Chapter 23 Tumor/Oncology Imaging PDF

Chapter 23 Tumor/Oncology Imaging Copyright © 2017 Elsevier Inc. All rights reserved.  Objectives  Explain the role nuclear medicine plays in the diagnosis and treatment of infections and tumors.  Discuss the evolution of infection imaging from 67...

Chapter 23 Tumor/Oncology Imaging Copyright © 2017 Elsevier Inc. All rights reserved.  Objectives  Explain the role nuclear medicine plays in the diagnosis and treatment of infections and tumors.  Discuss the evolution of infection imaging from 67 Ga to 111In to 99mTc.  Describe the imaging procedures for parathyroid, prostate, colorectal, neuroendocrine, adrenal, breast, and lung tumors.  Describe radioimmunotherapy in lymphomas and radionuclide therapies for metastatic bone pain and other maladies. Copyright © 2017 Elsevier Inc. All rights reserved. 2  Key Terms  Antibodies  Neuroblastoma  Antibody fragment  Non-Hodgkin (Fab) lymphoma (NHL)  Cancer  Pheochromocytoma  Hodgkin lymphoma  Radioimmunotherapy (HD)  Radiosynoviorthesis  Murine (RSV)  Murine monoclonal  Somatostatin antibody (mab) Copyright © 2017 Elsevier Inc. All rights reserved. 3  Tumor Imaging  Parathyroid  Prostate Cancer  Colorectal Cancer  Neuroendocrine Tumors  Pheochromocytoma and Neuroblastoma  Breast Cancer  Lung Cancer Copyright © 2017 Elsevier Inc. All rights reserved. 4  Parathyroid  Radionuclide: 99mTc-sestamibi  Average adult dose – 20 mCi (740 MBq)  Flow study – acquired immediately after injection  First (thyroid) phase – begins 15 to 20 minutes post injection  Second (parathyroid) phase – 2 hours post injection Copyright © 2017 Elsevier Inc. All rights reserved. 5  Prostate Cancer  Indium-111–capromab pendetide (ProstaScint)  an IgG1 murine monoclonal antibody (mab) directed toward prostate-specific membrane antigen (PSMA), a glycoprotein expressed by prostate epithelium  Procedure is performed over 96 to 120 hours  Day 1: Injection of 5 mCi (185 MBq) 111In–capromab pendetide infused over 3 to 5 minutes  Blood pool activity can be imaged 30 minutes to 4 hours  For optimal targeting and minimal blood pool activity, imaging should be performed at 96 to 120 hours post injection Copyright © 2017 Elsevier Inc. All rights reserved. 6  Colorectal Cancer  Technetium-99m-arcitumomab (CEA-Scan) is used in the diagnostic evaluation of recurrent or metastatic colorectal cancer.  Dose: 20 to 30 mCi (740 to 1110 MBq)  Anterior/posterior 800,000 to 1 million planar or whole-body images of the chest, abdomen, and pelvis are acquired 2 to 5 hours post-injection. Copyright © 2017 Elsevier Inc. All rights reserved. 7  Neuroendocrine Tumors  Indium-111-pentetreotide (OctreoScan) is used to visualize primary neuroendocrine tumors and neuroendocrine metastasis.  Dose: 6 mCi (222 MBq) for an adult and 0.14 mCi/kg (5 MBq/kg) for children  Images are acquired at 4, 24, and 48 hours. Copyright © 2017 Elsevier Inc. All rights reserved. 8  Pheochromocytoma and Neuroblastoma  Pheochromocytomas – catecholamine-secreting tumors from the pheochromocytes of the adrenal medulla  Neuroblastomas – malignant tumors of the sympathetic nervous system and are found most often in infants and children (