based on the abstract and publisher page text, which may omit key findings, nuance, or data tables.\n- As a narrative review, it does not provide pooled effect sizes or systematic quality assessments.\n- Clinical translation of many described techniques remains early-phase or investigational.","practice_takeaway":"Clinicians should be aware that a growing toolkit of hallmark-targeted imaging agents (e.g., PSMA-PET, CD8-PET, hyperpolarized ¹³C-MRI, PD-L1 PET) can guide treatment selection, monitor immunotherapy responses, and detect tumor heterogeneity non-invasively. AI-based radiomics tools are increasingly validated for predicting molecular status (e.g., EGFR, KRAS, HRD) from standard imaging, with direct implications for therapy stratification."}},{"doi":"10.1038/s41380-026-03717-x","pmid":"42350786","title":"Widespread synaptic density loss in schizophrenia follows molecular and network architecture","journal_title":"Molecular Psychiatry","journal_issn":"1359-4184","published_at":"2026-06-25T00:00:00.000Z","url":"https://doi.org/10.1038/s41380-026-03717-x","source_score":24,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-02T13:33:18.400Z","updated_at":"2026-07-02T13:33:18.400Z","tags":[{"paper_doi":"10.1038/s41380-026-03717-x","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1038/s41380-026-03717-x","tag_type":"category","value":"Psychiatry","value_numeric":null},{"paper_doi":"10.1038/s41380-026-03717-x","tag_type":"condition","value":"Schizophrenia","value_numeric":null},{"paper_doi":"10.1038/s41380-026-03717-x","tag_type":"generic","value":"UCB-J","value_numeric":null},{"paper_doi":"10.1038/s41380-026-03717-x","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1038/s41380-026-03717-x","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1038/s41380-026-03717-x","tag_type":"modality","value":"Positron Emission Tomography","value_numeric":null},{"paper_doi":"10.1038/s41380-026-03717-x","tag_type":"sample_size","value":"n=122","value_numeric":122},{"paper_doi":"10.1038/s41380-026-03717-x","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41380-026-03717-x","tag_type":"study_design","value":"Case-Control Study","value_numeric":null},{"paper_doi":"10.1038/s41380-026-03717-x","tag_type":"warning","value":"The patient group is small (n=29), which may limit the robustness of the network diffusion and lateralisation findings. The 'practice_changing' flag reflects the novelty of in vivo synaptic imaging evidence, but replication in larger cohorts is needed before clinical translation. [11C]UCB-J targets SV2A as a proxy for synaptic density; it does not directly measure synaptic function or specific synapse subtypes. Neurochemical receptor maps used for correlation were derived from normative external datasets, introducing potential confounds.","value_numeric":null}],"summaries":{"what_studied":"This PET study used [11C]UCB-J radiotracer to map brain-wide synaptic density in 29 people with schizophrenia vs. 93 healthy controls, examining spatial patterns, neurochemical correlates, and network diffusion models to identify potential foci of synaptic pathology.","key_result":"Synaptic density was widely and significantly lower in schizophrenia (Cohen's D 0.58–1.47; pFWE < 0.05), with the left hemisphere more affected than the right (Cohen's D = 1.14; p < 0.001). Frontal, temporal, cingulate, thalamic, striatal, and hippocampal areas were most impacted. These changes did not overlap with grey matter volume loss on MRI. Left-hemisphere deficits correlated with higher normative concentrations of GABAA/BZ, 5HT2A, mGluR5, and 5HT1B receptors (rcca = 0.68; p = 0.022). Network diffusion modelling nominated left inferior frontal areas as the likely origin of pathology.","limitations":"Small patient sample (n = 29) limits statistical power and generalizability. Cross-sectional design prevents causal inference about propagation direction. Normative neurochemical maps came from external reference datasets, not the study participants themselves.","practice_takeaway":"Synaptic density loss in schizophrenia is widespread, left-lateralised, and tied to specific receptor systems (GABA, serotonin, mGluR5) — not simply grey matter atrophy. Clinicians should be aware that standard structural MRI likely underestimates the true extent of synaptic pathology in these patients."}},{"doi":"10.1002/alz.71555","pmid":"42304165","title":"APOE ε4 and amyloid status moderate the associations between sleep, physical activity, and tau‐PET burden in cognitively unimpaired older adults","journal_title":"Alzheimer's & Dementia","journal_issn":"1552-5260","published_at":"2026-06-16T00:00:00.000Z","url":"https://doi.org/10.1002/alz.71555","source_score":41,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-28T13:27:00.277Z","updated_at":"2026-06-28T13:27:00.277Z","tags":[{"paper_doi":"10.1002/alz.71555","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1002/alz.71555","tag_type":"brand","value":"MK-6240","value_numeric":null},{"paper_doi":"10.1002/alz.71555","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1002/alz.71555","tag_type":"condition","value":"Alzheimer's Disease","value_numeric":null},{"paper_doi":"10.1002/alz.71555","tag_type":"condition","value":"Preclinical Alzheimer's Disease","value_numeric":null},{"paper_doi":"10.1002/alz.71555","tag_type":"generic","value":"flortaucipir","value_numeric":null},{"paper_doi":"10.1002/alz.71555","tag_type":"generic","value":"Pittsburgh compound B","value_numeric":null},{"paper_doi":"10.1002/alz.71555","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1002/alz.71555","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1002/alz.71555","tag_type":"modality","value":"Actigraphy","value_numeric":null},{"paper_doi":"10.1002/alz.71555","tag_type":"modality","value":"Positron Emission Tomography","value_numeric":null},{"paper_doi":"10.1002/alz.71555","tag_type":"sample_size","value":"n=120","value_numeric":120},{"paper_doi":"10.1002/alz.71555","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/alz.71555","tag_type":"study_design","value":"Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.1002/alz.71555","tag_type":"warning","value":"18F-MK6240 is the tau tracer used; findings may not generalize to studies using 18F-flortaucipir, which has different binding characteristics.","value_numeric":null},{"paper_doi":"10.1002/alz.71555","tag_type":"warning","value":"The BIOCARD cohort is enriched for AD family history (~75%), which may not represent the general cognitively unimpaired older adult population.","value_numeric":null},{"paper_doi":"10.1002/alz.71555","tag_type":"warning","value":"The mean interval between actigraphy and tau-PET was approximately 2.6 years (SD ~3 years), introducing potential temporal misalignment; statistical adjustment for this interval does not fully resolve the limitation.","value_numeric":null},{"paper_doi":"10.1002/alz.71555","tag_type":"warning","value":"The paradoxical finding that higher physical activity (TVPA) was associated with greater tau burden in Aβ-positive individuals is discussed as potentially reflecting cognitive resilience or selection bias, not a harmful effect of exercise — clinicians should interpret this cautiously.","value_numeric":null},{"paper_doi":"10.1002/alz.71555","tag_type":"warning","value":"The TVPA × amyloid interaction was attenuated and lost significance in sensitivity analyses excluding 'impaired not MCI' participants and when amyloid was modeled continuously, suggesting this finding is less robust than the WASO interactions.","value_numeric":null}],"summaries":{"what_studied":"This cross-sectional study (n=120 cognitively unimpaired older adults, mean age 69.5 years) examined whether actigraphy-derived total volume of physical activity (TVPA), total sleep time (TST), and wake after sleep onset (WASO) were associated with early tau-PET burden (Braak I–II, using 18F-MK6240), and whether APOE ε4 carrier status or amyloid-PET positivity moderated these associations.","key_result":"No sleep or activity measure was associated with tau burden in the full sample. After risk stratification: greater WASO was linked to higher Braak I–II tau burden in APOE ε4 carriers (β=0.238, p=0.005) and Aβ-positive individuals (β=0.302, p=0.001), but not in lower-risk groups. Higher TVPA was paradoxically associated with *greater* tau burden in Aβ-positive individuals (β=0.225, p=0.006) and showed no significant association in Aβ-negative individuals. All key interaction effects survived FDR correction.","limitations":"- Cross-sectional design with a mean ~2.6-year gap between actigraphy and tau-PET limits causal inference and raises reverse-causation concerns.\n- Aβ-positive and APOE ε4 subgroups were modest in size (n=33 and n=43, respectively), limiting statistical power and making interaction findings exploratory.\n- The sample was highly educated, predominantly non-Hispanic white, and enriched for AD family history, limiting generalizability.","practice_takeaway":"When assessing modifiable lifestyle risk factors in cognitively unimpaired older adults, stratify by APOE ε4 status and amyloid burden — sleep fragmentation (WASO) may be a meaningful early behavioral signal of tau burden specifically in high-risk individuals. Routine lifestyle counseling should not rely on unstratified group-level data, as risk-dependent heterogeneity can mask clinically relevant associations."}},{"doi":"10.1016/j.jtcvs.2026.04.025","pmid":"42092511","title":"Ostial Occlusion of All Epicardial Coronary Arteries: Living off Bypass Grafts","journal_title":"The Journal of Thoracic and Cardiovascular Surgery","journal_issn":"0022-5223","published_at":"2026-05-07T00:00:00.000Z","url":"https://doi.org/10.1016/j.jtcvs.2026.04.025","source_score":5,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-05-06","doi":"10.1016/j.jtcvs.2026.04.025","days":"14","issn":"0022-5223","rank":"9","field":"Clinical Medicine","score":"5","category":"Respiratory System","categories":["Respiratory System"],"_categories":["Respiratory System"]},"pubmed":{"doi":"10.1016/j.jtcvs.2026.04.025","title":"Ostial Occlusion of All Epicardial Coronary Arteries: Living off Bypass Grafts.","journal":"The Journal of thoracic and cardiovascular surgery","methods":"","results":"Of the 165, 88(53%) presented with symptoms primarily related to ischemia, 67(41%), with symptoms primarily related to heart failure; 19(12%) were asymptomatic; 64/89(72%) had positive stress imaging. Of 543 existing grafts, 344(63%) were patent. Of 64 patients with a patent ITA to LAD and had PET tests, 9(14%) showed scar only, 25(39%) ischemia only, and 19(30%) both. Collaterals supplied LAD, circumflex, and RCA territories in 50, 83, and 100 patients, respectively, with LAD 28/50(56%) receiving collaterals from RCA. Of 233 collaterals, 103(44%) were Rentrop grade 1 (filling without epicardial vessels); 81/165(49%) had complete vascularization (patent grafts or high-grade collaterals to all territories). Post-diagnosis, 14(8.4%) patients underwent CABG, 50(30%) percutaneous intervention, and 100(61%) medical management, with median survival of 7.6, 6.0, and 3.0 years, respectively (P=.027).","abstract":"$30","keywords":["Internal thoracic arteries","coronary artery disease","coronary collateralization","ischemia burden","patent arterial grafts"],"pubmed_id":"42092511","conclusions":"","publication_date":"2026-05-07T00:00:00"},"crossref":{"DOI":"10.1016/j.jtcvs.2026.04.025","URL":"https://doi.org/10.1016/j.jtcvs.2026.04.025","ISSN":["0022-5223"],"link":[{"URL":"https://api.elsevier.com/content/article/PII:S0022522326009141?httpAccept=text/xml","content-type":"text/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://api.elsevier.com/content/article/PII:S0022522326009141?httpAccept=text/plain","content-type":"text/plain","content-version":"vor","intended-application":"text-mining"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Ostial Occlusion of All Epicardial Coronary Arteries: Living off Bypass Grafts"],"author":[{"given":"Ahmed K.","family":"Awad","sequence":"first","affiliation":[]},{"given":"Laura","family":"Young","sequence":"additional","affiliation":[]},{"given":"Mahmoud","family":"Alshneikat","sequence":"additional","affiliation":[]},{"given":"Rami","family":"Alaraj","sequence":"additional","affiliation":[]},{"given":"Richard","family":"Ramsingh","sequence":"additional","affiliation":[]},{"given":"Penny L.","family":"Houghtaling","sequence":"additional","affiliation":[]},{"given":"Marijan J.","family":"Koprivanac","sequence":"additional","affiliation":[]},{"given":"Michael Z.","family":"Tong","sequence":"additional","affiliation":[]},{"given":"Shinya","family":"Unai","sequence":"additional","affiliation":[]},{"given":"Nicholas G.","family":"Smedira","sequence":"additional","affiliation":[]},{"given":"Edward G.","family":"Soltesz","sequence":"additional","affiliation":[]},{"given":"Lars 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practice_changing is applied cautiously; the finding is novel but based on a non-randomized retrospective cohort.","value_numeric":null}],"summaries":{"what_studied":"Clinical profile and coronary perfusion of 165 adults with complete ostial occlusion of all epicardial coronary arteries (RCA + left main or left main equivalent) and prior CABG, followed from 2009–2025; graft patency, collateralization, ischemia/scar burden by PET, and post-diagnosis management strategies were assessed.","key_result":"63% of 543 existing grafts were patent; 49% of patients had complete vascularization via grafts or high-grade collaterals. Median survival was 7.6 years (repeat CABG), 6.0 years (PCI), and 3.0 years (medical management alone; P=.027). 72% of those with stress PET had positive imaging.","limitations":"Retrospective, single-center design spanning 16 years limits generalizability. Management strategy was not randomized—selection bias likely favors surgical/PCI groups. Survival analysis does not adjust for baseline comorbidities or presentation severity.","practice_takeaway":"In patients with complete ostial occlusion of all epicardial coronary arteries, patent bypass grafts can sustain long-term survival. When feasible, repeat revascularization (CABG or PCI) appears to offer a survival advantage over medical management alone, with median survival more than double that of medical therapy."}},{"doi":"10.1002/alz.71366","pmid":"42015324","title":"Divergent patterns of cognitive decline in preclinical Alzheimer's disease: Implications for secondary prevention trials","journal_title":"Alzheimer's & Dementia","journal_issn":"1552-5260","published_at":"2026-04-22T00:00:00.000Z","url":"https://doi.org/10.1002/alz.71366","source_score":153,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-04-23","doi":"10.1002/alz.71366","days":"30","issn":"1552-5260","rank":"7","field":"Clinical Medicine","score":"153","category":"Clinical Neurology","categories":["Clinical Neurology"],"_categories":["Clinical Neurology"]},"pubmed":{"doi":"10.1002/alz.71366","title":"Divergent patterns of cognitive decline in preclinical Alzheimer's disease: Implications for secondary prevention trials.","journal":"Alzheimer's & dementia : the journal of the Alzheimer's Association","methods":"","results":"Three trajectory classes were identified: stable, slow decliners, and fast decliners. 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The modality/brand tags reflect the parent trial context.","value_numeric":null},{"paper_doi":"10.1002/alz.71366","tag_type":"warning","value":"The 'practice_changing' impact flag was applied because the power analysis findings directly challenge standard trial design assumptions for preclinical AD, with quantitative implications for enrollment and outcome selection.","value_numeric":null},{"paper_doi":"10.1002/alz.71366","tag_type":"warning","value":"The study design is primarily a secondary analysis of RCT (A4) and observational (LEARN) data using latent class modeling—not a traditional RCT or prospective cohort; level of evidence reflects this hybrid design.","value_numeric":null}],"summaries":{"what_studied":"This study applied latent class mixed-effects models (LCMM) to data from 1,629 cognitively unimpaired older adults (A4 Study: n=1,110 Aβ+; LEARN Study: n=519 Aβ−; median follow-up 6.0 years) to identify subgroups of cognitive trajectory and evaluate baseline biomarkers—including plasma p-tau217, amyloid PET, tau PET, and hippocampal volume—as predictors of class membership, using the Preclinical Alzheimer Cognitive Composite (PACC) as the primary outcome.","key_result":"Three trajectory classes emerged: stable (77%), slow decliners (16%), and fast decliners (7%). About 70% of Aβ+ individuals were cognitively stable. Higher plasma p-tau217 (OR 3.2), greater hippocampal atrophy (OR 3.9), and elevated tau PET (OR 3.6 for fast decliners) were the strongest predictors of declining classes. Power analysis showed trials enrolling Aβ+ stable individuals had only 30–44% power at 2–4 years even assuming 100% treatment benefit, while trials targeting decliners had 93–98% power detecting just 20% of maximum benefit.","limitations":"- Tau PET was available in only 427 of 1,629 participants, limiting generalizability of tau PET findings.\n- Latent class assignments are probabilistic and sensitive to model specification; follow-up may be insufficient to capture long-term change in stable individuals.\n- Highly selected trial-eligible sample may not represent community-dwelling older adults, and unmeasured confounders (comorbidities, lifestyle) were not accounted for.","practice_takeaway":"Most amyloid-positive cognitively unimpaired adults remain stable over a 6-year window, so enriching prevention trials with plasma p-tau217 and tau PET—rather than relying on amyloid positivity alone—may improve power by targeting the minority who actually decline. Trial designs should use simulation-based power calculations that account for this trajectory heterogeneity, not single-effect-size assumptions."}},{"doi":"10.1016/j.nuclcard.2026.102644","pmid":"41621466","title":"Optimizing protocol efficiency in [18F]flurpiridaz positron emission tomography myocardial perfusion imaging through dose ratio–driven reduction of relative residual activity","journal_title":"Journal of Nuclear Cardiology","journal_issn":"1071-3581","published_at":"2026-01-30T00:00:00.000Z","url":"https://doi.org/10.1016/j.nuclcard.2026.102644","source_score":105,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-09T13:22:23.986Z","updated_at":"2026-05-09T13:22:23.986Z","tags":[{"paper_doi":"10.1016/j.nuclcard.2026.102644","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.nuclcard.2026.102644","tag_type":"brand","value":"Flurpiridaz","value_numeric":null},{"paper_doi":"10.1016/j.nuclcard.2026.102644","tag_type":"category","value":"Cardiac & Cardiovascular Systems","value_numeric":null},{"paper_doi":"10.1016/j.nuclcard.2026.102644","tag_type":"condition","value":"Coronary Artery Disease","value_numeric":null},{"paper_doi":"10.1016/j.nuclcard.2026.102644","tag_type":"condition","value":"Myocardial Perfusion Imaging","value_numeric":null},{"paper_doi":"10.1016/j.nuclcard.2026.102644","tag_type":"generic","value":"flurpiridaz F-18","value_numeric":null},{"paper_doi":"10.1016/j.nuclcard.2026.102644","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.nuclcard.2026.102644","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.nuclcard.2026.102644","tag_type":"modality","value":"Positron Emission Tomography","value_numeric":null},{"paper_doi":"10.1016/j.nuclcard.2026.102644","tag_type":"sample_size","value":"n=115","value_numeric":115},{"paper_doi":"10.1016/j.nuclcard.2026.102644","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.nuclcard.2026.102644","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.nuclcard.2026.102644","tag_type":"warning","value":"Flurpiridaz F-18 was FDA-approved but brand name details are not confirmed in the abstract; 'Flurpiridaz' is used as a placeholder brand tag.","value_numeric":null},{"paper_doi":"10.1016/j.nuclcard.2026.102644","tag_type":"warning","value":"Sex distribution of the 115-patient cohort is not reported in the abstract; the 'mixed' sex tag is inferred from the general clinical context.","value_numeric":null},{"paper_doi":"10.1016/j.nuclcard.2026.102644","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously: while the findings suggest a protocol shift for digital PET scanners, the authors themselves call for further validation, especially for non-digital systems.","value_numeric":null},{"paper_doi":"10.1016/j.nuclcard.2026.102644","tag_type":"warning","value":"The study design is described as analyzing 'consecutive' patients, which suggests a retrospective or prospective observational cohort — classified here as a retrospective cohort, but the paper does not explicitly state data collection methodology.","value_numeric":null}],"summaries":{"what_studied":"This study evaluated how stress-to-rest dose ratio and injection time interval affect residual rest activity in 115 consecutive patients undergoing [18F]flurpiridaz PET myocardial perfusion imaging (MPI), using linear regression and mixed-effects models.","key_result":"Higher stress-to-rest dose ratios were significantly associated with lower relative residual activity (β = −3.41 per 1-unit increase; 95% CI: −4.72 to −2.11), while time intervals up to 39 minutes showed no significant effect. A dose ratio of **3.2–4.3** reduced residual activity to **<20%** across all time intervals tested.","limitations":"- Single-center, consecutive cohort design limits generalizability.\n- Findings validated only on digital PET systems; applicability to older, non-digital scanners is uncertain.\n- Time interval analysis was constrained to ≤39 minutes, so longer intervals were not assessed.","practice_takeaway":"When using [18F]flurpiridaz for PET MPI on digital scanners, target a stress-to-rest dose ratio of **3.2–4.3** to keep residual activity below 20%, enabling back-to-back rest/stress imaging without mandatory waiting periods. Waiting longer between injections (up to ~39 min) does not meaningfully reduce residual activity and may be unnecessary."}}],"initialOffset":9,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Positron Emission Tomography"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Positron Emission Tomography"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Positron Emission Tomography"}}}]]

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