Download Clinical Nuclear Medicine Fourth Edition by Cook, Gary J.R PDF

By Cook, Gary J.R

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5 Although the classic definition of a receptor includes effector function upon ligand binding, with most imaging ligands biological effects are undesirable. For molecular imaging studies the quantity of imaging ligand is far below therapeutic levels, thus avoiding any adverse side events, and is specific for the target. Molecular imaging can allow identification of biochemical processes in normal and diseased cells and organs, and provide evidence of receptor expression that has implications in diagnosis and potential therapy, such as somatostatin receptor expression in carcinoid tumors (Fig.

The principal role for clinical PET is in oncology. 6,39,65–70 This has major implications in terms of improving the planning of treatment and avoiding unnecessary treatment and its associated morbidity and cost. High uptake of 18F-FDG is not always seen in primary tumors, however, and many renal cell carcinomas, low-grade lymphomas, hepatocellular carcinomas and lowgrade gliomas show low 18F-FDG uptake. 12 Molecular imaging of thyroid cancer. A 75-year-old woman with an initial diagnosis of papillary carcinoma of the thyroid with lymph node involvement, treated with surgery and radioiodine ablation, presents with a rising thyroglobulin and negative whole body 131I scan (a, b).

3). 9,10 This has become an accepted methodology for confirmation of normal biodistribution of peptides/antibodies, and uptake in tumor, prior to therapy infusions. This is important for a number of reasons. Firstly, it identifies possible targeting of normal tissue which would lead to potential toxicity with a subsequent therapy infusion, therefore allowing patients to be stratified into modified dosing, or even not proceeding with therapy at all. Examples of this scenario include abnormal uptake in liver or spleen, or other tissues, that would impact on dose to those normal organs.

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