Molecular SPECT Imaging: An Overview

Molecular imaging has witnessed a tremendous change over the last decade. Growing interest and emphasis are placed on this specialized technology represented by developing new scanners, pharmaceutical drugs, diagnostic agents, new therapeutic regimens, and ultimately, significant improvement of patient health care. Single photon emission computed tomography (SPECT) and positron emission tomography (PET) have their signature on paving the way to molecular diagnostics and personalized medicine. The former will be the topic of the current paper where the authors address the current position of the molecular SPECT imaging among other imaging techniques, describing strengths and weaknesses, differences between SPECT and PET, and focusing on different SPECT designs and detection systems. Radiopharmaceutical compounds of clinical as well-preclinical interest have also been reviewed. Moreover, the last section covers several application, of μSPECT imaging in many areas of disease detection and diagnosis

Current paradigm of the 18-kDa translocator protein (TSPO) as a molecular target for PET imaging in neuroinflammation and neurodegenerative diseases

Neuroinflammation is a process characterised by drastic changes in microglial morphology and by marked upregulation of the 18-kDa translocator protein (TSPO) on the mitochondria. The continual increase in incidence of neuroinflammation and neurodegenerative diseases poses a major health issue in many countries, requiring more innovative diagnostic and monitoring tools. TSPO expression may constitute a biomarker for brain inflammation that could be monitored by using TSPO tracers as neuroimaging agents. From medical imaging perspectives, this review focuses on the current concepts related to the TSPO, and discusses briefly on the status of its PET imaging related to neuroinflammation and neurodegenerative diseases in humans

Sigma receptor ligands: novel applications in cancer imaging and treatment

Sigma receptoren (subtypes sigma-1 en sigma-2) zijn unieke bindingsplaatsen die een aanzienlijk hogere expressie vertonen in kanker dan in gezond weefsel. Hoewel de endogene agonisten niet met zekerheid geïdentificeerd werden, zijn vele kunstmatige liganden beschikbaar voor onderzoek van de normale en pathofysiologische functie van sigma receptoren. Van therapeutische doseringen van zulke verbindingen (met name sigma-1 antagonisten en sigma-2 agonisten) is bekend dat zij de proliferatie en overleving van kankercellen doen afnemen maar nauwelijks invloed hebben op normale cellen. Het onderzoek dat in dit proefschrift wordt beschreven was gericht op de verdere ontwikkeling van sigma liganden voor diagnostische beeldvorming en als chemotherapeutica in de oncologie. We presenteren gegevens die erop wijzen dat competitie door steroïdhormonen variabiliteit van de opname van sigma liganden tijdens PET-imaging kan veroorzaken. Met name progesteron competeert met 11C-SA4503 voor binding aan sigma receptoren in kankercellen. We tonen ook aan dat sigma-1 receptoren in spontane hypofysetumoren tot overexpressie komen en dat 11C-SA4503-PET een geschikte methode kan zijn om zulke laesies aan te tonen. We rapporteren dat het anti-kankereffect van sigma liganden wordt bepaald door de sigma-2 receptorbezetting in kankercellen. Cytotoxiciteit gaat gepaard met opvallende, vroege veranderingen van het metabolisme in zulke cellen. Meting van de sigma-2 receptor bezetting in menselijke tumoren d.m.v. PET kan wellicht worden gebruikt om de therapeutische dosis te voorspellen. Een combinatie van sigma liganden en cytokine-gebaseerde therapie werd getest en bleek robuste anti-kanker effecten te veroorzaken in melanoma cellijnen en in primair materiaal van ovariumcarcinoom afkomstig van kankerpatiënten. Sigma receptors (subtypes sigma-1 and sigma-2) are unique binding sites showing a considerably higher expression in cancerous compared to non-cancerous tissues. Although the endogenous agonists have not been identified with certainty, many artificial ligands are available to study the function of sigma receptors in health and disease. Therapeutic doses of such compounds (particularly sigma-1 antagonists and sigma-2 agonists) are known to decrease proliferation and survival of cancer cells, but minimally affect non-cancer cells. Research described in this thesis was aimed at further development of sigma ligands as diagnostic imaging agents and therapeutic drugs in oncology. We present evidence indicating that competition by steroid hormones accounts for variability of sigma ligand uptake during PET imaging. Specifically, progesterone competes with 11C-SA4503 for binding to sigma-1 receptors in cancer cells. We also show that sigma-1 receptors are overexpressed in spontaneous pituitary tumors and that 11C-SA4503-PET may be a suitable method for detection of such lesions. We report that sigma receptor occupancy in cancer cells determines the observed anti-cancer effect of sigma ligands. Cytotoxicity is accompanied by striking, early changes of metabolism in such cells. Assessment of sigma-2 receptor occupancy in human tumors with PET may be employed for prediction of the therapeutic dose. A combination of sigma ligands and cytokine-based therapy was tested and found to display robust anti-cancer effects in melanoma cell lines and in patient-derived primary samples of ovarian carcinoma.

A perspective on the radiopharmaceutical requirements for imaging and therapy of glioblastoma

Despite numerous clinical trials and pre-clinical developments, the treatment of glioblastoma (GB) remains a challenge. The current survival rate of GB averages one year, even with an optimal standard of care. However, the future promises efficient patient-tailored treatments, including targeted radionuclide therapy (TRT). Advances in radiopharmaceutical development have unlocked the possibility to assess disease at the molecular level allowing individual diagnosis. This leads to the possibility of choosing a tailored, targeted approach for therapeutic modalities. Therapeutic modalities based on radiopharmaceuticals are an exciting development with great potential to promote a personalised approach to medicine. However, an effective targeted radionuclide therapy (TRT) for the treatment of GB entails caveats and requisites. This review provides an overview of existing nuclear imaging and TRT strategies for GB. A critical discussion of the optimal characteristics for new GB targeting therapeutic radiopharmaceuticals and clinical indications are provided. Considerations for target selection are discussed, i.e. specific presence of the target, expression level and pharmacological access to the target, with particular attention to blood-brain barrier crossing. An overview of the most promising radionuclides is given along with a validation of the relevant radiopharmaceuticals and theranostic agents (based on small molecules, peptides and monoclonal antibodies). Moreover, toxicity issues and safety pharmacology aspects will be presented, both in general and for the brain in particular.http://www.thno.orgdm2022Nuclear Medicin