Objective To evaluate the effectiveness of integrating MRI qualitative and quantitative parameters with the prostate health index (PHI) to differentiate between benign and malignant prostate lesions in patients with elevated prostate-specific antigen (PSA) levels. Methods The study involved 346 patients with elevated PSA levels who underwent prostate MRI at the North China University of Science and Technology Affiliated Hospital from April 2022 to June 2024. These patients had prostate imaging reporting and data system (PI-RADS) scores ranging from 3 to 5. Based on biopsy pathology results, which served as the gold standard, patients were categorized into benign group ( n=118) and malignant group ( n=228). The PI-RADS score, apparent diffusion coefficient (ADC), slow ADC (D), fast ADC (D ^*), perfusion-related volume fraction (f), and PHI between these groups were compared. Logistic regression and decision tree classification were employed to develop models using these parameters, and the diagnostic performance of each model was assessed through ROC curves, calibration curves and decision analysis curves. Results The malignant group exhibited higher PI-RADS 5 proportion, pro-2 PSA, and PHI, while the values of ADC, D, D ^*, and f were lower compared to the benign group ( P<0.05). The area under the ROC curve for model 4B, a decision tree classification model initially including PI-RADS, PHI, ADC, D, D ^*, and f, but ultimately retaining PHI, ADC, D, and D ^*, was comparable to model 3B, which incorporated PI-RADS, ADC, D, D*, f ( P>0.05). However, model 4B outperformed other models (models 1A-4A, 1B, 2B) ( P<0.05). The calibration curves for models 3B and 4B closely aligned with the diagonal, indicating high calibration accuracy, whereas the other models showed greater deviation. Model 4B demonstrated the highest net benefit across all threshold ranges. Conclusion The decision tree classification model constructed with PHI, ADC, D and D ^* exhibited superior discriminative ability, calibration accuracy, and clinical utility in distinguishing between benign and malignant prostate lesions in patients with elevated PSA and PI-RADS scores of 3 to 5.

Objective To evaluate the clinical value of a novel metric, the volume ratio of peritumoral edema (VPE) to tumor core (VTC), in the diagnosis and prognostic assessment of brain gliomas using MRI. Methods A retrospective analysis was conducted on preoperative MRI data and clinical records of 51 patients with brain gliomas admitted to the Second Affiliated Hospital of Xinjiang Medical University from January 2019 to June 2023. The cohort included 22 cases of low-grade gliomas (LGG) and 29 cases of high-grade gliomas (HGG). Tumor core and peritumoral edema regions were delineated semi-automatically using 3D-Slicer software following MRI sequence registration, with manual adjustments to ensure accuracy. Three-dimensional models of the core and edema regions were constructed for quantitative analysis, and the VPE/VTC ratio was calculated. Results The VPE/VTC ratio was significantly higher in the HGG group than in the LGG group (P<0.05). The VPE/VTC ratio demonstrated high diagnostic performance in distinguishing HGG from LGG (AUC=0.851), with an optimal cut-off value of 0.929, achieving the highest Youden index of 0.771, sensitivity of 86.2%, and specificity of 90.9%. Kaplan-Meier survival analysis revealed that patients with higher VPE/VTC ratios had poorer prognoses (P<0.05), indicating its strong predictive ability for prognosis evaluation. Conclusion As a novel evaluation metric, the VPE/VTC ratio holds significant clinical value and provides more effective support for individualized treatment and surgical planning in patients with brain gliomas.

Objective To construct a staging prediction model on deep vein thrombosis (DVT) based on the deep learning and black-blood magnetic resonance thrombus imaging (BTI), and investigate its prediction value. Methods A retrospective observational study was conducted, where clinical data and BTI from 196 patients admitted to Guangzhou Panyu Central Hospital from November 2015 to July 2022 were collected and analyzed. The dataset was split into a training set (70%, n=136), a validation set (15%, n=30), and a test set (15%, n=30). The experimental group were annotated in rectangular boxes manually, then the corresponding minimum bounding rectangular boxes of the lesion areas were cropped, resized, and sliced, and input to the deep learning model. The three models, ResNet50, Vit and EfficientNet, were established for lower limb staging prediction. Their predict value were compared by accuracy rate and the area under the curve (AUC). Results The accuracy of ResNet50, Vit and EfficientNet-b0 in the testing set were 0.693, 0.733, 0.787. The EfficientNet-b0 outperforms than other two models in the test set. The area under the curve of the acute, sub-acute and chronic phase were 0.700(0.568-0.811), 0.778(0.652-0.875), 0.850(0.737-0.914), respectively. Conclusion Deep learning combined with BTI has certain application values in staging prediction of DVT. It provides an effective technique for the precisive staging for DVT.

Objective To explore the diagnostic value of umbilical artery blood flow color Doppler ultrasound parameters on fetal growth restriction (FGR). Methods Fifty pregnant women with FGR diagnosed in the third trimester of pregnancy in the Department of Obstetrics and Gynecology, Suzhou Hospital Affiliated to Nanjing University School of Medicine from January 2022 to June 2024 were retrospectively analyzed as FGR group, and another 50 pregnant women with normal fetal intrauterine development during the same period were selected as control group. Fetal umbilical artery blood flow indicators were diagnosed by color Doppler ultrasound. The baseline data and clinical indicators of pregnant women and fetuses in FGR group and control group were compared. The fetal umbilical artery blood flow indicators[pulsatility index (PI), resistance index (RI), end-systolic velocity (PSV), end-diastolic velocity (EDV), end-systolic/end-diastolic velocity (S/D)] were compared between FGR group and control group. According to the pregnancy outcomes, they were divided into good group (n=14) and poor group (n=36). The PI, RI, PSV, EDV and S/D of fetal umbilical artery were compared between good group and poor group. Binary logistics equation was used to analyze the related influencing factors affecting the prognosis of FGR. ROC curve was drawn and the area under the curve (AUC), sensitivity and specificity were calculated to evaluate the diagnostic value of umbilical artery blood flow color Doppler ultrasound parameters on FGR. Results The proportion of normal birth in FGR group was significantly higher than that in control group (P<0.05) while the fetal body weight, Apgar, head circumference, double parietal diameter and femoral diameter were significantly lower than those in control group (P<0.05). The PI, RI and S/D in FGR group were significantly higher (P<0.05) while the EDV was significantly lower than that in control group (P<0.05), but there was no statistical significance in PSV between groups (P>0.05). PI, RI and S/D in poor group were significantly higher than those in good group (P<0.05) while EDV was significantly lower (P<0.05), but there was no statistical difference in PSV between both groups (P>0.05). Umbilical artery PI, RI, S/D and EDV were correlated with adverse pregnancy prognosis (P<0.05). When the critical values of PI, RI and S/D were 1.365, 0.679, 3.115, 13.638, the AUCs were 0.704, 0.925, 0.760, 0.734, respectively, and the AUC of combined diagnosis of adverse pregnancy outcomes was 0.980, indicating a higher value of combined diagnosis. Conclusion Umbilical artery blood flow color Doppler ultrasound parameters have certain evaluated value for the diagnosis of FGR, which can be used as a reference for clinical diagnosis.

Objective To investigate the correlation between the imaging of contrast-enhanced mammography (CEM) and different molecular subtypes of mass breast cancer. Methods The clinical, pathological and imaging data from 220 patients who were initially diagnosed with mass breast cancer were collected from February 2018 to December 2021. All patients underwent routine CEM before surgery, and were divided into Luminal A, Luminal B, HER2-enriched, and triple-negative subtype according to immunohistochemistry. According to the breast imaging report and data system (BI-RADS) of CEM, the imaging signs of patients with low energy images and subtraction images were extracted respectively, including 11 features such as tumor shape, margin and enhancement degree. Finally, the relationship between different molecular types and the signs of CEM-BI-RADS was analyzed. Results A total of 220 patients with breast cancer were diagnosed, including 50 patients with Luminal A, 128 patients with Luminal B, 15 patients with HER2-enriched, and 27 patients with triple-negative. Among the clinicopathologic characteristics of different molecular subtypes of breast cancer, only the pathological type and molecular subtype of breast cancer had statistical significance ( P=0.012). Invasive breast cancer was the main pathological type of the four molecular types of breast cancer, and there was no significant statistical significance between age, menopause and lymph node metastasis and molecular subtype of breast cancer ( P>0.05). In low-energy maps, there were statistically significant differences in mass margins and mass with calcification among different molecular subtypes. Luminal A breast cancer tumor margins were mostly spiculated (64.0%, 32/50), while other breast cancer molecular subtypes were mostly indistinct, and most HER2-enriched breast cancer tumors (66.7%, 10/15) were mostly accompanied by calcification. In subtraction images, there were statistically significant differences between the margin, length diameter, internal enhancement and molecular classification of breast cancer. The maximum diameter of Luminal A and Luminal B breast cancers is less than 2.0 cm, while the maximum diameter of HER2-enriched and triple-negative breast cancers is 3.1-5.0 cm. In addition, although the edges of the four molecular subtypes of tumor enhancement were most common with obscured edges and the internal enhancement was uneven, compared with other molecular subtypes of breast cancer, the internal enhancement of some triple-negative breast cancer tumors showed circular enhancement (22.2%, 6/27). Conclusion The imaging signs of different molecular subtypes of mass breast cancer in CEM have certain characteristics, which can provide important reference value in guiding the diagnosis, treatment and prognosis evaluation of breast cancer.

Objective To explore the impact of using a self-made auxiliary device (consisting of a base fixing device and a rice bag) on reducing artifacts caused by uneven fat suppression and its influence on diagnosis when performing 3.0T magnetic resonance foot examination with fat suppression sequences. Methods Thirty healthy volunteers and thirty volunteers with foot lesions recruited in our hospital from April to August 2024 were selected. The healthy volunteer group was scanned in sagittal position with the three-dimension-volume isotropic turbo spin echo acquisition-proton density weighted-spectral attenuated inversion recovery sequence (3D-VIEW-PDWI-SPAIR )of the foot by using the conventional fixation method (conventional group) and the self-made auxiliary device (experimental group) respectively. The obtained images were subjectively and objectively evaluated and compared and analyzed. The volunteer group with foot lesions used the self-made auxiliary device alone for sagittal scanning of the 3D-VIEW-PDWI-SPAIR sequence, and the obtained images were subjectively evaluated. Results In the healthy volunteer group: In the subjective evaluation method, the image quality of the experimental group was significantly better than that of the conventional group ( P<0.01). In the objective evaluation method, in the comparison of signal-to-noise ratio of 23 regions of interest, the experimental group was significantly higher than the conventional group ( P<0.01). In the volunteer group with diseases: Subjective evaluation: 93.33% of the images reached the highest quality rating. Conclusion In 3.0T MR foot fat suppression sequence scanning, the application of the self-made auxiliary device has a uniform fat suppression effect, can significantly improve image quality. It is easy to operate, low in cost, and can be adapted to various head coils for use. It has innovation and potential clinical promotion value.

Objective To evaluate the diagnostic utility of amide proton transfer (APT) imaging for assessing the ischemic penumbra in patients with acute ischemic stroke and to predict patient prognosis. Methods Fifty-eight patients with acute ischemic stroke who were treated at the Fifth Affiliated Hospital of Zhengzhou University from January to November 2023 were retrospectively analyzed. All patients underwent routine 3T MRI sequences, including arterial spin labeling and APT examinations. The infarct core (IC), ischemic penumbra (IP), and contralateral normal-appearing white matter (CNAWM) were measured using diffusion weighted imaging and arterial spin labeling. APT values and their differences were analyzed. Neurologists assessed the patients using the National Institutes of Health Stroke Scale (NIHSS) on the first day of admission. Patient prognosis was followed up via telephone after three months, assessing modified Rankin Scale (mRS) scores to evaluate neurological recovery. Patients were divided into good prognosis group (n=24, mRS<2) and poor prognosis group (n=34, mRS≥2). Clinical data and APT values for the IC and CNAWM were compared between the two groups. The difference in APT signal intensity between the IC and contralateral CNAWM (ΔAPT) was calculated. Then the analysis of variance was performed, and ROC curve were plotted to determine the AUC based on ΔAPT values. Additionally, correlations between ΔAPT and NIHSS scores were analyzed. Results APT imaging effectively differentiated between the IC, IP and CNAWM regions (P<0.05). The difference in APT values between the IC region and the ΔAPT values of patients in the good and poor prognosis groups was also statistically significant (P<0.001). Additionally, there was a statistically significant difference in NIHSS scores between the two groups (P<0.001). In contrast, no significant differences were found in the remaining clinical data as well as the APT values in the CNAWM region between the two groups (P>0.05). The ΔAPT values served as a better predictor of patient prognosis (AUC=0.732, cut-off value: 1.00, 95%CI: 0.605-0.860). ΔAPT correlated with NIHSS scores on day 1 (r=0.569, P<0.001). Conclusion APT imaging can more accurately delineate a patient's ischemic penumbra and predict their prognosis.

Objective To evaluate the degeneration of joint cartilage in patients with chronic ankle instability before and after surgery by exploring T2 mapping quantitative analysis. Methods Sixty patients with chronic ankle instability who underwent anterior talofibular ligament (ATFL) repair or reconstruction treatment in our hospital from January 2021 to June 2022 were selected as the research subjects. They were divided into ATFL repair group ( n=30) and ATFL reconstruction group ( n=30) according to the treatment method. Another 30 healthy subjects were selected as the control group. The ATFL repair group and ATFL reconstruction group underwent MRI T2 mapping scan, ankle plantar flexion, back extension mobility, pain visual analog score (VAS) and American ankle-hind foot functional system (AOFAS) and Karlsson ankle function score (KAFS) evaluation before and one year after surgery, the control group underwent MRI T2 mapping scans, and the T2 values of the anterior medial, lateral, and central medial, lateral, and posterior medial, and lateral cartilaginous regions of the talus were measured and calculated in three groups. Results The T2 values of the ATFL repair group were higher than those of the control group ( P<0.05) in the medial, anteromedial, and lateral cartilage areas before surgery; The T2 values in the medial, lateral, anteromedial, and lateral cartilage regions of the ATFL repair group were higher than those in the control group one year after surgery ( P<0.05); The T2 values in the medial and anterior medial and lateral cartilaginous regions of the bone crest in the ATFL repair group were higher than those before surgery at 1 year ( P<0.05). The T2 values of the ATFL reconstruction group were higher than those of the control group ( P<0.05) in the medial, lateral, anteromedial, and lateral cartilaginous areas before surgery; The T2 values in the medial, lateral, anteromedial, and lateral cartilage regions of the ATFL reconstruction group were higher than those in the control group one year after surgery ( P<0.05); The T2 values in the central lateral and anterolateral cartilaginous regions of the bone crest in the ATFL reconstruction group were higher than those before surgery one year after surgery ( P<0.05). There was no statistically significant difference in T2 values between the ATFL repair group and the ATFL reconstruction group in each cartilage region before and 1 year after surgery ( P>0.05). One year after surgery, the ankle plantar flexion and dorsal extension activities in the ATFL repair group and ATFL reconstruction group were greater than preoperative ( P<0.05), the VAS scores were lower than preoperative ( P<0.05), the AOFAS and KAFS scores were higher than preoperative. Conclusion Patients with chronic ankle instability may still experience talar cartilage degeneration after ATFL repair or reconstruction treatment, mainly on the anterior and central sides of the talus. T2 quantitative analysis can evaluate the degree of talar cartilage degeneration in patients with chronic ankle instability after surgery.

Objective To analyze the causes of trigeminal neuralgia without vascular compression by MRI. Methods The clinical data of 86 patients with trigeminal neuralgia diagnosed in the second neurosurgery ward of Zhoukou Central Hospital from January 2018 to September 2023, who underwent microvascular decompression without preoperative MRI findings of vascular compression, were retrospectively analyzed, and 74 of them met the inclusion criteria. Endoscopic images obtained during microvascular decompression and postoperative follow-up were used as reference standards, and the images were read separately by radiologists with more than five years of experience, and the images of responsible vessels not found in MRI preoperative examination were analyzed. Postoperative outcomes were assessed using the Barrow neurological institute pain intensity score, and the differences were compared using a repeated measures analysis of variance. Results Among the 74 patients with trigeminal neuralgia, 30 cases (40.5%) had intraoperative venous compression, 15 cases (20.3%) had venous compression with arachnoid adhesion, 12 cases (16.2%) had arterial branch compression, 11 cases (14.9%) had arachnoid adhesion, 3 cases (4.1%) had tumor compression, and 3 cases (4.1%) had no intraoperative vascular compression or arachnoid adhesion. Compared with before operation, the pain of patients was significantly relieved at all time points after operation, and the difference was statistically significant (P<0.05). Conclusion MRI is commonly used in the preoperative diagnosis of trigeminal neuralgia, which can clearly show the neurovascular interaction. Different surgical strategies should be adopted for different causes of trigeminal neuralgia.A specific test sequence is required for trigeminal neuralgia patients without vascular compression and whose secondary cause is unknown, and imaging doctors should check the medical history carefully and make comprehensive analysis to improve the diagnostic accuracy.

Objective To investigate the correlation between preoperative serum inflammatory indicators combined with enhanced CT image features and the risk classification of gastrointestinal stromal tumor (GIST), and analyze its diagnostic efficacy for GIST risk classification. Methods A lot of 148 patients with pathologically confirmed GISTs were collected from March 2022 to March 2024 in Yancheng First People's Hospital and classified according to the National Institutes of Health revised criteria. Preoperative serum inflammatory indicators [neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic immunoinflammatory index (SII)] and enhanced CT image features [tumor length, tumor location, enhancement pattern, shape, intratumor cystic or necrosis, calcification, surface ulcer] were retrospectively analyzed. These patients were divided into low risk group (n=73, very low risk, low risk) and high risk group (n=75, intermediate risk, high risk). The differences of relevant indicators between low and high risk groups were compared, and Spearman correlation was used to analyze the correlation between inflammatory indicators, enhanced CT image features and risk classification. Results NLR, PLR, SII, tumor length, tumor location, intratumoral cystic or necrosis, enhancement pattern, and shape were positively correlated with different risk classification. The optimal cut-off values for high risk group were NLR>2.285(AUC=0.741), PLR>167.135(AUC=0.654), SII>410.495 (AUC=0.711), tumor length>4.65(AUC=0.931), the AUC of combining multi-indexes was 0.941, better than the above single index. Conclusion Preoperative serum inflammatory indicators combined with enhanced CT imaging features can better predict the risk classification of GIST, the combined diagnosis has the best efficiency, and provides reference for patients to make personalized plan.

Objective To analyze the effectiveness of CT and magnetic resonance imaging in evaluating lymph node metastasis in elderly patients with rectal cancer. Methods Ninety elderly patients with rectal cancer admitted to our hospital from March 2022 to May 2024 were included. Surgical and pathological results were used as the gold standard, and 128 slice spiral CT examination provided by Philips (scanning the diaphragm to the lower edge of the pubic bone, accompanied by enhanced scanning) and Discovery 3.0T magnetic resonance imaging examination provided by GE (scanning the lower edge of the pubic symphysis to the level of iliac bifurcation) were provided to evaluate the effectiveness of CT and magnetic resonance imaging in assessing lymph node metastasis in elderly patients with rectal cancer. Results According to the gold standard results, there were 85 positive cases and 5 negative cases. CT examination results showed 60 positive cases and 30 negative cases. CT and magnetic resonance imaging results showed 84 positive cases and 6 negative cases; There are differences in sensitivity, accuracy, and other indicators between CT examination and CT combined with magnetic resonance imaging for the diagnosis of lymph node metastasis in rectal cancer, and CT combined with magnetic resonance imaging has a higher diagnostic value (P<0.05). There is no statistically significant difference in the specificity, positive predictive value, negative predictive value, and other indicators between the two measures (P>0.05); The diameter, number, short to long diameter ratio, venous entrapment sign, serosal infiltration, and mixed signal sign of perirectal fat in positive patients were higher than those in negative patients (P<0.05). Conclusion For elderly patients with rectal cancer, CT combined with magnetic resonance imaging for intervention has good sensitivity and accuracy, it can effectively determine the signs of the disease.

Objective To investigate the value of prenatal ultrasound quantification combined with serum β-human chorionic gonadotropin (β-HCG), alpha fetoprotein (AFP) and uncojugated estriol (uE₃) in screening fetal facial deformities. Methods A total of 123 pregnant women in the second trimester of pregnancy who received prenatal screening at the hospital from February 2021 to February 2024 were selected as the research subjects. All of them underwent ultrasound examination and detection of serum indexes. The outcomes of induced labor or pregnancy were used as the gold standard to analyze the diagnostic value of prenatal ultrasound quantitative parameters and serum indexes for fetal facial deformities. Results Among 123 pregnant women, 71 (57.72%) were found to have fetal facial deformities, and 52 (42.28%) did not have any fetal facial deformities. They were included in the deformity group and the non-deformity group, respectively. Univariate analysis and multivariate logistic regression analysis results showed that fetal nuchal translucency (NT) thickness, and the levels of β-HCG, AFP and uE₃ were risk factors for fetal facial deformities (P<0.05). 61 cases and 56 cases of fetal facial deformities were diagnosed by NT and serum indexes, respectively. Combination of the two diagnosed 67 cases of fetal facial deformities. The diagnostic sensitivity, specificity, and accuracy of NT combined with serum indexes were higher than those of separate diagnosis. There was a statistically significant difference in sensitivity (P<0.05), but there was no statistically significant difference in specificity or accuracy (P>0.05). Conclusion Abnormal NT, and abnormal levels of β-HCG, AFP and uE₃ all indicate a high risk of fetal facial deformities. The combination of prenatal ultrasound quantitative parameters and serum β-HCG, AFP and uE₃ can significantly improve the sensitivity in detecting fetal facial deformities. It has relatively high clinical value in fetal facial deformities screening.

Objective To investigate the value of uterine artery polyflow parameters combined with peripheral blood D-dimer (D-D) in the assessment of adverse pregnancy outcomes in pregnant women with recurrent miscarriage in early pregnancy. Methods Eighty cases of early pregnancy recurrent miscarriage admitted to Huai'an Maternal and Child Health Hospital from January 2021 to June 2023 were selected as the study group and followed up until 28 weeks of gestation, and they were categorized into the pregnancy loss group (n=35) and the pregnancy success group (n=45) according to the pregnancy outcome, and 92 pregnant women with normal pregnancies who underwent obstetric examination in the same period of time in the hospital were selected as the control group. The uterine artery early diastolic index (NI), resistance index (RI), ratio of maximum peak systolic flow rate to end-diastolic flow rate (S/D), pulsatility index (PI), and levels of peripheral blood D-D were compared between the study group and the control group, the pregnancy loss group and the pregnancy success group, and the pregnancy loss group was included as positive and the pregnancy success group was included as negative, and the predictive value of uterine artery NI, RI, S/D, PI, peripheral blood D-D single and combined tests for the diagnosis of adverse pregnancy outcomes in pregnant women with recurrent miscarriages in the early stages of pregnancy was analyzed by plotting the ROC curves. Results Uterine artery NI was lower in the study group than in the control group (P<0.05); uterine artery RI, S/D, PI and peripheral blood level of D-D were higher than in the control group (P<0.05). Uterine artery NI was lower in the pregnancy loss group than in the pregnancy success group (P<0.05); uterine artery RI, S/D, PI, and peripheral blood level of D-D were higher than those in the pregnancy success group (P<0.05). ROC curve analysis showed that the AUC value of the joint test for predicting adverse pregnancy outcomes in pregnant women with recurrent miscarriage in early pregnancy was higher than that of NI, RI, S/D, PI and peripheral blood D-D in a single test (P<0.05). Conclusion The combination of uterine artery multiflow parameters and peripheral blood D-D testing was more advantageous in predicting adverse pregnancy outcomes in women with recurrent miscarriages in early pregnancy, and the clinical follow-up could be carried out by means of the combination of uterine artery multiflow parameters and peripheral blood D-D testing for timely assessment of the adverse pregnancy outcomes of pregnant women with recurrent miscarriages, so as to promote the improvement of the pregnancy outcomes of pregnant women with recurrent miscarriages.

Immune checkpoint inhibitors that target the programmed death receptor (PD-1) and its ligand (PD-L1) pathway have emerged as a promising strategy for cancer therapy. The expression level of PD-L1 in tumors is strongly correlated with the effectiveness of this form of immunotherapy. Clinically, PD-L1 expression is typically evaluated through immunohistochemistry, an invasive technique that has significant limitations due to the spatial and temporal heterogeneity of PD-L1 expression within tumor tissues. Consequently, this method may not provide a comprehensive assessment of PD-L1 expression. In contrast, molecular imaging techniques in nuclear medicine offer a non-invasive, real-time, and dynamic means of visualizing PD-L1 expression. Technetium-99m is the most commonly used radionuclide for single-photon emission computed tomography (SPECT) imaging, as it is inexpensive, easily available, and possesses suitable energy and half-life characteristics. SPECT is the most frequently employed imaging modality in nuclear medicine globally. Accordingly, technetium-99m-labeled molecular probes targeting PD-L1 hold significant potential for widespread clinical application. This review aims to summarize current advancements in the development of technetium-99m-labeled molecular probes for PD-L1 to guide future efforts to identify novel probes for SPECT imaging of PD-L1.