Nuclear Medicine Physics Lecture 5: Nuclear Oncology 2

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Questions and Answers

What is the major role of nuclear medicine in the management of malignant tumors?

Detection of benign tumors

Treatment of infectious diseases

Diagnosis of cardiovascular diseases

Detection, staging, and restaging of malignant tumors (correct)

What is the purpose of sentinel node identification and localization in nuclear medicine?

To diagnose benign tumors

To evaluate the response to therapy

To detect residual or recurrent disease

To plan the most suitable management for several tumors (correct)

What is the function of 99mTc - Octreotide in nuclear medicine?

Detection of malignant tumors

Evaluation of the response to therapy

Specific agent for tumor imaging (correct)

Radiotherapy planning

What is the purpose of 67Ga in nuclear medicine?

A nonspecific agent for tumor imaging Signup and view all the answers

What is the role of nuclear medicine in the management of malignant tumors?

Includes detection, staging, restaging, and evaluating response to therapy Signup and view all the answers

What is the purpose of 18F-FDG in nuclear medicine?

Specific agent for tumor imaging Signup and view all the answers

What is the role of nuclear medicine in tumor management?

Includes diagnosis, staging, restaging, and evaluating response to therapy Signup and view all the answers

What is the purpose of 99mTc - Sestamibi in nuclear medicine?

Specific agent for tumor imaging Signup and view all the answers

What is the primary challenge in using MRI and CT scans after surgical, radiation, or chemotherapy treatment?

Differentiating post-therapy changes from residual viable tumor tissue Signup and view all the answers

What is the role of radiopharmaceuticals in different malignancies?

To detect recurrence of the tumor Signup and view all the answers

What is the benefit of using PET scans in detecting tumor recurrence?

It can differentiate between tumor recurrence and necrosis Signup and view all the answers

What is the purpose of using F-18-FDG-PET/CT studies?

To detect residual or recurrent disease Signup and view all the answers

What is the limitation of MRI and CT scans in differentiating post-therapy changes?

They cannot differentiate between residual viable tumor tissue and necrosis Signup and view all the answers

What is the role of thallium-201 in detecting tumor recurrence?

It is used as an alternative to PET scans Signup and view all the answers

What is the benefit of using radiopharmaceuticals in cancer treatment?

They help in detecting recurrence and differentiating it from necrosis Signup and view all the answers

What is the purpose of evaluating response to therapy?

To monitor the response to therapy Signup and view all the answers

What is the main challenge in individualizing therapy for patients?

Heterogeneity of tumors and their hosts Signup and view all the answers

What is the primary goal of individualizing therapy?

To rapidly assess the effectiveness of a chosen treatment strategy Signup and view all the answers

What is the limitation of using tumor volume changes to evaluate response to therapy?

It is not early enough to detect changes before toxicity and side effects occur Signup and view all the answers

Which radiopharmaceutical agent is used to predict response to treatment in lymphoma?

Gallium Signup and view all the answers

How soon can radiopharmaceutical agents like FDG and Gallium predict response to treatment?

After 1-3 cycles of chemotherapy Signup and view all the answers

What is the advantage of using radiopharmaceutical agents like FDG and Gallium to evaluate response to therapy?

They can predict response to treatment earlier than other methods Signup and view all the answers

What is the purpose of a Ga-67 study in a patient with non-Hodgkin's lymphoma?

To evaluate response to treatment Signup and view all the answers

Why is it important to rapidly assess the effectiveness of a chosen treatment strategy?

To avoid toxicity and side effects Signup and view all the answers

What is the purpose of sentinel node imaging?

To identify the lymph node where the primary tumor drains Signup and view all the answers

What is the role of a gamma probe during surgery?

To localize the sentinel node during surgery Signup and view all the answers

What does a follow-up FDG-PET study showing decreased uptake indicate?

Favorable response to therapy Signup and view all the answers

What is the next step after sentinel node localization?

Immunohistological staining of the sentinel node Signup and view all the answers

What type of cancer is shown in figure 26?

Breast cancer Signup and view all the answers

What is the purpose of immunohistological staining?

To identify micrometastases in the sentinel node Signup and view all the answers

What is used to detect radioactive sentinel nodes?

Gamma camera Signup and view all the answers

What can be identified using sentinel node imaging?

The lymph node where the primary tumor drains Signup and view all the answers

What is the acceptable alternative to routine total node dissection in breast cancer?

Sentinel lymph node localization technique Signup and view all the answers

What is PET/CT used for in oncology?

Disease restaging and diagnosis of recurrent and metastatic disease Signup and view all the answers

What is the role of PET and PET/CT in surgical management of breast cancer?

Review of the role in surgical management Signup and view all the answers

What is the title of the book edited by Elgazzar AH?

Pathophysiologic basis of nuclear medicine Signup and view all the answers

Which of the following is NOT a use of PET/CT in oncology?

Routine total node dissection Signup and view all the answers

What is the title of the review by Bahl S, Alavi A, Basu S, Czerniecki BJ?

The role of PET and PET/CT in the surgical management of breast cancer: a review Signup and view all the answers

Who edited the book 'Pathophysiologic basis of nuclear medicine'?

Elgazzar AH Signup and view all the answers

What is the title of the article by Francis IR, Brown RKJ, Avram AM?

The clinical role of CT/PET in oncology: an update Signup and view all the answers

Study Notes

Nuclear Medicine in Oncology

Nuclear medicine plays a vital role in managing malignant tumors, incorporating advancements in molecular imaging and imaging equipment.
It aids in the detection, staging, restaging, and early detection of recurrence in malignant diseases, as well as evaluating therapy response and predicting prognosis.
Important applications include the identification and localization of sentinel lymph nodes for biopsy, enhancing management strategies for various tumors.

Radiopharmaceuticals for Tumor Imaging

Nonspecific agents:
- 67Gallium (67Ga)
- 201Thallium (201Tl)
- 99mTechnetium (99mTc) - MDP
Specific agents:
- 131I /123I
- 111Indium (111In)
- 99mTc-Octreotide
- 99mTc-Sestamibi
- 18F-Fluorodeoxyglucose (FDG)

Diagnosis of Tumors

Nuclear medicine is effective for detecting and characterizing tumors, particularly in differentiating post-therapy changes from viable tumor tissue.
Imaging helps identify viable tumors, addressing difficulties faced by MRI and CT scans in patients post-treatment.
PET imaging enhances detection of tumor recurrence and differentiates between necrosis and actual tumor recurrence.

Residual or Recurrent Disease Detection

Imaging, such as F-18-FDG-PET/CT, provides baseline and follow-up studies to detect recurrent tumors, exemplified by its use in cases like Hodgkin’s lymphoma.

Evaluating Response to Therapy

Patient responses to treatment can vary, emphasizing the need for personalized therapy approaches.
Rapid assessment of therapy effectiveness is crucial due to heterogeneity in tumors and hosts.
Traditional tumor volume assessment through CT or MRI takes longer, potentially delaying treatment adjustments.
Radiopharmaceuticals like Ga-67 in lymphoma and FDG in various cancers assess treatment responses as early as after 1-3 cycles of chemotherapy.

Sentinel Lymph Node Localization

Sentinel node imaging identifies lymph nodes draining the primary tumor, assisting in surgical planning.
This technique is the preferable alternative to total node dissection in breast cancer management.
Immunohistological staining of sentinel nodes helps identify micrometastases, enabling more targeted treatment options.

Summary of Advantages

Nuclear medicine enhances detection and characterization of tumors, while also facilitating individualized therapy through real-time assessment.
It provides critical insights into tumor behavior and therapy effectiveness, thus improving overall cancer management strategies.

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Description

This quiz covers the role of nuclear medicine in the management of malignant tumors, including detection and staging, as well as the advancements in molecular imaging and equipment.