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This book describes in detail a clinical project that reveals the tumoricidal efficacy of Auger and internal conversion electrons, emitted from n.c.a. 111In and implemented in oncology as a treating armamentarium for peptide receptor radionuclide therapy (PRRT), targeting small size (ø ≤ 20 mm) tumors and micro-metastases. The keen interest in n.c.a. 111In began when it was observed that its Auger electron emission could be highly radiotoxic, due to its high LET when it decayed in the vicinity of cellular DNA. The somatostatin analog octreotide, labeled with [111In-diethylenetriaminepentaacetic acid (DTPA0-D-Phe1)] is an established diagnostic agent for the imaging of somatostatin receptor-positive neuro- (or non-neuro) endocrine tumors. It relies on receptor-mediated binding, internalization and installation in the lysosomes in the proximity of the nucleus; administered in large doses, loco-regionally, via the feeding artery of solid tumors, can be highly radiotoxic if they over-express somatostatin receptors, mainly of the sst2 histotype. The book compares the results between i.v. and i.a. implementation in more than 80 patients after over 800 i.a. infusions in neuroendocrine tumors, meningiomas, paragangliomas and colorectal carcinomas in a single Institute (Aretaieion University Hospital) and encourages the i.a. way, leading to “tumor melting”, while minimizing the toxicity to healthy peritumoral liver tissue and critical organs (kidneys and bone marrow). The volume is an invaluable tool for nuclear medicine physicians, interventional radiologists and oncologists dealing with radiopeptide therapies.
In medicine, endocrinology is perhaps the domain that encompasses the most molecular imaging using radioactive agents, also called radiopharmaceuticals. This is due to the diversity of molecular targets, including hormone synthesis pathways expressed uniquely by endocrine tumors and the growing knowledge in their pathophysiology and genetics. Those radiopharmaceuticals not only serve as diagnostic agents, but can also serve as a platform for characterizing endocrine disorders and treat patients and be used to monitor intracellular events that are induced by various therapies. Finally, they may be able to predict the aggressiveness and metastatic potential of endocrine tumors. This book provides comprehensive and up-to-date insights into the diagnostic, therapeutic, and future approaches of nuclear medicine to endocrine tumors in a new spirit of precision medicine. It will be of interest to practicing physicians, including nuclear medicine specialists, radiologists, endocrinologists, and oncologists, as well as fellows in training, students, and other health care professionals.
This book provides the reader with a comprehensive understanding of both the basic principles and the clinical applications of nuclear oncology imaging techniques. The authors have assembled a distinguished group of leaders in the field who provide valuable insight on the subject. The book also includes major chapters on the cancer patient and the pathophysiology of abnormal tissue, the evaluation of co-existing disease, and the diagnosis and therapy of specific tumors using functional imaging studies. Each chapter is heavily illustrated to assist the reader in understanding the clinical role of nuclear oncology in cancer disease therapy and management.
The Evolution of Radionanotargeting towards Clinical Precision Oncology is a remarkable book honoring Professor Kalevi Kairemo, who is known among academic and medical circles as a pioneer in novel radiolabeled therapeutics. This festschrift provides an overview of key advances in the field of radionanotargeting, and the directions for future development in patient care. Prof Kairemo’s research is based on multiomics, which involves multiple elements: genomics, transcriptomics, proteomics, metabolomics, microbiomics, epigenomics, exposome, imaging, and precision medicine, which is reflected by the unique collection of articles presented. The articles start from the angle of radionanotargeting and theragnostics leading to imaging and therapy, which includes sections for thyroid cancer, head and neck cancer, genitourinary cancers and neuroendocrine neoplasms. Theragnostics, nanoparticles and precision oncology have also been covered in their own segments, while also giving a glimpse of research in metabolic imaging, cardiovascular radionuclide imaging, and bone therapies. The sequence of chapters demonstrates how, through Professor Kairemo’s efforts, radionanotargeting has evolved to a practice changing therapeutic approach in the clinic, particularly in oncology. Finally, Professor Kairemo’s own memoir, “Seven decades in health care” and memoirs from colleagues including a personal introduction to him with a photographic cavalcade reveals the world of a multitasking person with a multidisciplinary approach to science, that ushered his development of significant expertise across the fields of chemistry, biology, engineering, physics and clinical medicine. This book is excellent for medical historians, trainees and specialists in clinical and radiological oncology in expanding their understanding of the role of radionuclide imaging over the years, making it an ideal tribute that belongs in the library of anyone involved in the field.
Based on the most novel approaches and cutting-edge clinical and scientific information regarding radionuclide imaging and therapies for neuroendocrine tumors, this clinical guidebook represents a unique collaborative effort between endocrinologists, nuclear physicians, oncologists, surgeons, physicists, radio-pharmacists and geneticists. It begins with the embryology, classification and molecular genetics of gastroenteropancreatic neuroendocrine tumors and carcinoids, chromaffin cell tumors, and MEN1- and MEN2-related tumors. Following a chapter on radiopharmaceuticals in neuroendocrine imaging, it turns to the physics and technology of current and cutting-edge radiology, including SPECT/CT and PET/CT and PET/MR. Discussing of radionuclide imaging covers the tumors mentioned above, as well as pulmonary and thymic neuroendocrine tumors and medullary thyroid carcinoma. A presentation of radionuclide therapies follows, including 131I-MIBG therapy, somatostatin receptor-based therapy, and alpha radionuclide therapy, as well as the role of nanoparticles. Comprehensive and up-to-date, Diagnostic and Therapeutic Nuclear Medicine for Neuroendocrine Tumors will assist and guide physicians who encounter patients with these conditions, either from a diagnostic or therapeutic standpoint, and particularly emphasizes the current and emerging medical devices and imaging and therapeutic options.
Featuring chapters from specialists in endocrinology, physiology, pathology, and nuclear medicine, this book provides a multidisciplinary approach to a wide variety of issues concerning somatostatin and its analogues. The book: Provides the most up-to-date coverage of somatostatin analog use in diagnostic and therapy Integrating the specialties of endocrinology, physiology, pathology, and nuclear medicine, providing the multidisciplinary approach to the topic Focuses on future applications, novel compounds, and areas for further research Covers topics by authors who are renowned experts and researchers in the field
This book provides detailed information on therapeutic radiopharmaceuticals and discusses emerging technologies which have potential for broad clinical implementation. Recent advances in molecular biology, radiopharmaceutical chemistry and radioisotope production have stimulated a new era for the use of radiopharmaceuticals for targeted radionuclide therapy (TRT). Emerging clinical trials include use of peptides and monoclonal antibodies radiolabeled with therapeutic radionuclides for cancer therapy. In addition, small molecules are used for the treatment of chronic diseases such as metastatic bone pain palliation and radiation synovectomy of inflammatory joints. In the interventional arena, therapy of primary and metastatic liver cancer and arterial restenosis following angioplasty of both the coronary and peripheral arteries are being explored. Reactor and accelerator production of therapeutic radioisotopes is also integrated into these discussions. The development and use of radiopharmaceutical targeting characteristics required for treatment of specific disease processes and how these are implemented for radiopharmaceutical design strategies are also described. Radiopharmaceuticals for Therapy will benefit audiences in nuclear medicine and radionuclide therapy and will thus prove an invaluable source of up-to-date information for students, radiopharmaceutical scientists and professionals working in the radiopharmacy and nuclear medicine specialties.
The recent revolution in molecular biology offers exciting new opportunities for targeted radionuclide therapy. This up-to-date, comprehensive book, written by world-renowned experts, discusses the basic principles of radionuclide therapy, explores in detail the available treatments, explains the regulatory requirements, and examines likely future developments. The full range of clinical applications is considered, including thyroid cancer, hematological malignancies, brain tumors, liver cancer, bone and joint disease, and neuroendocrine tumors. The combination of theoretical background and practical information will provide the reader with all the knowledge required to administer radionuclide therapy safely and effectively in the individual patient. Careful attention is also paid to the role of the therapeutic nuclear physician in coordinating a diverse multidisciplinary team, which is central to the safe provision of treatment.
This book explores in detail the primary liver cancers of hepatocellular carcinoma and cholangiocarcinoma examining the pathogenesis of disease along with diagnosis and current management options together with exploration of future treatment strategies and areas of controversy. Furthermore, the book highlights management of the common secondary malignancies and touches on benign liver tumours and how to best manage these. Written in a clear and didactic style, this volume includes summaries of the key learning points and questions so that the reader can gauge their knowledge and understanding. This book is aimed to broaden the knowledge base of primary care physicians, general physicians along with specialists in hepatology, oncology and hepato-biliary surgery
This pocket book provides up-to-date descriptions of the most relevant features of neuroendocrine tumors (NETs) and the imaging modalities currently available to assist specialists (clinicians, pathologists, radiologists, nuclear medicine physicians) in selecting optimal patient management based on interdisciplinary collaboration. As the title indicates, the focus is particularly on PET/CT, with coverage of basic principles, the available radiopharmaceuticals, indications, typical and atypical appearances, normal variants and artifacts, advantages, limitations, and pitfalls. In addition, succinct information is provided on the use of other imaging modalities, including SPECT, CT, and MRI, and on pathology and treatment options. Imaging teaching cases are presented, and key points are highlighted throughout. The book is published as part of a series on hybrid imaging that is specifically aimed at referring clinicians, nuclear medicine/radiology physicians, radiographers/technologists, and nurses who routinely work in nuclear medicine and participate in multidisciplinary meetings.