Immuno-positron emission tomography as a new frontier in imaging hematologic malignancies

Immuno-positron emission tomography (immuno-PET) is an innovative medical imaging technique that combines antibodies (Abs) or other immune-targeting molecules with positron-emitting radionuclides. By targeting antigens that are highly expressed in hematologic malignancies, immuno-PET has transformed diagnostic capabilities and enables precise monitoring of therapeutic responses through highly sensitive and specific tumor cell detection. Additionally, it plays a critical role in advancing therapeutic approaches by seamlessly linking diagnostic imaging with personalized treatment strategies. Its non-invasive nature and ability to provide whole-body imaging offer significant advantages over traditional diagnostic methods, especially for detecting minimal residual disease and guiding adaptive therapeutic interventions. In Ab-based immuno-PET, positron-emitting radionuclides must have a half-life sufficient for slower pharmacokinetics and blood clearance of Abs. Recent studies have highlighted the advantages of long-lived radionuclides, such as ⁸⁹Zr, which exhibit low positron energy and enable high sensitivity and resolution, making them particularly effective for tumor visualization and characterization. This review explores the current applications, recent advancements, and potential of immuno-PET for hematologic malignancies, emphasizing its pivotal role in improving patient outcomes and advancing precision medicine.