Type:
Educational Exhibit
Keywords:
Oncology, Molecular imaging, Hybrid Imaging, SPECT-CT, SPECT, Nuclear medicine conventional, Radionuclide therapy, Radiation safety, Outcomes analysis, Cancer, Metastases, Education and training
Authors:
M. Vyas, S. Shaikh; Auckland/NZ
DOI:
10.26044/ecr2019/C-1772
Background
The ‘theranostic’ term is used when a disease can be diagnosed and treated with the same agent using the same physiological uptake method (Palekar-Shanbhag,
Jog,
Chogale,
& Gaikwad,
2013).
The first time the theranostics term was proposed by John Funkhouser (Chief executive officer,
PharmaNetics) at the end of the last century.
He used this term to define his model of philosophy for diagnostic and therapy techniques (Idée,
Louguet,
Ballet,
& Corot,
2013).
Theranostics branch of medicine has an exciting future because it can eliminate additional steps of diagnosing and treating diseases separately by two different agents.
In addition,
by using one agent for two applications,
practitioners can minimise individual’s exposure to unnecessary toxic agents and optimise the safety of patients.
In nuclear medicine,
Theranostics is being used since 1946 when first time Samuel M.
Seidlin (Endocrinologist and Nuclear medicine specialist) used radioactive isotope Iodine-131 to treat thyrotoxicosis (Siegel,1999).
Since then,
a low dose of Iodine is being used to diagnose the mainly poorly differentiated thyroid carcinomas,
which is followed by a relatively larger therapeutic dose for its treatment and management (Siegel,
1999; Bonnema & Hegedüs,
2012).
In recent times,
several radioactive isotopes have evolved and currently being used for theranostic purposes in the field of Nuclear Medicine (See table 1).
Although radionuclide Lutetium-177 (Lu177) is a late entrant,
it is being used widely as a promising radionuclide for targeted therapy and emerging as a game changer especially for the treatment of Neuro Endocrine Tumours (NETs) (Yao et al.,
2010;D.
J.
Kwekkeboom et al.,
2003;Dik J.
Kwekkeboom et al.,
2010).
It is also showing encouraging results for the treatment of metastatic castration-resistant prostate cancer(mCrpc) (Hofman et al.,
2018).
In this poster we have focused on the application of Lutetium as the choice of theranostic agent,
we have briefly discussed the characteristics of an ideal theranostic agent,
mechanisms by which theranostic agents target cancer cells and characteristics which make Lu-177 a better choice for theranostic purposes.