34 research outputs found

    Novel radiopharmaceuticals for therapy

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    In the era of personalizedmedicine, "target radionuclide therapy" (TRT) is designed to damage only the cancerous cells while sparing unnecessary damage to the adjacent healthy cells/tissues. Unlike conventional external beam radiation therapy, TRT is intended to cause less or no collateral damage to normal tissues, as it aims at achieving targeted drug delivery either to a clinically diagnosed cancer not amenable to surgery or to metastatic tumor cells and tumor cell clusters, thus providing systemic therapy of cancer. Currently there are hundreds of new pathwaytargeted anticancer agents undergoing phase II and phase III clinical trials. TRT is just one type within the domain of "targeted therapies." In addition to the effective targeted radiopharmaceuticals already well validated for routine clinical use, newer radiolabeled agents are still in the phase of either preclinical or clinical validation. This chapter describes the main physical and radiochemical characteristics of radionuclides that have potential or have already been employed to label biologically reactive molecules for the development of novel radiopharmaceuticals for therapy. Some of these agents have entered advanced clinical trials in tumor-bearing patients. Results of these clinical trials cover a wide spectrum of potential clinical usefulness. The chapter is divided into two main parts depending on the type of particle emission (α- or β-associated or not with the emission of either γ- or β+-radiation). Within each domain, there is some exchange of experience and shift of focus in the various phases of development, depending on the modalities of ascertaining efficient tumor targeting according to the principles of theranostics. The example of a novel α-emitting radiopharmaceutical that has most recently achieved approval by regulatory agencies for clinical use ( 223 Ra-dichloride) is presented in detail as the paradigm for an agent that is showing a survival advantage besides the original target of pain palliation from bone metastases

    Thyroid ultrasound and other imaging procedures in the pediatric age

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    The purpose of this review is to provide a reappraisal of the diagnostic imaging procedures for thyroid carcinoma in pediatric patients, including thyroid ultrasound (US), ultrasound-guided fine-needle aspiration biopsy (FNAB), scintigraphy, radiological techniques (CT, MR), and PET/CT. The most frequent indication for thyroid imaging is characterization of a palpable mass in the neck or thyroid gland. Thyroid US is a first-line examination for visualizing the thyroid gland as it provides anatomic and perfusion in-formation; on the other hand, scintigraphy mostly provides functional information but combined with some anatomic information as well. CT and MRI have a supplemental role in these patients. Furthermore, with the introduction of PET/CT and the development of new imaging agents, nuclear medicine plays an important role in different phases of neoplastic disease in terms of both staging and evaluation of response to medical/surgical treatments

    Functional Imaging and Peptide Receptor Radionuclide Therapy

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    - Clear elements of understanding such uncommon entities - Opinion of the main experts of the specific field - Newest published literature evidence Uncommon tumors of the pancreas are of increasing interest for clinicians: cross imaging techniques development makes it possible to detect small lesions in the pancreatic gland of asymptomatic patients, and in the last decades a more detailed and specific pathological classification definitivelyopened an unexpected world of more or less rare pancreatic tumors. As a matter of fact, nowadays most surgical procedures deal with these so called uncommon pancreatic tumors such as cystic, endocrine and others unfrequent histotypes, and many patientsexperiencing an accidental discovery of this type of tumor need therefore a specialistic evaluation. The concept behind this volume is the need to give the correct clinical relevance to these \u201cuncommon\u201d tumors, that are ranked at the first place among pancreatic tumors, and that are definitively curable with a multimodal approach. Aim of the book is therefore to get clinicians closer to these pathologies, describing their complexity and the current state of the art in diagnostic, therapeutic and pathological classification strategy, thus providing them with the tools for a modern and updated clinical management of these patients
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