The recent development of small molecules and antibodies that can selectively target cancer cells or specific tissues enhances the efficacy of radionuclide therapy. In recent phase 3 clinical trials, it has been shown that the use of radioligands, such as Lu-177-DOTATATE (for the NETTER trial) and Lu-177-PSMA (for the VISION trial), significantly increases overall survival of patients either against standard of care or in combination, leading to increased confidence in radionuclide therapy. Imaging in the context of radioligand therapy plays a relevant role in both providing quantitative and qualitative information about the ligand's distribution throughout the patient’s body. Even before therapy, imaging techniques such as Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT) are used to identify and localize specific targets or disease sites within the body. This is essential for determining whether the radioligand binds effectively to the intended target. On the other hand, during therapy, imaging techniques can be used to calculate the radiation dose delivered to the tumour and surrounding healthy tissues. This is critical for assessing the safety and efficacy profile of new radioligands or the extension of established radioligands to new diseases or different stages of disease. Hybrid imaging is the backbone of this emerging field, integrating the therapeutic and diagnostic versions of the same ligand into a single treatment. Nuclear medicine technologists and radiographers, who are responsible for the technical management of intratherapeutic hybrid imaging, need to be equipped with the relevant technical and physical principles. As healthcare resources become scarce and patient population aging, it is desirable that imaging procedures are performed efficiently to optimize resources and minimize patient burden. This can be achieved not only through technical advancements at the device level but also through the continuous education of all healthcare professionals, with a particular focus on technologists and radiographers.

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Hybrid Imaging in Radionuclide Therapy

  • Pedro Fragoso Costa,
  • Henry-Aravinth Devendranath,
  • Alexandros Moraitis

摘要

The recent development of small molecules and antibodies that can selectively target cancer cells or specific tissues enhances the efficacy of radionuclide therapy. In recent phase 3 clinical trials, it has been shown that the use of radioligands, such as Lu-177-DOTATATE (for the NETTER trial) and Lu-177-PSMA (for the VISION trial), significantly increases overall survival of patients either against standard of care or in combination, leading to increased confidence in radionuclide therapy. Imaging in the context of radioligand therapy plays a relevant role in both providing quantitative and qualitative information about the ligand's distribution throughout the patient’s body. Even before therapy, imaging techniques such as Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT) are used to identify and localize specific targets or disease sites within the body. This is essential for determining whether the radioligand binds effectively to the intended target. On the other hand, during therapy, imaging techniques can be used to calculate the radiation dose delivered to the tumour and surrounding healthy tissues. This is critical for assessing the safety and efficacy profile of new radioligands or the extension of established radioligands to new diseases or different stages of disease. Hybrid imaging is the backbone of this emerging field, integrating the therapeutic and diagnostic versions of the same ligand into a single treatment. Nuclear medicine technologists and radiographers, who are responsible for the technical management of intratherapeutic hybrid imaging, need to be equipped with the relevant technical and physical principles. As healthcare resources become scarce and patient population aging, it is desirable that imaging procedures are performed efficiently to optimize resources and minimize patient burden. This can be achieved not only through technical advancements at the device level but also through the continuous education of all healthcare professionals, with a particular focus on technologists and radiographers.