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Internal radiation therapy: a neglected aspect of nuclear medicine in the molecular era.

Lin Y - J Biomed Res (2015)

Bottom Line: With increasing evidence, internal radiation therapy, also known as brachytherapy, has become a neglected aspect of nuclear medicine in the molecular era.Relevant differences and status of their applications in China were mentioned as well.These molecular mediated internal radiation therapies are gaining increasing importance by providing palliative and curative treatments for an increasing number of diseases and becoming one of the important parts of molecular nuclear medicine.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, Peking Union Medical College Hospital , Beijing 100730 , China .

ABSTRACT
With increasing evidence, internal radiation therapy, also known as brachytherapy, has become a neglected aspect of nuclear medicine in the molecular era. In this paper, recent developments regarding internal radiation therapy, including developments in radioiodine-131 ((131)I) and thyroid, radioimmunotherapy (RIT) for non-Hodgkin lymphoma (NHL), and radiopharmaceuticals for bone metastases. Relevant differences and status of their applications in China were mentioned as well. These molecular mediated internal radiation therapies are gaining increasing importance by providing palliative and curative treatments for an increasing number of diseases and becoming one of the important parts of molecular nuclear medicine.

No MeSH data available.


Related in: MedlinePlus

Elevated levels of unstimulated Tg (ng/mL) and Tg-Ab (IU/mL) with corresponding TSH (A), 131I–negative image with TSH stimulation (TSH>30 uIU/mL) (B), and 99mTc-RGD-positive planar (C) and SPECT images (D).Cited from Zhao D. et al. J Nucl Med, 2012; 53:1872–1877 with permission.
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f03: Elevated levels of unstimulated Tg (ng/mL) and Tg-Ab (IU/mL) with corresponding TSH (A), 131I–negative image with TSH stimulation (TSH>30 uIU/mL) (B), and 99mTc-RGD-positive planar (C) and SPECT images (D).Cited from Zhao D. et al. J Nucl Med, 2012; 53:1872–1877 with permission.

Mentions: In well-differentiated thyroid cancer (WDTC), during the natural process of the disease, 2%–5% patients lose their differentiated phenotype and dedifferentiate to a more aggressive type, which is defined as dedifferentiation. Dedifferentiated thyroid cancers (dDTC) usually present with RAI resistance and are prone to be more aggressive and more malignant, with a median survival of less than 5 years[22]. Early identification of dDTC is the key point for subsequent management. In metastatic patients with elevating Tg level and negative radioiodine uptake, dDTC should be suspected and 18FDG PET/CT imaging should be considered for further localization. However, it is important to realize that 18FDG trapping is not tumor-specific. Malignant thyroid tumors and some benign thyroid diseases, cervical lymph nodes with inflammation, or other inflamed tissues could show high 18FDG uptake. At present, in China, SPECT is more widely available than PET and most patients cannot afford the expense of 18FDG PET for diagnosis instead of treatment. A recent study indicated that dDTC lesions can be traced using angiogenesis imaging such as 99mTc-RGD imaging (Fig. 3), thus providing a new approach for diagnosis and localization of dDTC. Meanwhile, the highly neovascularized lesions confirmed by angiogenesis imaging may afford an alternative therapeutic target and monitor the efficacy of certain anti-angiogenetic therapy[23].


Internal radiation therapy: a neglected aspect of nuclear medicine in the molecular era.

Lin Y - J Biomed Res (2015)

Elevated levels of unstimulated Tg (ng/mL) and Tg-Ab (IU/mL) with corresponding TSH (A), 131I–negative image with TSH stimulation (TSH>30 uIU/mL) (B), and 99mTc-RGD-positive planar (C) and SPECT images (D).Cited from Zhao D. et al. J Nucl Med, 2012; 53:1872–1877 with permission.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4585428&req=5

f03: Elevated levels of unstimulated Tg (ng/mL) and Tg-Ab (IU/mL) with corresponding TSH (A), 131I–negative image with TSH stimulation (TSH>30 uIU/mL) (B), and 99mTc-RGD-positive planar (C) and SPECT images (D).Cited from Zhao D. et al. J Nucl Med, 2012; 53:1872–1877 with permission.
Mentions: In well-differentiated thyroid cancer (WDTC), during the natural process of the disease, 2%–5% patients lose their differentiated phenotype and dedifferentiate to a more aggressive type, which is defined as dedifferentiation. Dedifferentiated thyroid cancers (dDTC) usually present with RAI resistance and are prone to be more aggressive and more malignant, with a median survival of less than 5 years[22]. Early identification of dDTC is the key point for subsequent management. In metastatic patients with elevating Tg level and negative radioiodine uptake, dDTC should be suspected and 18FDG PET/CT imaging should be considered for further localization. However, it is important to realize that 18FDG trapping is not tumor-specific. Malignant thyroid tumors and some benign thyroid diseases, cervical lymph nodes with inflammation, or other inflamed tissues could show high 18FDG uptake. At present, in China, SPECT is more widely available than PET and most patients cannot afford the expense of 18FDG PET for diagnosis instead of treatment. A recent study indicated that dDTC lesions can be traced using angiogenesis imaging such as 99mTc-RGD imaging (Fig. 3), thus providing a new approach for diagnosis and localization of dDTC. Meanwhile, the highly neovascularized lesions confirmed by angiogenesis imaging may afford an alternative therapeutic target and monitor the efficacy of certain anti-angiogenetic therapy[23].

Bottom Line: With increasing evidence, internal radiation therapy, also known as brachytherapy, has become a neglected aspect of nuclear medicine in the molecular era.Relevant differences and status of their applications in China were mentioned as well.These molecular mediated internal radiation therapies are gaining increasing importance by providing palliative and curative treatments for an increasing number of diseases and becoming one of the important parts of molecular nuclear medicine.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, Peking Union Medical College Hospital , Beijing 100730 , China .

ABSTRACT
With increasing evidence, internal radiation therapy, also known as brachytherapy, has become a neglected aspect of nuclear medicine in the molecular era. In this paper, recent developments regarding internal radiation therapy, including developments in radioiodine-131 ((131)I) and thyroid, radioimmunotherapy (RIT) for non-Hodgkin lymphoma (NHL), and radiopharmaceuticals for bone metastases. Relevant differences and status of their applications in China were mentioned as well. These molecular mediated internal radiation therapies are gaining increasing importance by providing palliative and curative treatments for an increasing number of diseases and becoming one of the important parts of molecular nuclear medicine.

No MeSH data available.


Related in: MedlinePlus