{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T06:00:20Z","timestamp":1785218420894,"version":"3.55.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nucl. Med."],"abstract":"<jats:p>\n                    We report a case that combines several aspects of molecular diagnostics and clinical follow-up with innovative imaging of [\n                    <jats:sup>89<\/jats:sup>\n                    Zr]Zr-DFO-trastuzumab positron emission computed tomography (PET\/CT) to depict human epidermal growth factor receptor 2 (HER2)-targeted tracer uptake in several metastatic sites in advanced platinum-resistant high-grade serous ovarian cancer (HGSOC). A 74-year-old woman underwent this procedure, and PET\/CT images were interpreted alongside conventional biomarkers [CA125 and immunohistochemistry (IHC)] and contrast-enhanced computed tomography (CE-CT). PET imaging revealed intense tracer uptake in the primary ovarian tumour site (SUVratio 13.8), with corresponding HER2\u2009+\u2009expression (3+) observed on the IHC of the primary tumour. Moreover, moderate uptake was observed in abdominal wall metastases (SUVratio 3.6) and near-background uptake in hepatic lesions (SUVratio 1.6), consistent with image-suggestive spatial heterogeneity in HER2-targeted tracer uptake. CA125 measurements corroborated early biochemical response, with values declining from 676 to 254 U\/mL after six weeks of trastuzumab deruxtecan (T-DXd) treatment as third-line therapy. Follow-up CE-CT showed qualitative regression of [\n                    <jats:sup>89<\/jats:sup>\n                    Zr]Zr-DFO-trastuzumab-avid lesions, despite non-measurable disease by RECIST and a subsequent CE-CT imaging after 20 weeks demonstrated a mixed response pattern, without a clear relationship to pre-T-DXd [\n                    <jats:sup>89<\/jats:sup>\n                    Zr]Zr-DFO-trastuzumab uptake. This case study illustrates how integrating non-invasive [\n                    <jats:sup>89<\/jats:sup>\n                    Zr]Zr-DFO-trastuzumab PET molecular imaging with conventional radiology, IHC, and biochemical markers within the clinical pathway may support individualised therapeutic decision-making.\n                  <\/jats:p>","DOI":"10.3389\/fnume.2026.1832138","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T05:37:33Z","timestamp":1785217053000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Non-invasive [89Zr]Zr-DFO-trastuzumab positron emission tomography in the multimodal characterisation of platinum-resistant high-grade serous ovarian cancer"],"prefix":"10.3389","volume":"6","author":[{"given":"Joana do Mar","family":"Ferreira Machado","sequence":"first","affiliation":[{"name":"Department of Translational Imaging in Oncology, National Center for Tumor Diseases (NCT), NCT\/UCC Dresden, a Partnership between DKFZ, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, and Helmholtz-Zentrum Dresden-Rossendorf","place":["Dresden, Germany"]},{"name":"Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf","place":["Dresden, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Winzer","sequence":"additional","affiliation":[{"name":"Department of Translational Imaging in Oncology, National Center for Tumor Diseases (NCT), NCT\/UCC Dresden, a Partnership between DKFZ, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, and Helmholtz-Zentrum Dresden-Rossendorf","place":["Dresden, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudi","family":"Apolle","sequence":"additional","affiliation":[{"name":"Department of Translational Imaging in Oncology, National Center for Tumor Diseases (NCT), NCT\/UCC Dresden, a Partnership between DKFZ, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, and Helmholtz-Zentrum Dresden-Rossendorf","place":["Dresden, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almuth","family":"Forberger","sequence":"additional","affiliation":[{"name":"Institute of Pathology, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology","place":["Dresden, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristof","family":"Zarschler","sequence":"additional","affiliation":[{"name":"Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf","place":["Dresden, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torsten","family":"Knie\u00df","sequence":"additional","affiliation":[{"name":"Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf","place":["Dresden, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Kreller","sequence":"additional","affiliation":[{"name":"Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf","place":["Dresden, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Kopka","sequence":"additional","affiliation":[{"name":"Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf","place":["Dresden, Germany"]},{"name":"Faculty of Chemistry and Food Chemistry, School of Science, TUD Dresden University of Technology","place":["Dresden, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver C.","family":"Ki\u00df","sequence":"additional","affiliation":[{"name":"Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf","place":["Dresden, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Dominik","family":"Kuhlmann","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology","place":["Dresden, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Wimberger","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology","place":["Dresden, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Miederer","sequence":"additional","affiliation":[{"name":"Department of Translational Imaging in Oncology, National Center for Tumor Diseases (NCT), NCT\/UCC Dresden, a Partnership between DKFZ, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of 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